I'm only highlighting this new poll as pushback against the lazy media narrative that Obamacare is suddenly popular now that Republicans are finally in a position to dismantle it. It's true that status quo bias and the public's general aversion to even more healthcare policy turmoil has swelled the ranks of the "don't repeal" crowd -- but as we've already noted, most Americans favor Trump's anti-Obamacare executive order, and a large majority support repealing and replacing the law. When CNN recently asked Americans if they supported just repeal, only one in five said yes. But another 55 percent were behind the idea of uprooting the failing status quo and supplanting it with another policy. In other words, repeal plus replace attracted roughly 75 percent support. Which brings us to the new survey results, via the Free Beacon:
Survey respondents were asked whether they would prefer lower health insurance premiums, Obamacare's preexisting conditions protections to stay the same, or would they rather different preexisting condition provisions be implemented that wouldn't raise premiums as much. In October of last year, the Obama administration announced that Obamacare premiums were set to increase by double digits, increasing at a faster rate than they have in the past. Premiums for the silver benchmark plan are set to increase by 22 percent this year. The plurality, 37.1 percent, said they would prefer lower health insurance premiums. Meanwhile, 26.8 percent wanted to keep Obamacare's provisions the same and 25.8 percent preferred new provisions for those with preexisting conditions that didn't raise premiums as much. About 10 percent were unsure.
Democrats, take note: Only about 27 percent of Americans polled are impressed enough with the status quo as to favor its ongoing endurance. Democrats are defenders of a bad status quo of their making, with no good ideas to improve their mess. Nearly two-thirds support significant changes. Republicans, take note: A majority still wants to make sure that people with pre-existing conditions are able to obtain coverage. Any GOP replacement plan -- and the polling referenced above demonstrates the paramount importance of implementing a replacement -- must take care of Americans who suffer from pre-existing ailments that have made it very difficult to get insurance in the past. Fortunately, Paul Ryan's House GOP proposal does include such protections through a "continuous coverage" provision:
The plan also addresses the question of consumers with expensive pre-existing conditions. Insurers would be barred from charging higher-than-normal premiums to, or restricting coverage for, customers who have stayed continuously insured. This means that people who have a chronic condition, or have previously battled an expensive disease like cancer, can move freely from employer coverage to the individual market, and vice versa, without penalty so long as they have continued to stay covered. Unlike the ACA, which may be encouraging some young and healthy people to go uninsured (since they can wait until they get sick to buy coverage, knowing that insurers will be legally required to insure them), the House plan provides strong incentives for everyone to stay insured and thus remain under the umbrella of the plan’s “continuous coverage protection” approach.
The Free Beacon also quotes conservative healthcare wonk Jeffrey Anderson of the Hudson Institute (which commissioned the poll) discussing this element of the policy challenge under a post-Obamacare paradigm:
[According to Anderson], Americans still want provisions for those with preexisting conditions. "It seems clear, then—based on the poll's results—that Americans do want preexisting-conditions protections, but they do not want Obamacare's preexisting-conditions protections [to] lead to significantly higher premiums, which they unquestionably do," Anderson says. Anderson's alternative would provide funding for state-run high-risk pools, where no one with preexisting conditions could be denied coverage. Young adults with preexisting conditions could have a one-year buy-in period, in which they could purchase coverage but be exempted from paying more. For those who have kept continuous coverage in the individual market, they could switch to another plan without paying more because of a preexisting condition.
I'll leave you with two important pieces from Ramesh Ponnuru, in case you'd missed my links to them in previous posts: One with additional thoughts on how to cover people with pre-existing conditions, and the other laying out the broad strokes of a successful "repeal and replace" roadmap.