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John Patrick Grace: Health insurance exchanges open but questions remain

Oct. 01, 2013 @ 01:23 PM

Insurance exchanges under the Affordable Care Act — otherwise known as “Obamacare” — open today for 36 of our 50 U.S. states, including West Virginia. A last-ditch effort to abort the health care reform, led by Sen. Ted Cruz, R-Tex., and former South Carolina Sen. Jim DeMint, fell short.

The main ploy of Tea Party-backed Republicans was to refuse to pass a federal spending bill in the House, in an attempt to shut down the federal government, unless President Barack Obama renounced his signature reform, the ACA.

Shutting down the government would not, it was learned recently, have stopped federal funding for the ACA. That funding has a separate mandate and would not have been affected by a shutdown.

What happens next?

If Obamacare is to fail, it will have to fail on its own — for lack of enforcement (e.g., not exacting financial penalties from people who do not sign up for health insurance) — or for lack of efficent operations.

A few sundry observations:

Ferocious opposition from the right was marshalled against Social Security, an initiative of the Franklin D. Roosevelt administration. Similar attacks were made against Medicare, a product of Lyndon B. Johnson's White House and a Democratic congress.

Today both programs are solidly entrenched in our governmental systems and in the minds and hearts of the American public. President George W. Bush's efforts to privatize a portion of Social Security went absolutely nowhere.

Cruz alluded to the potential appeal of Obamacare, comparing it to an addiction to sugar.

That, apparently, is the major fear on the right -- that the ACA will actually work well, provide better access to health care for millions more Americans, help families avert bankruptcy due to medical bills, and, in the long run, cut the rate of increase of health care spending.

The supreme irony in all this is that the ACA has strong Republican roots, reaching back to President Richard M. Nixon's term in office. In the main it was later brainstormed by the conservative Heritage Foundation, of which DeMint is now the head, and ended up as universal health care for Massachusetts during Mitt Romney's term there as governor.

Later, while running for president against Obama in 2012, Romney was forced by his party into the awkward position of renouncing his own health care reform ideas, and vowing to repeal Obamacare.

One gapingly open question: Will Obamacare “click” with American voters to the point that its popularity ratings will flip from negative to positive before the midterm congressional elections in fall 2014?

If ratings stay negative, the Republicans will be advantaged in their efforts to retain control of the U.S. House and seize control of the U.S. Senate. If ratings turn positive, Democrats will be advantaged and likely will not only keep control of the Senate but also oust Republicans from their current majority status in the House.

John Patrick Grace formerly is an award-winning former health care writer for the Greensboro (N.C.) News and Record. He currently is a book editor and publisher based in Huntington and a weekly columnist for The Herald-Dispatch.

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