Obamacare's Post Mid-Term Future

Jason Millman discusses a Harvard meta-analysis of polls on the Affordable Care Act on The Washington Post's Wonkblog.

Although the politics of Obamacare have cooled down this year — and even with declining interest in this year's midterms — the upcoming election will have a bigger influence on the direction of health care than you may think.
That's the major takeaway from a new Harvard University analysis of 27 public opinion polls from 14 organizations on President Obama's signature law. The analysis, published in the New England Journal of Medicine, offers a pretty comprehensive view of how the Affordable Care Act — less than a year into its major coverage expansion — will shape the agenda for the next Congress and potentially the 2016 presidential race.

Even Republican Senators are now talking down the possibility of full repeal. Instead, GOP leaders are talking about more targeted efforts to scale back the law, like weakening its coverage mandates and reducing subsidies for private insurance sold on the ACA's marketplaces. Democrats, meanwhile, are promoting "fixes" to the law, like cheaper insurance offerings and efforts to close coverage gaps. And if they maintain control of the Senate, they might try to pour more resources into supporting the law.

A Republican Senate, the researchers write, would scale back the law's mandates and taxes, mostly through the budgetary process. They may put up some Obamacare replacement plans, but likely wouldn't pass any. They say if Democrats keep the Senate, they would try to provide more resources for the law, and the political environment would encourage more of the 23 Medicaid expansion hold-out states to opt into the program. And it would give Democrats' 2016 presidential candidates more confidence to push for expanded coverage.