Where is Healthcare in the Election Discussion?

December 20, 2011

With election season in full swing, the role that healthcare issues will play in the Republican nomination, and then the general election remains to be seen.

With election season in full swing, the role that healthcare issues will play in the Republican nomination, and then the general election remains to be seen. But the current lens suggests the possibility of a myopic, limited conversation.

Now, instead, we are talking bigger picture, like “economy” and “unemployment” and “Where did Gingrich come from?” The barbs tossed at Mitt Romney and his Massachusetts healthcare coverage plan are not particularly aggressive, and really are being used mostly to paint a flip-flop picture rather than engage the detailed pro versus con debate.

With current events, there are serious questions about a drone captured by Iran, an unemployment rate hovering near 9 percent, and the personal character traits of various GOP candidates. The Affordable Care Act (ACA) / Obamacare is getting very little airtime, but for the occasional promise to repeal from the more fringe, edge-of-the-stage candidate.

How big is the issue for you?

Many folks, given the complexities of political debate and societal challenges, wind up as one or two-issue voters. Finding that perfect candidate who agrees with every one of our positions is very difficult. Finding that perfect candidate - who also is electable in a general election, with such strong passion coming from the outer reaches of the political see-saw - is almost impossible.

The Affordable Care Act is in various stages of implementation, and the uncertainty at the state level where the bulk of the legwork must be done is staggering. Here in Virginia alone there is great debate over what resources to put towards the establishment of insurance exchanges. And this debate is taking place as our Attorney General (soon to be gubernatorial candidate) leads the charge to have the whole initiative ruled unconstitutional.

You likely have heard that, come around March, the Supreme Court will consider the constitutionality of the ACA, with a particular consideration of the individual mandate that requires people to purchase health insurance. More than five hours of argument time has been given to the topic. (Upon hearing this, I found it interesting that, in typical cases - which are considered the most complex and important the nation faces - justices usually hear only an hour or so of debate.)

It is expected that a decision may be rendered in mid-summer, which most certainly will pique interest in the topic as the political field is completely narrowed and likely down to one elephant versus one donkey. There, the ACA may pick up as a topic that better defines the public choice. It does, after all, remain arguably the signature moment of President Obama’s tenure - perhaps in competition with the killing of Osama bin Laden.

Widespread implementation of the ACA is slated for mid-2014, when the bulk of uninsured individuals will purportedly gain access to affordable health insurance options and the impoverished will be granted easier access to healthcare financing from the government. It therefore seems inevitable that as the message of the sluggish economy is used in the back-and-forth between both political parties, healthcare coverage and the ACA will once again rise to a prominent exposure on the Sunday talk shows and in the televised town halls. We are, after all, coming quickly upon 2012.

What is most likely occurring here is that the uniformity of opinion amongst the current candidates for the GOP nomination - that Obamacare is bad - has rendered the issue functionally moot. There are certainly some nuanced opinions, and the facts behind whether repeal could pragmatically take place haven’t been fully elucidated.

But for now we will look at Fannie Mae, and eliminating spending, and personal character to dominate the headlines, until the field is winnowed and the true differences between the aisles is demonstrated.

Find out more about Bryan Fine and our other Practice Notes bloggers.