The Magazine

What’s the Alternative?

Apr 14, 2014, Vol. 19, No. 29 • By JEFFREY H. ANDERSON and WILLIAM KRISTOL
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The crowing by the Obama administration over getting 7 million people to sign up for mandatory health insurance—with some portion actually paying for it—will soon fade. The big picture will remain clear: Obamacare isn’t working. And Americans, who didn’t like Obamacare when the Democrats passed it four years ago, don’t like it now, don’t want it to remain, and doubt it can be fixed. But they also don’t much want to go back to the pre-Obamacare world.

weekly standard illustration; elephant, bigstockphoto

weekly standard illustration; elephant, bigstockphoto

According to Real Clear Politics, a recent ABC News/Washington Post poll of registered voters was the 111th consecutive poll to find more opposition to Obamacare than support for it. That poll—which was more favorable to Obamacare than most—found 48 percent support for Obamacare, 50 percent opposition to it, and a 12-point deficit for it among those who feel “strongly” (27 to 39 percent). A recent Wall Street Journal/NBC News survey found that, by a tally of 49 to 35 percent, respondents judged Obamacare a “bad idea” rather than a “good idea.” 

That same WSJ/NBC News poll, however, also asked whether people would vote for a Democratic congressional candidate “who supports fixing and keeping” Obamacare or a Republican candidate “who supports repealing and eliminating it.” By artfully joining “keeping” and “fixing,” while combining “repealing” not with “replacing” but with the redundant “eliminating,” the question suggested that repeal would mean a return to the pre-Obamacare status quo. In response, Americans were essentially split (48 to 47 percent, with the Democrat up 1 point).

So Americans are ambivalent about whether to try to “fix” this “bad idea” or simply eliminate it. But what they really want is for Obamacare to be replaced by something better.

Recent polling conducted by McLaughlin & Associates for the 2017 Project, with which we’re associated, substantiates this notion. The poll, in line with party affiliation nationally, included more Democrats than Republicans—37 to 32 percent—and it showed Obama’s approval rating at 44 percent, similar to other current polls. Its results for Obama-care were similar to the WSJ/NBC poll (41 percent approving, 54 percent disapproving).

But it also asked the following question: 

Which comes closest to your view of the Patient Protection and Affordable Care Act, commonly known as Obama-care? 1. It should remain the law of the land, either in its current form or in amended form. 2. It should be repealed and replaced with a conservative alternative that aims to lower health costs and help people get insurance. 3. It should be repealed but not replaced with an alternative.

The responses show how important it is for Republicans to join repeal with replace: 32 percent preferred to keep Obama-care as the law of the land, whether in its current or amended form; 44 percent preferred repeal and the passage of a conservative alternative; and 16 percent preferred repeal alone. With an alternative—a conservative alternative—put into play, a clear plurality favored repeal and replace. And since the 16 percent who favored repeal alone would presumably easily accept a message of repeal and replace, it’s safe to say that “repeal and replace” commands the support of a large majority of Americans.

In other words, when Americans are given a choice between (a) keeping or “fixing” Obama-care and (b) repealing it in the absence of an alternative, repeal splits the electorate evenly. When they are given a choice between (a) keeping or “fixing” Obama-care and (b) repealing it in the context of a conservative alternative, repeal becomes a nearly 2-to-1 winning proposition.

Moreover, this is a Main Street majority. Among those who make under $40,000, Obama beat Mitt Romney by about 20 points (according to exit polling). Yet that same group favors repeal and replace by a 29-point margin (60
to 31 percent)—slightly more than the 27-point margin (60 to 33 percent) among those who make over $40,000.

All of this suggests that the key to ending Obama-care is for Republicans to advance a well-conceived alternative. It’s not enough to have House Republicans pass a smattering of piecemeal health bills. Americans want to know what the conservative alternative to Obama-care would look like in all.

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