Thursday, October 23, 2014
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How the Partisan War Over Health Care Can End

With the political divide so deep over Obamacare, is there any hope for bipartisanship on health care? The answer may be yes.

How the Partisan War Over Health Care Can End

By guest blogger Robert Field:

The House of Representatives voted on Wednesday to repeal Obamacare. The move is almost certain to die in the Senate, where Democratic majority leader Harry Reid has vowed to prevent it from even coming up for a vote. Even if repeal somehow squeaked through, President Obama would veto it.

Republicans have promised an alternative reform plan but have not set a timetable for producing it. That means that if repeal were somehow to be achieved, there could be chaos in the interim. Important elements of Obamacare that have already taken effect would suddenly disappear.

Would adult children lose the coverage they just gained under their parents’ policies? Would coverage limits be reinstated for patients with major expenses? Would co-payments reappear for preventive care? Would the doughnut hole in drug coverage reemerge for Medicare beneficiaries?

The repeal effort has avoided addressing these and other key practical issues. Perhaps this is because even its proponents do not expect the effort to succeed. It is really the latest chapter in the partisan theatrics over health reform. If there are compromise solutions to improving Obamacare, this process is not going to achieve them.

However, the partisan divide over health reform remains pervasive. It is not limited to Congress but reflects attitudes among the broader public. Support for keeping or expanding the law stands at two-thirds among Democrats but at only 12% among Republicans (see the latest Kaiser Family Foundation poll). Total repeal is backed by only 6% of Democrats but by 55% of Republicans. Even in this age of intense partisanship, this is a remarkable division, and it has remained stable over time.

With a divide this deep, is there any hope for bipartisanship on health care? The answer may be yes.

Two former Senate majority leaders, Democrat Tom Daschle and Republican Bill Frist, have launched an effort to promote bipartisan solutions to implementing health reform at the state level (see Politico). They are joined by former Democratic Ohio governor Ted Strickland, and they expect more former governors of both parties to join. The effort is under the auspices of the nonprofit Bipartisan Policy Center.

States have a major role in implementing Obamacare. Most notably, they are charged with establishing insurance exchanges where individuals and small businesses can purchase coverage. Many states have already begun to develop their exchanges. In some cases, they are doing so even when their own attorney general has joined the court case challenging the law.

Across the country, the nuts and bolts work of implementing the law is proceeding with little notice or controversy. It lacks visibility because most of the media attention goes to the partisan shouting over repeal.

Whether or not the Daschle/Frist effort succeeds, it reflects a deep undercurrent of aspiration for bipartisan on health care. While views of Obamacare may differ across the political divide, there are many people who would prefer collaboration that promotes compromise and moves health reform forward to continued partisan posturing. To me, that soundslike a good idea.

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About this blog

Check Up covers major health events in our region and offers everything from personal health advice to an expert look at health reform. Read about some of our bloggers here.

For Inquirer.com. Portions of this blog may also be found in the Inquirer's Sunday Health Section

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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