Politics of ObamaCare

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With the passage of the Affordable Care Act in 2010, supporters of the legislation hoped this would finally eliminate the issue of healthcare from all future political debates. However, that has not been the case.   Since President Barack Obama signed the legislation into law, there has been constant and consistent criticism of the Act from a wide array of groups.  The Republicans have been extremely vocal about their desire to repeal the law, and every election cycle ramps up this rhetoric once again. Over the last four years, the law has hit many bumps in the road, opening up avenues for critics to claim it as a failure.

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As we approach the midterm elections, and the campaigns begin to heat up, ObamaCare is handled quite differently by politicians depending on their party affiliation and the political office they are running for in the upcoming election. In races for the United States Senate and House of Representatives, Republicans take every opportunity to argue about the perceived flaws in the legislation.  They point to the shifting of deadlines, changing mandates, and mistake filled roll out for the open enrollment for health insurance.  There are a number of hotly contested races, with the real possibility of a shift in political power in the United States Senate.  Based on President Obama’s current approval ratings and the lack of clear and convincing support by the American public for the Affordable Car e Act, Republicans are using this issue to hammer their Democratic opponents who voted for this bill.

On the other hand, Democrats running in close races in both the House of Representatives and the Senate are attempting to distance themselves from ObamaCare, even going so far as criticizing the legislation.   Of course, they do not criticize the bill, which they in all likelihood voted for, but they criticize the administration’s handling and implementation of the legislation.  Democrats realize that if they lose the majority In the Senate, there is a good chance that ObamaCare will be repealed, or at the very least gutted.   The result will be President Obama and core Democrats fighting hard to maintain a semblance of the law over the next two years.  So, in order to keep their seats and win the election, Democrats feel addressing the weaknesses of the law will deflate the Republicans arguments.  It is a narrow tightrope they are walking in this heated political environment.

One of the issues under the law is expansion of coverage. The goal was universal healthcare, and the number of uninsured Americans was cited numerous times during the debate surrounding passage of the bill. This expansion of coverage argument may not be working at the Federal level, but some Democrats running in state races have embraced the issue in their campaigns.  Under ObamaCare, states are given the freedom to adjust the criteria for state run, but federally sponsored, programs like Medicaid and Children’s Health Insurance Program. This would require an increase in federal funds, funds already allocated in the ObamaCare legislation.

Since the opening of the health care marketplace, many states have elected to expand Medicaid coverage, thus enabling an expansion of the n number of people covered under the law.  There are a number of states which have chosen not to expand the coverage and all of them have Republican Governors.  There are at least five states with highly competitive races for Governor, and it is in these races where you see a flip in the arguments for the political parties.  In Florida, Maine, Kansas, Wisconsin, and Georgia, the Democratic candidate for Governor has argued for an expansion of the Medicaid budget as authorized under ObamaCare.  The politicians feel safe advocating this position because Medicaid is still a popular program for a majority of Americans. In addition, the end result of enabling more individuals, including poverty stricken children, access to health care resonates in the states.

In political campaigns at the State level, Democrats are isolating one central theme of ObamaCare to advocate their positions and gain a stronghold in the election. At the federal level, Republicans are attacking the entire law, forcing Democrats to back away from the legislation.    The arguments are based on what the public opinion polls tell the politicians is acceptable with the American people.  In elections this is how it always works. But, it leads to a troubling question.   Does anyone in government really care about Americans getting health care coverage or is it all about winning elections?


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