Why Some Democrats Also Want To ‘Fix’ The Affordable Care Act

Politico’s Sarah Kliff notes that several Democrats have been bitten by the change the health care bill bug and are now promising to modify the bill if elected:

I want to reform it and fix it and make sure that it works for small businesses and their families,” Alexi Giannoulias, the Democrat seeking President Barack Obama’s old Senate seat, said on “Meet the Press” on Sunday.

“If you can fix it — Democrats and Republicans agree on six or seven items — that’s a pretty darn good start,” West Virginia Gov. and Democratic Senate candidate Joe Manchin told Fox News on Monday.

“I’d like to fix health care,” Democratic Kentucky Senate candidate Jack Conway said in a debate last week with Republican contender Rand Paul. “He wants to repeal it. And I think that’s a stark difference.”

Giannoulias, Manchin and Conway weren’t in Congress when Democrats pushed through the reform bill earlier this year. But even some Democratic incumbents who voted for the bill are now saying that it’s time to go back in and change it.

“Is the bill perfect? Absolutely not,” Rep. Brad Ellsworth said during a debate with other Indiana Senate candidates Monday. “Will it be added to and deleted from? It will.”

North Dakota Rep. Earl Pomeroy told one local newspaper last month that “improvements need to be made” in the bill. Then he followed up by telling another paper that “none of us believe our work is done or that the bill is perfect.”

Manchin is the only Democratic senate candidate to endorse repealing the law in its entirety, but other Democrats are clearly trying to carve out a space in which they can support the popular provisions of the law and talk about eliminating the more (politically) problematic elements. This kind of approach certainly polls well, but it is premature to fix a law that has not even been implemented.


It also doesn’t bode well for some of the more controversial cost containment mechanisms — the excise tax on high-cost plans, the Medicare cost board — that don’t go into effect until 2016 and will require lawmakers to make certain cuts to providers in order to reduce overall health care spending. By arguing that elements of the law that have not yet been implemented must be fixed or repealed, Democrats are not only playing into the GOP’s framework that the law is problematic, but they’re also opening the flood gates for stripping the most essential cost-containment provisions from the law. In other words, the frame may seem like a good election-season talking point over the short term, but if taken seriously it would cause serious policy problems down the road, as Democrats struggle to explain why the law has not lived up to expectations and decreased health spending.