Gingrich And The Fate Of The ‘Unpopular’ Health Reform Law

In a speech at the National Press Club on Friday, likely presidential candidate Newt Gingrich said he expects that the Affordable Care Act would be repealed by 2013 and predicted an “enormous mess” if the Supreme Court doesn’t strike down the law and the administration is forced to “defend the indefensible.” Politico’s Jennifer Haberkorn:

“We have very few examples of reform which has been opposed by the American people which survives”… “The sheer weight of public opinion consistently forces the system to ultimately follow the people, rather than the other way.” [...]

In the short-term fight against health reform, Gingrich said he’s confident that House Republicans can deny money to the program in the next appropriations bill. The White House and Senate Democrats “can block them from repeal, but they can’t coerce them into funding” all of the Affordable Care Act provisions, he said.

For the long term, the former House speaker has his own reform plans at the ready. He supports a flat tax credit to help Americans buy insurance, and he would also use block grants to reform the state Medicaid system.

Newt’s own proposal aside (I’ll return to it in a future post), his argument that the health law is destined to fail because it is “opposed by the American people” is unlikely. This country has adopted its share of contentious legislation, most of which has remained on the books, as will the health law.

The 1965 Medicare law provides the best parallel. Opponents of that measure relied on the very same rhetoric as today’s Republican party: they referred to the bill as socialized medicine, warned Americans that it would erode personal freedom and lead to health care rationing. As a result, public opinion remained mixed. A July 1962 Gallup poll found that just 28 percent of responds “said they held generally favorable views” of the plan, “24 percent were generally unfavorable, and a sizable plurality (33 percent) said they didn’t have an opinion on it or hadn’t heard about the plan.” By 1965, more Americans supported than opposed the measure, but the public was still decidedly divided. Today, nearly 96 percent of Americans consider the plan “very” or “somewhat” important.

The point here isn’t to say that all unpopular plans can survive — this was clearly not the case with the 1988 Medicare Catastrophic Coverage Act — or to draw a direct comparison to the political atmosphere of the 1960s (when Americans were far more trustworthy of the federal government). Rather, it’s to say that a bill’s immediate unpopularity is not the best predictor of its longevity. And this is doubly true for the health law which more Americans want to expand or leave it as is than repeal it entirely or replace with a yet-to-be-determined GOP alternative. Most also support key provisions of the law.

But if Newt’s standard for repealing law is its popularity, then he should probably start with NAFTA, which was supported by just 38% of the population in 1993 and for which support remains rather subdued today.