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Sunday, December 11, 2016

Politically speaking, here’s the thing about those melodramatic ads attacking the Affordable Care Act currently running on TV: In terms of actual policy, they’re as futile as the 40-odd votes to repeal the law that House Republicans have already cast.

GOP hardliners are like a drunk in a bar fight threatening to whip somebody twice his size if only his friends would let go of his arms.

It’s all over but the shouting.

Even if Republicans make big gains in the 2014 congressional elections, they can’t possibly win enough votes to overcome a presidential veto. What’s more, chances of capturing the White House in 2016 on a platform of canceling millions of Americans’ health insurance benefits appear so remote as to be downright delusional. Like it or not, the ACA is here to stay.

Indeed, governors and legislatures in previously recalcitrant states including New Hampshire, Tennessee, Pennsylvania, Utah and Virginia are considering Medicaid expansion they’d previously shunned. Despite early signup problems with the federal HealthCare.gov exchange, signups for individual private policies have increased to where it now appears the ACA will come close to meeting its projected goal of 7 million enrollees by the March 31 deadline.

Moreover, for all the predictions of actuarial doom heard on Fox News and elsewhere—supposedly caused by an imbalance of old, sick enrollees versus younger, healthier ones—the Washington Post reported last month that “the Kaiser Family Foundation estimates that if the market’s age distribution freezes at its current level—an extremely unlikely scenario—‘overall costs in individual market plans would be about 2.4 percent higher than premium revenues.’”

That’s a minor problem, but nothing like a “death spiral.”

In terms of affecting health care policy, then, the TV ads are largely symbolic — scripted melodramas calculated to arouse the partisan passions of the GOP “base” in states where control of the U.S. Senate could be determined this fall. Financed by Americans for Prosperity, the Scrooge McDuck-style front group controlled by the Koch brothers and fellow anti-government tycoons, they’re aimed less at killing the Affordable Care Act than convincing voters that Democrats are their enemies.

Maybe that’s why the ad campaign has proven so singularly unpersuasive to skeptics. In Lousiana, where Democratic Sen. Mary Landrieu is up for re-election this fall, AFP has run a commercial featuring a group of actors pretending to be ordinary Louisiana citizens whose health insurance was canceled due to “Obamacare.” But it’s make-believe; a scripted TV drama as fictive as a Viagra advertisment.

In Arkansas, virtually every news program features a pretty, AFP-sponsored actress plaintively begging viewers to remind Democratic Sen. Mark Pryor that health care is about “people,” and that “the law just doesn’t work.” More in sorrow than anger, it seems, because Pryor remains personally popular.

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