Maybe it’s not surprising that politicians don’t pay attention to most voters. Most voters don’t seem to pay attention to what the candidate they vote for actually says. Policy doesn’t matter, campaign promises don’t matter.
For years most voters polled seemed to disapprove of health insurance reform as delineated in the Patient Protection and Affordable Care Act – derisively referred to as Obamacare – and voting for Republicans so that they quickly won the House of Representatives and then the Senate, too. Yet they re-elected Obama president. Mixed signals!
OK, the pollsters said, Americans just like divided government.
Then the Republicans took the White House, too, as well as increasing their majorities in the Congress. Except we still have divided government. The Republicans are divided against themselves, from (relatively) moderate to far right. The two wings of the party can’t decide when and in which direction to flap.
Still, now Congress did have a real chance to repeal Obamacare. Then the pollsters asked voters, again, what they think of Obamacare: suddenly a majority likes it. And at town halls and protests around the country, voters say they don’t want key provisions of the ACA repealed. Coverage for pre-existing conditions? Keep it! Coverage for substance use disorder treatment and mental illness? Keep it! Raise or keep the taxes enacted to pay for Obamacare? No way!
What has to happen, almost everybody agrees, is that prescription drug costs must come down, and that the requirement that everybody must have health insurance or else pay a penalty be eliminated. But that requirement was one of the mechanisms by which costs would be kept down: make young healthy people buy insurance to offset the high costs of the elderly and sick, people with pre-existing conditions and those in need of drug abuse rehab and mental health treatment.
You could argue that they these voters think they can eat their cake and have it too because that’s what Presidential candidate and President Elect Donald J. Trump said they would have: better coverage, everybody covered, and for less money than we were already paying. He also promised that he wasn’t going to wait for Congress to act. His Health and Human Services Secretary Tom Price would have a great plan ready from Day One that would accomplish just that.
To be fair, Price did have a plan that he came up with while he was in Congress, but it didn’t do anything that Trump promised, and in the end the President left it to House Speaker Paul Ryan who had been working on healthcare for years.
Trump praised the Ryan’s American Health Care Act – until it proved unpopular with the voters; then he called it “mean mean mean” and not “generous” enough – and then the Senate’s Better Care Reconciliation Act. Neither came close to his pre-inauguration promises.
The House version passed. The Senate version may pass, too, though as of this writing it looked unlikely. Then both chambers will have to agree to a final draft, which Trump seems likely to sign. Then they can wait and worry to see if the Americans who belatedly liked ACA will punish the Republicans for in effect dismantling it, or if they’ll just shrug it off as usual,
