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Messaging is Overrated

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A funny thing happened to public opinion and the Affordable Care Act:

Republicans may not have even realized until recently how deeply their ability to make political hay on Obamacare depended on not having power. They could posture against every inconvenient aspect of an industry nobody has ever liked, and promise all things to all people, with no responsibility to fulfill their grandiose promises. Now the dynamic has reversed. Loss aversion has inspired massive, energetic protests to speak up for a law Democrats could hardly be roused to defend before, while the energy has drained away from the opposition. Amazingly, polling for Obamacare, which has been unpopular since the outset, has sharply reversed. The last ten polls all show net positive approval for the Affordable Care Act. If Republicans somehow muster the partisan discipline to tear down Obamacare, as opposed to settling for minor changes, they will have to be willing to endure searing political pain.

There is one potential way of interpreting this:

It it, I guess, theoretically possible that the ACA had suddenly become significantly more popular because the Democrats have suddenly gotten much better and/or the Republicans much worse at messaging. The far, far more plausible explanation is that public opinion on the issue is driven primarily by structural factors. When comprehensive health care reform is being proposed, the very loss-averse public tends to focus on the downsides, and the people with the least to gain tend to be among the most influential (a problem that has only gotten worse since the passage of Medicare.) What’s changed is that the loss-aversion shoe is now on the Republican jackboot.

Again, we shouldn’t be complacent — a lot of Republican legislators want to kill the ACA and they’re not guaranteed to fail. But the very heavy status quo bias is American politics, which has almost always been the enemy of better health care policy, is for once working in its favor.

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