Repeal or reform: Next steps aren't simple

A recent conservative poll found that 60 percent of voters want Congress to repeal the Affordable Care Act.

The Kaiser Family Foundation's polling found the opposite, that 63 percent would rather see Congress work to improve it.

So what's up?  According to a piece by Jeffrey Anderson in The National Review Online,  it's a sign that the Kaiser foundation skewed results by casting the issue as a choice between  "work to improve the law"  and  "repeal the law and replace it with something else."  The political research and strategy firm McLaughlin and Associates offered the options of   "it should remain the law of the land,  either in its current form or in amended form,"  "it should be repealed and replaced with a conservative alternative that aims to lower health costs and help people get insurance,"  or "it should be repealed but not replaced with an alternative"  (the last two combined got 60 percent). 
Anderson is executive director of The 2017 Project,  which promotes a conservative agenda. He argues that Kaiser isn't the  "gold standard"  on health care polling that many in both parties believe it to be,  but  "a pro-Obamacare outfit." 

Given the Observer's decision  (and mine)  to work with Kaiser Health News,  which is funded by the foundation,  I thought that was worth checking out.  It didn't take long to find that the McLaughlin questions were focused on conservative alternatives promoted by The 2017 Project  --  or that Anderson's group commissioned that poll,  which he failed to mention in the National Review piece.  As I reported last month,  the Kaiser poll also found plenty of anti-Obamacare sentiment  --  in fact,  the Kaiser poll got a stronger negative reaction to  "a health reform bill signed into law in 2010"  (49 percent unfavorable to 35 percent favorable)  than The 2017 Project poll got to  "the Patient Protection and Affordable Care Act, also known as Obamacare"  (52 percent disapproval to 43 percent approval).

But there's an important kernel of truth in Anderson's piece when he notes that  "improve the law"  and  "replace it with something else"  are vague options.  That's the nature of public polling;  we get people's gut reaction to broad terms,  not an in-depth analysis.   From what I can tell,  most Americans agree that our health care system needs a lot more work and few of us know how to make that happen.

So here's my suggestion:  If you're trying to think through what needs to happen next year,  check out Politico's recent piece on Obamacare 2.0.  The online magazine asked 15 leaders in the health care scene to describe the next steps.  The authors span the political spectrum.  Some tout the act's successes while others proclaim it a disaster.  But they all talk about follow-up actions,  whether that's creating a single-payer system  (independent Sen.  Bernie Sanders),  rolling out a new system that emphasizes choice and cost control  (GOP Sen. Lamar Alexander) or making adjustments to what's in place.  Reading this piece takes time,  but it's the kind of discussion regular people need to tap into if we want to get beyond sound bites.
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