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I decided to use this website to address the issue of Obamacare because, at least at the time I am writing this, it is once again the hot topic in New Hampshire politics.

The Myth

I have read, repeatedly in a number of different places, a defense of the Affordable Care Act, that give same concern. The argument goes something like this: Voters elected a Democratic president as well as giving the majority of both houses to the Democrats. Acting on the will of that majority, Obamacare was duly passed and signed into law as well as vetted by the Supreme Court. The voters then overwhelmingly supported the law (I presume b re-electing Obama). In this story, Republicans are described sore losers who are using parliamentary tricks to thwart the will of the people.

The Reality

The problem with this story goes back to the presidential primary, when Barack Obama and Hillary Clinton squared off on the topic of expanding health care. Both campaigned on a promise to extend coverage to those who were uninsured, but differed in their approach. While Clinton proposed an "individual mandate," Obama explicitly opposed that approach.

After the election, Obama's positions began to change as the realities of actually passing the legislation began to assert themselves. Despite majorities in both houses, passage of a health care bill was by no means assured. Too timid of a plan might lose the support of those on the left who wanted nothing short of a single-payer (i.e., government) system. At the other end of the spectrum, fiscally-conservative Democrats did not want a proposal that would result in increased federal costs. If you remember the language of the time, Obamacare was supposed to "bend the cost curve" and thereby offset the additional costs of insurance by savings in the costs of medicine itself. However, even this would not balance the scales. A number of new taxes were required on top of the individual mandate, which put extra money in the pockets of the insurance companies without having to pass through the federal government as taxes.

The Legislature struggled with this balancing act to produce a proposal that "paid for itself." In the end, even with a majority, they had difficulty creating a plan that the majority could support. The House version of the bill passed by a tiny majority (220-215), with 39 Democrats opposing (and one Republican voting in support). Difficulties with passage through the Senate were overcome using parliamentary tricks. The point is that the vote to pass was so close and hinged on so many delicate compromises, any one of the issues that plague Obamacare today might have sunk it during the original vote.

Popular Opinion

As to the issue of the will of the voters, the claim of overwhelming support is unfounded. The best that can be said it is an issue that divides the public. In national polls, support for Obamacare has not been able to get a majority and has more often than not lagged behind the opposition.

Of course, like in the original debate, the opposition to this program takes a number of different forms. It ranges from those on the far left that want free health care provided by the government. It also contains people who have supported the idea in principle, but are concerned about current costs. Then there are those that are opposed completely.

Frankly, it is easy for me to understand why those on the left would be disappointed. Especially here in New Hampshire. Obamacare has created a situation where we are all required to purchase insurance through a insurance company that has essentially been guaranteed a monopoly. Factors that are cited as contributing to the high cost of health care - a lack of competition, the profits of the insurance company - these all remain. We are largely stuck with the same old options, except now we go through a government-run website, and pay more for the privilege. Nonetheless, the bulk of Democrats do seem to support Obamacare as, I suppose, "a step in the right direction."

Here in New Hampshire, the trend is similar to that at the national level, but more clearly opposed to Obamacare and it's implementation. As discussed before, peoples opinions are more varied than can be expressed in a simple support/oppose chart. It is worth reading the report from which the chart shown on page 2 was taken, to see the breakdown of the data. One thing that seems pretty clear to me; Even when New Hampshire elects a Democratic majority, it is not because they want to be forced to purchase overpriced insurance products from a monopoly advisor.



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