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The Obamacare of 2010 doesn’t exist anymore

Ordinarily, this column is dedicated to discussing public affairs in North Dakota. There are plenty of writers closer to the national scene that can scoop up those leaks about the falling sky.

However, the public conversation about Obamacare is in need of some elementary input. Admittedly, it is more of a rant than a conversation but even rants can use enlightenment.

The whole situation reminds me of a speaking duty at Crystal Springs Bible Camp some years ago when I heard a visiting Canadian pastor observe that “the Catholic church we used to hate doesn’t exist anymore.”

That conciliatory concession can’t be appreciated unless you were around in the old days of Protestant suspicion about the sort of revolution those Catholics were planning.

Catholic-phobia has since disappeared so we no longer think that the Pope will run the country if we get a Catholic president. Besides, we have new phobias to fan our fears.

But back to Obamacare.

When the Democrats passed Obamacare in 2010, it was greeted with antagonism by conservatives who didn’t want to see big government get bigger, or high taxes get higher. In fact, everyone who already had insurance thought Obamacare was unnecessary. To them, the problems of the uninsured were strictly academic.

Because of the inept rollout of the plan, Republicans had a field day disparaging the whole jerry-rigged complex creation. They spent seven years beating up on the Congresspersons who supported this mind boggling proposal. Scores of Democrats lost their seats in the wave of anger that swept the country.

Those who already had insurance attended public forums and denounced Democratic candidates. Finally, with “repeal Obamacare” as a major issue, the Republicans rolled into Washington with ease.

So we get to the present Congress where the wording of the “repeal Obamacare” has been tempered with “repeal and replace Obamacare.” But the mood of the public has changed since 2010. The Obamacare the people hated in 2010 doesn’t exist anymore.

It is now the Republican members of Congress who don’t want to go home to face the hostile crowds. Congressman Kevin Cramer’s last appearance in North Dakota bordered on a riot.

Something has happened over the past seven years, with the latest poll showing that a majority of poll respondents want to keep Obamacare. According to Kaiser Tracking Surveys, support for Obamacare has increased by 17 percent since 2014, a remarkable shift in public sentiment.

The explanation for this dramatic change is quite simple. In 2010, there were no beneficiaries of Obamacare; by 2017, there were millions who realized they have a stake in the program. And, not only that, these beneficiaries have family, friends and relatives to swell Obamacare supporters by the millions.

This brings us to a dilemma for Republicans and Democrats alike. The beneficiaries of Obamacare are both poor and high risk. Insurance companies are in no position to absorb these high risk medical cases without raising premiums commensurate to the risk.

Any of the proposals to broadening or increase coverage requires new calculations. They will all force an increase in the cost of coverage. So when President Donald Trump promises better coverage for all at reduced premiums, he will have to pull more than rabbits out of the hat to implement that promise.

The health care issue is beyond the realm of partisan politics. Both parties must come to terms with the fact that adding millions of high risk beneficiaries is going to be terribly expensive and that somebody has to pay for every new benefit. It’s time for reality to set in.

Lloyd Omdahl is a former lieutenant governor of North Dakota and former political science professor at the University of North Dakota, Grand Forks.

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