{UAH} Why is it so important for Republicans to get rid of Obamacare? Are insurers large donors?

ROBERT Honyrman

Originally Answered: Why is the Affordable Care Act/Obamacare so vilified?

ACA is a plan similar to the plan Mitt Romney instituted in Massachusetts while governor. It uses private health insurers as the foundation, and, as in Massachusetts, adds a mandate to drive towards universal coverage.

Turns out that universal coverage does two things: it increases insurance companies overall revenues, and it reduces actual per capita premiums. A side effect is that with universal coverage, doctors and hospitals no longer have to absorb the cost of care from uninsured patients. Everyone wins.

Insurance companies are large donors, but they were at worst neutral about ACA. Had a Republican president put forth such a plan, it would have been universally supported, with criticism coming at the margin (as it did anyway) over the lack of a public option.

ACA was written to be administered at the state level. Because so many states were politically opposed to Obama and to allowing the Obama administration even the smallest victory, they ignored public policy and took a staunch stand opposing the implementation of a plan emanating from Heritage House's policy arm (maybe not HH, but that's a nit; it was policy developed by the right).

As a result, most state exchanges had to be administered from DC, not local state capitals. I would assert that this was a significant cause of pricing issues. But the other main pricing issue was the willingness to compare ACA policies to its replaced junk policies. Junk policies are cheap because they don't cover very much. ACA is comprehensive.

Bottom line: had Bush introduced ACA, it would have looked similar and would have engendered very little negative attacks. But because it was introduced by a Democrat, the right was completely invested in trashing what was, in fact, decent public policy

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