The Affordable Care Act – often referred to by the nickname “Obamacare” – has been a source of controversy since Congress passed it along partisan lines back in 2010. Since its passage, the law has had an undeniable impact on the health insurance marketplace, and in the lives of millions of American citizens – both positive and negative. Republicans have vowed to repeal the law since shortly after it came into being, and have successfully campaigned on the issue in several electoral cycles. Now, with control of the Presidency and both houses of Congress, many of those Republicans are intent on finally following through on that commitment. If a new Michigan poll is any indication of broader public sentiment, however, they would do well to treat with caution.
That poll from EPIC-MRA of Lansing sampled the views of 600 voters in Michigan earlier this month. It found that only 8% of those voters were in favor of repealing the healthcare law without first taking steps to implement a replacement. Other polling has indicated that there are several insurance protections that American voters are in favor of keeping under any new law.
Disruption Caused by ACA
It’s only natural for many Americans to be more than a little cautious about attempts to undo the law. It was designed to impact nearly every area of health care coverage, and it did just that. In some instances, that impact could be viewed as a positive thing – such as in areas where Medicaid expansion has resulted in dramatic increases in the number of insured individuals. At the same time, however, millions of other Americans have seen their old insurance policies fall by the wayside, as they failed to meet the arbitrary standards established by the new law. Many of those Americans struggled to find replacement plans that were as affordable as their old policies.
And while the number of insured persons has increased, it is important to recognize that most of that increase has been due to that expansion of Medicaid – something that could have been achieved without impacting those private insurance policies. At the state level, however, even Medicaid expansion can be controversial. Some state legislatures are already struggling to cope with budgetary realities, and scrambling to find funds to pay for their share of the Medicaid bill.
The bottom line for politicians couldn’t be clearer, however. The ACA was designed to be virtually impossible to repeal. There were predictions prior to passage that indicated that insurers would leave certain markets, and that the private marketplace would be disrupted in unpredictable ways. That happened in many jurisdictions. So, repeal is not as simple as some voters have previously thought – since the private marketplace has been disrupted by the law to such an extent that some period of transition may be necessary just to re-establish some semblance of normalcy.
Michigan Voters Weigh In
The new poll indicates that Michigan voters understand that concern. In addition to that eight percent who are in favor of a quick repeal even without a replacement, another 57% want to see repeal – but only after a replacement plan has passed. Only a third of surveyed voters were in favor of leaving the law intact. That’s a huge margin in favor of repeal and replace, but the details of any replacement plan will be critical to ensuring that voters approve of any repeal measure.
Polling in recent years has consistently shown Americans’ dissatisfaction with Obamacare, and a desire to try something new. Still, much of that polling has failed to capture the nuance between those who want a strict return to market-based insurance and those who want to move further toward total government-financed health care of the single-payer variety. Still, polling has revealed several areas of importance to voters that politicians would do well to keep in mind.
For example, large numbers of Americans support the idea of keeping ACA provisions that prevent insurers from denying coverage based on pre-existing conditions. They’re also supportive of the provision that allows parents to keep their children on their insurance policies until the age of 26. The coverage mandate, on the other hand, is a far more controversial provision.
The Impact in Michigan
According to recent news reports, the Affordable Care Act provides coverage to roughly one million Michigan residents. About one-third of those residents have insurance coverage that was purchased through the state’s exchange, while the other two-thirds rely on the state’s expanded Medicaid program, Healthy Michigan. On the surface, those numbers should serve as a warning to Congress. Any repeal that fails to address Medicaid expansion, or which leaves the state’s exchange-reliant insurance customers without assistance could be politically disastrous.
It’s also worth noting that the poll’s results indicate that about four-fifths of the surveyed residents are in favor of seeing the federal government provide some type of low-cost insurance plan that would be available to adults earning no more than $34,000 annually. The support for such a measure is broad-based, with more than two-thirds support across both parties and among independents.
Government Must Act Responsibly
The bottom line from the polling is something that should be evident in most areas in the country: the ACA, along with previous government intervention in the healthcare and insurance markets, has created distortions in price and availability that cannot be ignored during any effort to repeal a law. Michigan residents recognize those problems, and appear to understand that it will be even more disruptive to simply repeal this law and leave people to their own devices. The good news is that Congress appears to be equally hesitant to simply undo the ACA without first crafting a plan that would help to minimize disruption in the lives of their constituents.
At Michigan attorneys Biddinger & Estelle, PC, we’ll continue to monitor future developments in this and other areas of legal concern, to ensure that we can properly protect our clients’ estate planning and elder law interests. To learn how we can help you with wills, trusts, Medicaid planning for long-term care, and other important planning efforts, contact us online or call us today at (989) 872-5601.