With wary eyes fixed on the midterm elections, Democrats in tight races are pushing hard for changes to the Affordable Care Act. The WSJ reports that five Democratic senators will this week and next week begin releasing proposals to repair and improve the ACA. Here’s a sampling of some of the ideas on offer:
Among the proposals likely to be included is one backed by [Sens. Mark Warner of Virginia and Mark Begich of Alaska] offering a new kind of insurance plan, a “copper” plan featuring lower premiums and higher out-of-pocket costs than the “bronze,” “silver” and “gold” options on the government-run health-care exchanges.Lawmakers also would like to make health care more affordable for small businesses by expanding certain tax credits and making them available for longer. And Mr. Warner said on Fox News earlier this week that he favors enabling the sale of health insurance across state lines, an idea that has garnered interest among House Republicans as well. Other bills are expected to be introduced, with an emphasis on changes that don’t undercut the law’s foundations, aides said.
These seem like sensible changes, and we wish the Senators success in promoting them. But more important than the ideas themselves—which may never come to a vote—is the politics at play here. The growing consensus that the ACA as currently written is deeply flawed is remarkable in its own right. Very few people are willing to give an unqualified, full-throated defense of the law today.But more importantly, proposing changes is more than a defensive measure for embattled Democrats. By saying they will keep the “good parts” of the ACA and find ways to change the “bad parts,” they are putting themselves in a stronger rhetorical position than Republican politicians who have said little about health care beyond calling for its repeal. Certain aspects of the ACA are popular when considered separately from the law as a whole—for instance, allowing young adults to stay on their parents’ insurance until age 26. If conservatives want to win the ACA fight they have to offer the public something more than repeal: an alternative that is at least as attractive as a new and improved ACA.