Obamacare Is Becoming a Big Problem for Democrats

Democrats based much of their 2020 campaign on support for the Affordable Care Act. But the law has become less popular as the pandemic has exposed its flaws while continuing to enrich insurance companies.

Joe Biden delivers remarks about the Affordable Care Act and COVID-19 on October 28, 2020 in Wilmington, Delaware. (Drew Angerer / Getty Images)

During a combative Democratic House caucus call on Thursday, House majority whip Jim Clyburn warned that Democrats won’t win the two potential Georgia Senate races if the party’s candidates run on “socialized medicine” — even as new polling from Georgia shows that way more voters want access to a government-run health care plan than the status quo.

The disconnect between Democratic leaders’ views and reality spotlights a growing political problem: Democrats focused their 2020 election message on support for Obamacare and bashing Medicare for All, but the electorate isn’t very enthusiastic about an Affordable Care Act (ACA) that has failed to protect millions of people from a burgeoning health care crisis.

Similarly, Joe Biden is promising a presidency narrowly focused on strengthening the ACA and helping the insurance industry stop the push for Medicare for All. Those pledges have likely helped boost health care stocks since the election — but more and more data shows the ACA is not particularly popular among voters who’ve seen insurers make huge profits while millions have lost coverage.

What is far more popular according to polls: government-run health care.

Georgia Illustrates Democrats’ ACA Problem

The microcosm is Georgia, which could be the site of two runoff elections to decide control of the US Senate. In advance of those races, Clyburn, a top recipient of pharmaceutical industry campaign cash, told House lawmakers that if “we are going to run on Medicare for All, defund the police, socialized medicine, we’re not going to win,” according to Politico.

Fox News exit polls from Tuesday’s election tell a different story: 52 percent of Georgia voters want the ACA partially or completely repealed, while 63 percent of voters support “changing the health care system so that any American can buy into a government-run health care plan.”

The question describes a public health insurance option — an idea supported by both Georgia Democratic Senate candidates, Raphael Warnock and Jon Ossoff.

Those numbers roughly track the national figures — 52 percent of all Americans said in the Fox News poll that they want to keep or improve the law, while 71 percent want a change in policy that lets them buy into a government-run health care plan.

ACA Support Weakens as the Law Fails to Protect People During the Pandemic

Weak support for the ACA — and much stronger support for a government-run health care program — should not be surprising, considering what has happened in the decade since Obamacare passed.

While the law included some important health care protections, it fortified the political power of the private health insurers. In pushing the new program, President Barack Obama’s administration dropped its promise to push for a public health insurance option, while repeatedly suggesting that the ACA would at least guarantee that Americans could keep their existing coverage.

That assertion was always going to be false, because the ACA preserved the employer-based health care system — meaning that people can lose their plans with little warning if they are laid off or if their bosses decide to change offerings — a situation that most Americans loathe, according to a 2019 Emerson poll.

Meanwhile, many of the rosy promises about the ACA protecting Americans from insurance industry abuses have proven to be a cruel joke — insurance companies still frequently refuse to pay claims and limit their provider networks, a situation that leaves people exposed to massive “surprise” medical bills even when they visit hospitals that are in their insurance networks.

Now, during a historic pandemic, health insurance industry profits are skyrocketing as millions of Americans have lost their job-based medical coverage.

For those fortunate enough to keep their insurance, premiums are eating up a bigger and bigger share of take home pay: A new Kaiser Family Foundation study found that “annual premiums for employer-sponsored family health coverage reached $21,342 this year, up 4% from last year, with workers on average paying $5,588 toward the cost of their coverage.”

Workers’ health insurance premiums are rising much faster than wages. Source: Economic Policy Institute

Those realities are reflected in Kaiser’s tracking poll, which has shown consistently weak support for the ACA.

Particularly notable are the numbers among Americans aged fifty to sixty-four — the demographic that is not covered by Medicare but that uses more medical care than younger people. More Americans in that age group saw the ACA negatively than positively during the summer COVID burst — precisely the moment when more people needed medical care and were losing the health insurance that ACA advocates promised they would never lose.

Biden Seems to Be Trying to Limit a Public Option

During the Democratic primary, Biden kicked off his campaign with a fundraiser with the Republican CEO of the health insurer Independence Blue Cross. He also declined to pledge to reject contributions from health insurance industry donors. At the same time, donors from the health insurance industry have made significant contributions to Democrats during the election cycle.

Amid that stream of cash, Biden said he would oppose Medicare for All as president. He has said he instead supports a public health insurance option to compete with private insurers — but he has described his public option as a far more limited plan than the one on his campaign website.

Indeed, in the first presidential debate, he insisted that a public option would be limited to lower-income Americans rather than being open to everyone. “It’s only for those people who are so poor they qualify for Medicaid they can get that free in most states, except governors who want to deny people who are poor Medicaid,” Biden said. “Anyone who qualifies for Medicaid would automatically be enrolled in the public option. The vast majority of the American people would still not be in that option.”

A Democracy Corps poll found that voters reacted negatively to Biden’s description — the survey, using real-time dial meters, showed a steep drop in support when Biden said his public option would be limited.