Senior editor at The Atlantic, David Frum, titled his article, “The Question That Will Decide the 2016 Election.” The question is this: Will you take away my health insurance?
Health insurance coverage is on the rise among low-income households and in crucial swing states like Florida. In next year’s elections, health care programs, specifically the Affordable Care Act (ACA) -- also known as Obamacare -- will play a crucial role as a “swing issue” between Republicans and the Democrats.
Republican Candidates on Obamacare
Granted, Republican candidates have consistently expressed their plans to repeal and replace Obamacare. Both Donald Trump and Ted Cruz, first and second in the polls respectively, want a market-based health care system. Health insurance providers will need to compete with one another over state lines. Costs of premiums would ideally go down as the providers compete for insurance enrollees.
On the other hand, former neurosurgeon Ben Carson cautions that the ACA cannot simply be pulled out, leaving millions uncovered. He proposes to first replace the ACA with what he calls the Health Savings Accounts. These would be savings accounts held by every citizen, and would fund their health needs. Federal funds would only be used for those unable to contribute to their own accounts.
Marco Rubio is on another platform altogether. He proposes that citizens can use tax credits to fund their health care needs. Federal coverage would be used for patients with pre-existing conditions and high premiums. Jeb Bush believes that federal health care should only be extended when a family will overextend its means.
Rand Paul would repeal Obamacare, stating that everyone should have more choice in care. Chris Christie and John Kasich would expand Medicaid (and have done so in their respective states). Christie is in favor of offering Medicare to whoever can afford it, while Kasich focuses on tax cuts that would make basic health care more affordable.
Basically, what is shown is that the establishment GOP have no consensus on what they believe should replace the ACA. There is not even a unified front, since they attack each other’s health care plans. Therefore, what could have been their strongest weapon against the Democrats has faded into oblivion. This is evident in the Republican debates.
The Republican Debates and Obamacare
According to Sarah Kliff of Vox, for a party that shut down the government two years ago, the Republican presidential candidates have been remarkably close-mouthed on Obamacare during the debates. Besides having no GOP stand on the issue, the candidates have another problem: the current coverage of the ACA.
During the second Republican debate, “Obamacare” was only mentioned 6 times by 2 candidates, Ted Cruz and Scott Walker. While the government was shut down in 2013 to defund the program, in 2015, the word “Obamacare” barely passed the candidates’ lips.
Most significantly, the number of uninsured American citizens.
According to Gallup’s Well-Being Index, from a peak of 18% in 2013, the number of uninsured Americans dropped drastically to 11.6% in 2015. It is the lowest drop in the 2008-2015 time period covered by the index. Working-age Americans (26 to 34 years of age) saw the biggest change -- the uninsured dropped by -8.3%.
Low-income and minority demographics also saw significant changes. Uninsured blacks dropped -7.5%, while uninsured Hispanics dropped -9.7%. Uninsured Americans earning less than $36,000/year dropped -8.5%. These are the numbers the Republican candidates have to face if they take on Obamacare.
What Obamacare Has Done (That Republicans Would Need to Deal With)
The Medicaid and Medicare Reforms
Both the Medicaid and Medicare insurance programs saw growth in just 2 years. The Medicaid program grew by 2.4 percentage points, bringing the percentage of Americans insured under that program to 9.3%. The Medicare program grew by 1.3 percentage points, raising the percentage of insured under the program to 7.4%.
This change accounts for over half of the percentage change (6.6 percentage points) in the number of uninsured Americans. The Medicaid program, under Obamacare, expanded its eligibility requirements to allow more poor families to be covered. The Medicare program saw reforms that cut overspending and subsidized more medical needs.
The Expansion of Benefits for Working Mothers
The ACA covers quite a few different benefits, but perhaps none are so helpful to the working mother as those pertaining to breastfeeding. Specifically, insurance can now cover the costs of getting breastfeeding support, even equipment such as breast pumps and counseling that breastfeeding mothers need to undergo.
Workplaces are also required to provide sterilized and isolated places, not the bathroom, where mothers can pump milk. In that way, mothers can work and provide for the health of their babies simultaneously. This keeps women in the workplace, contributing to the economy instead of quitting their jobs and staying home.
Obamacare: Definitely No Longer the GOP Scapegoat
As the fifth Republican debate weighs in, it is evident that Obamacare has even stopped being an issue at all. The present challenge right now is on foreign policy, and that’s what the candidates focused on. However, they will need to address the issue soon enough if they want to gain footing against their Democrat counterparts.