Is Obamacare in a death spiral? Probably not, but GOP market-based health policy might be

Me in Politico.

Since Republicans’ control pretty much everything in Washington and in most statehouses, they are accountable for the functioning of American government. Through “collapse and replace,” they are effectively holding themselves hostage. And whatever the partisan calculus, such rhetoric introduces political and policy uncertainty that dampens insurer and consumer commitment to the new marketplaces.

The long-run trajectory should really concern Republicans. The American Health Care Act, the putative replacement for the ACA, produced a surprisingly emphatic victory for Democrats. It bolstered the national consensus that every American is entitled to affordable and decent health coverage.

If the marketplaces can’t deliver on this promise, they won’t simply be scrapped. They will be supplanted by some form of expanded public coverage.

More here.

What does it mean to hold yourself hostage? Let me explain…

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect,, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

2 thoughts on “Is Obamacare in a death spiral? Probably not, but GOP market-based health policy might be”

  1. So much depends on messaging. Republicans over the past 30 years have gotten really good at convincing people that the US is a poor country that can't afford nice things for its citizens. If one of their cockamamie policies leads to an economic downturn, it will become "obvious" that we can't afford to subsidize healthcare, especially for Those People. And the Serious Class will still find some way to blame democrats and liberals for the debacle.

    The Blazing Saddles clip is funny precisely, alas, because everyone watching knew how counterfactual it was.

  2. I'm watching with Schadenfreude the current Republican attempts to launch AHCA's Mother, after the ignominious expiry of their first Franken-Grendel. It really beggars belief that any professional politician should think this a worthwhile improvement on just forgetting about the whole sorry mess. The rematch would inevitably have the same result, underline the Democrats' victory, and reinforce the ACA it seeks to destroy. However, I expect the effort will just peter out in frustrated grumbling.

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