Dean Baker’s good point about the Affordable Care Act is one that I’ve tended to play down: Everyone currently holding insurance, at least outside of Medicare, wins from the added security under the reform.
Baker is an excellent economist. I am less convinced by his political analysis:
This is a huge benefit that is being extended to tens of millions of people who will be voting in November. Due to poor coverage of the impact of the law, it is likely that most of these people do not recognize the extent to which the ACA provides them with security in their insurance coverage.
This lack of information probably isn’t due to “poor coverage of the impact of the law.” It’s more likely a consequence of the nature of the problem and of this particular solution.
The insecurity that Baker describes was real, and some people will realize that the ACA means they no longer have that worry, or at least not to the same extent. Still, there are several barriers to it being a voting issue. For one, people tend to be optimists about their own prospects, and no candidate wants to campaign by telling voters they are more likely to lose their jobs (and their insurance) than they realize. Also, the ACA only provides access, not a seamless guarantee of constant coverage, making it harder for the press (and politicians) to easily describe how it gives people more security.
And then there’s the gap between recognizing a benefit and vote choice. Baker isn’t the first to conflate the two; the article in the Sunday New York Times Baker is reacting to asserted that Obamacare is different from Social Security and Medicare because it won’t deliver votes to Democrats. But it’s not clear that either of those reforms, though they were perceived as successful, delivered votes. After Medicare passed in 1965, voters “rewarded” Democrats for Medicare with big midterm losses in 1966 and then by putting Republicans in the White House in five of the next six presidential elections.
Successful programs guarantee their own success, regardless of subsequent elections. That’s very likely to be the case with health-care reform, no matter how people feel about “Obamacare.” It’s hard for politicians to take away benefits people like. What successful programs almost never do — especially those that are targeted widely and don’t put pressure on specific groups to realign — is win elections. And Obamacare, with its largely invisible and abstract benefits, is particularly poorly designed to achieve that particular goal.
[Cross-posted at Bloomberg View]
