Meme and Pass: “Affordable Care Act” it is

What’s the name of the law we just passed? Let’s follow Yglesias: it’s the Affordable Care Act.

A few days ago I praised Steve Benen for making “Pass the Damn Bill” the focal point for Democrats after the Scott Brown debacle.

Now Steve is wondering what to call the Damn Bill for purposes of quick reference—and, one might add, political cadence. It’s officially the “Patient Protection and Affordable Care Act,” which is too long and doesn’t have a pronounceable acronym (unlike, say, COBRA, such a useful acronym that Republicans can defend COBRA without reminding people that it stands for a “budget reconciliation act”).

Steve likes Matt Yglesias’ proposal: “Affordable Care Act” or ACA.  I like it too: it’s short, memorable, and says what the law does.

Steve’s commenters haven’t come up with a good alternative. “AHA” for Affordable Healthcare Act is not bad, but I see no reason to add an extra syllable, and people are very used to taking “Care” to mean “health care.”  (Nobody thinks “Medicare” should be “MediHealthCare.”)  Some would like to rescue “ObamaCare” from being a Republican insult, but I don’t think that will work.  Nor does it seem wise on principle to stick a partisan label on a law whose biggest selling point should be that it that serves the whole country and represents what was once a dead-center consensus.  Besides, the portmanteau method of making a new brand name out of two old words has gone out of style—I can’t think offhand of too many popular brands concocted that way since the 80s—and good riddance.  Such labels always sounded a little greasy, as Orwell thought they did.  The same objection applies to “AffordaCare”: yes, it sounds like Medicare, but we wouldn’t call Medicare “Medicare” if we were naming it now. (Individual mandates being a Republican idea, part of me would like to see “RomneyCare” or “Dole-ChafeeCare,” but one can only dream.)

As for the Vice President’s “Big F*cking Deal,” I dislike the distributional effects: only Bill Maher can say that out loud, and people have to pay extra to get the channel where he says it.

So I vote for ACA.  Lather, rinse, and above all, repeat.

Author: Andrew Sabl

I'm a political theorist and Visiting Professor (through 2017) in the Program on Ethics, Politics and Economics at Yale. My interests include the history of political thought, toleration, democratic theory, political ethics, problems of coordination and convention, the realist movement in political theory, and the thought of David Hume. My first book, Ruling Passions: Political Offices and Democratic Ethics (Princeton, 2002) covered many of these topics, with a special focus on the varieties of democratic politics and the disparate qualities of mind and character appropriate to those who practice each of them. My second book Hume's Politics: Coordination and Crisis in the History of England was published in 2012; I am currently finishing a book on toleration, with the working title The Virtues of Hypocrisy, under contract with Harvard University Press. A Los Angeles native, I got my B.A. and Ph.D. from Harvard. Before coming to Yale I taught at Vanderbilt and at UCLA, where I was an Assistant, Associate, and Full Professor; and held visiting positions at Williams, Harvard, and Princeton. I am married to Miriam Laugesen, who teaches health policy and the politics of health care at the Mailman School of public health at Columbia, and we have a twelve-year-old son.

16 thoughts on “Meme and Pass: “Affordable Care Act” it is”

  1. Lieberman-Stupak Reactionary Appeasement Act.

    Lieberman-Nelson Health Industry Guaranteed Profit Act.

    PhArma Profit Care.

    Health Executive Bonus Enlargement Act.

    Democratic Sellout Act, part #91223.

  2. Would you like some cheese with that whine, Curmudgeon? Only of the greatest purity.

    It's a shame that probably the biggest step towards universal care in a century isn't up to your standards.

  3. As the founder of the Coalition for the Abolition of Contrived Acronyms (AKA ….), I hope that it will not be known as the Comprehensive Affordable Care Act.

  4. Warren, in defense of Curmudgeon, now that the bill has become law, the rules about criticizing it change. It's not as if Curmudgeon is urging not voting for it (it's too late for that), or urges its repeal. It's great that it became law, but let's not pretend that the appeasement and giveaways to which Curmudgeon alludes didn't happen, and lets amend the law to improve it. Let's make it the first step on the road to single payer!

  5. Henry, I'm all for improving it. I'd have loved Single-Payer (or Single-Provider if I could imagine a successful transition to it), which puts me squarely on the side of a vanishingly small part of Congress, and I'd have liked the Public Option, which puts me on the side of the House and about 40 Senators (assuming for the sake of argument and in the face of the evidence that the Senators who signed that document calling for a Public Option were sincere). But I also think that the bill is a genuinely good thing, even as it's the new status quo and a place from which to improve. You also clearly think it's a good thing, albeit far short of your goals. Curmudgeon, in full purity-troll mode, makes it very clear that s/he thinks the bill is an awful thing. I don't accept that judgement.

  6. Yeah, I was going to do a satire of the right, but curmudgeon sort of took the wind from my sails. I for one am much more impressed by the outstanding work of REALIST Democrats, including Obama, to try and craft a bill that passes, then the sanctimonious and utopian left who would rather relegate social justice to impotence than make the sacrifices required to see it realized.

  7. I think the self-congratulatory tone expressed here and elsewhere by supporters of this legislation is a tad premature. Most of this act's most significant provisions don't go into effect for another four years. In truth, no one knows with any certainty how this law will ultimately affect healthcare outcomes or what its ongoing costs will be. Undoubtedly, many people will benefit, but many others will suffer. For example, to the particular detriment of low income women, the act reinforces restricted access to abortion. And undocumented workers, people who contribute a vast amount of value to the economy, will be prohibited from participation in the exchanges even if they are willing to pay full cost.

    As for affordability, are you really sure this is the aspect you want to highlight? The US annually spends twice the amount per capita on healthcare than the mean amount spent by OECD developed countries (and by several indicators, gets worse results). The act does very little to address this. The growth of health insurance cost has far outpaced inflation for decades now. This growth will likely continue. When the amount paid this year by individuals is significantly greater than the amount paid last year, ad infinitum, at what point will the "Affordable Care Act" title become yet another piece of congressionally sponsored self mockery ala the "Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act"?

    So, you'll all work really, really hard to fix the act's shortcomings? Really? If you believe this, then I have a turnip truck I'd like to push you off of. On what rationale will you base proposed improvements? This bill was passed using Republican rhetoric recycled from the 1990s. Its most liberally-minded provisions were repeatedly shot down, by Democrats who were nominally supportive, as being unrealistic. Having surrendered to conservative intransigence on issues like abortion, government sponsored competition and–ahem–universal coverage, at what point in the future do more liberal measures become realistic? I understand that a more liberal bill likely would not have passed this time around, but where are the ideological foundations for liberal improvement being laid for the next iteration? Certainly not within the Democratic Party.

    So sure, some public good will come out of all this, but affordability isn't high on the list. A lot more good will accrue, at considerable cost to the rest of us, to those players with the largest financial stakes in healthcare. The greatest damage done by this act is that it strongly reinforces the reality that the capture of government policy is a very, very good return on investment. Corporate profits will increase significantly. Insurers will have an even greater incentive (and more resources) to resist improvements, and I'm pretty sure the Democrats will be more than accommodating.

  8. Charles,

    1) In our litigious society surely any law makes work for lawyers?

    2) You might want to double-check your acronym.

  9. jm,

    If the liberal foundations you seek are not present within either party, it is largely because of the constituents that those party members represent. There is still much uncertainty out there about this bill and how well it will work. No one can say for sure, not even its most ardent supporters. My hope is that successful implementation of this bill will serve as an important step towards achieving a shift in the larger culture, so that people across the political spectrum will become less inclined to view any expansion of government involvement in markets as an inherently bad thing. Despite how you and I might feel about this issue, its not exactly black and white. The healthcare debate ignited what has been a longstanding issue in this country, that is, what the role of government should be. Its a fundamental cultural issue at heart, and its going to take time to see the kind of reform we need to see. Lots of time. Your point is well taken that there are no guarantees that we're actually going to see more reform as we move forward, but you're in the wrong game if you're looking for guarantees in public policy. Policy is a never ending struggle, and many times you need to make a choice between two or more far from ideal options. Choosing the least worst option is the often the name of the game. This bill is far from ideal, but its better than what we have now and will hopefully turn into something better. For now, that's all you can really say.

  10. The most important part of all this is Andrew's last part: Rinse, and repeat.

    The law is on the books, it's a budget matter and now Congress must pay some attention to it.

  11. I'm wary of "affordable" anything. Public higher education is touted as affordable, and the average student debt nationally is over $20,000, before graduate school, a house, or a kid. We have "affordable luxury cars" that aren't by most, and affordable health care plans that aren't worth crap. Affordable is too relative; its use can cause a lot of resentment on the one side, or fear of getting a cheap product on the other. Americare is the name of a home health business in New York. I like that, patriotism and caring.

  12. I propose we call it the

    Compromise

    Health

    Insurance

    Reform

    Plan of 2010.

    Acronyms ought not be mere alphabet soup.

    –TP

  13. The proper name should be Americans Choose Healthcare Upgrade, or ACHU. Unforgettable acronym that reinforces the idea everybody gets sick every single time it gets said. Plus, all the "Bless you!' responses may finally usher in the era of civility the President campaigned on.

  14. Seems like magical thinking to me, to be so concerned about the name of the bill. Just call it "Senate Bill # whatever", and be done with it.

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