September 7, 2012 — President Barack Obama asked for 4 more years to revive the nation's economy in his acceptance speech last night at the Democratic National Convention in Charlotte, North Carolina, and took his time getting to the subject of healthcare, the most divisive issue of his presidency.
However, once he arrived at that subject, more than halfway into his remarks, Obama drew some lines in the sand.
Obama said he refused to "eliminate health insurance for millions of Americans who are poor, elderly, or disabled...all so those with the most can pay less." This was an oblique and solitary reference to Medicaid, which serves the poor, elderly, and disabled, and which Republican presidential nominee Mitt Romney wants to convert into a block-grant program to limit federal outlays.
Obama was even more defiant when it came to Medicare, vowing never to turn it into a "voucher," his way of describing Romney's plan to give seniors a fixed amount of money to purchase either traditional Medicare coverage or a private health plan.
"No American should ever have to spend their golden years at the mercy of insurance companies," Obama told convention delegates. "They should retire with the care and dignity they have earned. Yes, we will reform and strengthen Medicare for the long haul, but we'll do it by reducing the cost of healthcare — not by asking seniors to pay thousands of dollars more."
And the Affordable Care Act (ACA), the president's healthcare reform legislation that survived a Supreme Court challenge? Obama did not mention the law by name, but coyly referred to it twice. Characterizing the Republican preference for small government as an excuse for government inaction, he said, "If you can't afford health insurance, hope you don't get sick."
Later, he told the Democratic faithful that they were "the reason there's a little girl with a heart disorder in Phoenix who'll get the surgery she needs because an insurance company can't limit her coverage." Obama seemed to be touting the ACA provision that prevents insurance companies from denying coverage to children younger than 19 years because of a preexisting condition.
Obama referred to healthcare a final time in a defense of abortion rights when he decried "Washington politicians who want to...control healthcare choices that women should make for themselves."
By the end of the evening, Obama had discussed healthcare in more detail than his Republican opponent had done last week at the Republican National Convention in Tampa, Florida. However, as last night's speech demonstrated, Obama knows that the election on November 6 hinges mostly on whoever can best play the economy card. Obama uttered the word "job" or "jobs" 17 times, a considerable number, but 10 short of Romney's 27 references. Obama said his policies would translate into 1 million new manufacturing jobs during the next 4 years on top of the 500,000 already created in the last 2.5 years.
Voters Seem to Tolerate Healthcare Reform
If Obama downplayed the ACA in Charlotte, one reason may be that more Americans hold an unfavorable opinion of the law than a favorable one. That pattern has generally held true since the ACA was enacted in March 2010, according to monthly tracking polls by the Kaiser Family Foundation (KFF). In August, for example, 43% of Americans said they disliked the law, 38% liked it, and 19% were undecided or refused to comment. However, most Americans favor major provisions of the law on a stand-alone basis, such as free preventive care, health insurance exchanges, and premium subsidies, according to KFF.
The Supreme Court decision in June that preserved the ACA did not shift the survey numbers in any major way. After all, the ruling had something for ACA supporters and opponents alike. The high court said that the law's individual mandate violated the Constitution's Commerce clause, but that it was ultimately justified under the constitutional authority of Congress to levy taxes. Republicans who parsed the opinion could still argue, therefore, that the law had an unconstitutional odor. Likewise, the Supreme Court let a massive expansion of Medicaid proceed, but the court gave states the right to opt out of it.
Those reproofs aside, the law is still on the books, and the public seems resigned to letting it stay there. In July, 58% of Americans said that ACA opponents should stop trying to block the law and move on to other national problems, according to KFF. Only 37% supported further efforts to derail the ACA's implementation.
Another question posed by KFF has uncovered an odd kind of political support for the law: Each month since January 2011, KFF has asked Americans whether Congress should expand the law, keep it as is, replace it with a Republican alternative, or simply repeal it with no substitute. In August, the percentage of Americans who wanted to either maintain or expand the law stood at 49% compared with 40% who wanted to junk the law, with or without a replacement. The ACA has enjoyed this edge, by and large, since KFF started asking the question. So although the law is not popular with most Americans, only a minority actually seeks its demise.
This tolerance of healthcare reform may indeed be more evidence that voters have their minds on economic security, and which candidate can create the most jobs in the next 4 years.
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