Substantial majorities of Americans say they want specific health insurance reforms. According to pollsters, most Americans want rules to keep insurance companies from refusing to cover sick people or charging them more. They want government to help make insurance accessible and affordable for small businesses and families. Most applaud free preventive care — including contraception — as well as improvements in Medicare prescription drug coverage and rules that allow young adults to remain on their parents’ insurance plans.
{mosads}Here’s the irony: Most Americans do not know these changes are actually included in the Patient Protection and Affordable Care Act (ACA) that has been law since 2010.
Who is to blame for this amazingly persistent state of mass confusion? Although pundits routinely point fingers at “the media” for not informing the public, Republicans and Democrats alike deserve blame for keeping Americans in the dark.
Republicans are all-in on the falsification game. They decry in vague terms a government takeover of healthcare, and then fall silent when their prognostications of disaster prove untrue. They deny information to constituents about how to claim premium credits; and in many states, Republicans have refused 100-percent federal subsidies to extend Medicaid to 4.3 million low-income Americans. Worst of all, Republicans are still falsely campaigning on a promise to “repeal ObamaCare,” when they know this law is here to stay.
Democrats, of course, overwhelmingly favor the health reform law, and almost all those who were in Congress in 2010 voted for it. But, on the campaign trail, Democrats tend to follow the advice of consultants and say as little as possible about health reform. Their silence fosters confusion.
Scholars have amply documented how the words — or silence — of our leaders powerfully shapes public opinion. If one political party shouts lies from the rooftops and the other falls silent, the lies will win every time.
When policy debate stays at the level of stereotypes and abstractions, opponents of government action usually win. In contrast, when the benefits of the ACA are touted in jargon-free language — like using the state’s own name for Medicaid and simply stating the number of people who have gained coverage — it is easy to build public support and make people aware of what they would lose if the law were to be cut or gutted.
The 2014 election season is putting Democratic evasiveness on full display, especially in key races for Senate. Yes, Sen. Mark Begich in Alaska and Sen. Mark Pryor in Arkansas have run soft television spots endorsing insurance rules prohibiting discrimination against people with preexisting health problems. But few Democrats in tight Senate races have called out Republican opponents for wanting to deny or take away new health benefits.
In Kentucky, for example, over 413,000 people, nearly 10 percent of the state’s population, have gained new health insurance coverage. Why isn’t Democratic senatorial candidate Alison Lundergan Grimes shouting from the rooftops that her opponent, GOP incumbent Sen. Mitch McConnell, has voted many times to take healthcare away from all these Kentuckians — and promises to complete the job if he wins in November?
In Arkansas, where the percentage of people without health insurance has dropped from 22 percent last year to 12 percent this year, Pryor is missing the same opportunity.
“Loss aversion” is a powerful force in politics. Citizens will fiercely oppose parties and candidates who threaten to take away things they care about.
Democrats could be mobilizing support by heightening public awareness of all the specific parts of health reform people love. Sadly, so far most Democrats are cowering in silence. Until they find their tongues, the public stage will be dominated by opponents determined to stoke fears and confusion about one of America’s best reforms.
Skocpol is Harvard University’s Victor S. Thomas Professor of Government and Sociology. Grogan is a professor in the School of Social Service Administration at the University of Chicago. Both are members of the Scholars Strategy Network.