On Obamacare: polling, pathology, opposition


After a weekend break this is the third and final response to Ramesh Ponnuru’s column, and by extension the more general conservative criticism, describing the “inconvenient truths” about the Affordable Care Act (ACA). The first two responses were, I believe, worth expounding in great detail; on the incentives to provide employer-sponsored health insurance after the ACA, and the regulatory discretion over details inherent within the law. Due to some time constraints I’ll be quicker and more succinct with this one.

In case you missed the first post, here’s my summation of Ponnuru’s last four ‘truths:’

  1. “Third, the law is struggling politically.” Why? Because it doesn’t poll well.
  2. “Fourth, the administration is not following previous norms about how to build public support for a new program.” Why? Because the law was “jammed through” Congress against the people’s will.
  3. “Fifth, the law’s problems aren’t simply the result of Republican sabotage, as many of its supporters say.” Why? Because the economic consequences of the employer mandate is too frightful to contemplate, and thus has nothing to do with Republicans.
  4. “Sixth, opposition to Obamacare is reasonable.” Why? ACA proponents describe conservative opposition as pathological, but recent developments make clear that’s not the case.

Here is my abbreviated response to each:

  1. This is Ponnuru leaning heavily on the crutch of the ACA only garnering a 35 percent favorability rating when polled by the Kaiser Family Foundation. This is also highly misleading and probably the strongest indication that he’s succumbed to confirmation bias. Why? Because as I’ve written before that polling actually proves that most Americans don’t support the conservative position on Obamacare. In short, when you parse the numbers that 43 perfect unfavorable rating (the rest don’t know or refuse) includes people who don’t think the ACA goes far enough. When you include people who want to keep the law as it is or expand it that number goes to 54 percent versus 37 percent who want to see it repealed. Yes, that’s right, a majority of Americans want to keep the ACA or expand it. It’s takes a certain amount of disregard on the part of Ponnuru to throw out this polling when it doesn’t support his overall argument.
  2. The notion that the ACA was “jammed through Congress” against the “people’s will” is reactionary conservative rhetoric that’s very appealing from a populist perspective. It also requires one to forget that the majority that produced the legislation was…democratically elected. Nevertheless it lends itself to supporting the idea that the law is somehow illegitimate and is a necessary premise for the next two points
  3. On it’s own this sentence, that the “the law’s problems aren’t simply the result of Republican sabotage, as many of its supporters say” is correct I think. In fact if Ponnuru had stopped here this would definitely qualify as an inconvenient truth for some political supporters of the ACA (though most advocates I know wouldn’t even claim this to begin with). But he undermines this contention with the proceeding sentence, that this is therefore an “odd defense of a law — especially one that most people oppose — to say that it would work well if only the country were uniformly behind it.” Well, no, what supporters say is that many parts of the law could be made better if not for the uniform unwillingness of Republicans to do anything other than vote to repeal the law. Which segues nicely into Ponnuru’s last point…
  4. “Opposition to Obamacare is reasonable.” This isn’t an inconvenient truth because that would entail the consensus of supporters believing any opposition to the ACA is inherently unreasonable — which is a silly strawman claim. When Ponnuru writes that “Democrats have been portraying any disagreement with the law as pathological,” it’s not because of any one disagreement but because there is nothing but hysterical disagreement from conservatives towards the law. The explicit counter-factual here is that recent developments validate Republican opposition when it simply proves the law isn’t perfect. Disagreement itself isn’t pathological; voting to repeal a law 37 times is pathological.

I’d like to reiterate that this wasn’t an exercise in picking on Ramesh. Again, I enjoy reading him. Rather, this was simply an opportunity to respond to a grab-bag of criticisms against the ACA and a chance to highlight how confirmation bias against the law is notably pervasive. My simple test for the latter is to imagine that there could be any development of the ACA that wouldn’t somehow validate conservative opposition. I cannot think of any realistic scenario where that wouldn’t be the case. Can you?



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