The presence of a mandate is where the similarities between the ACA and the Heritage Plan end, and the massive remaining differences reveal the disagreement between Democrats and Republicans about the importance of access to healthcare for the nonaffluent. The ACA substantially tightens regulations on the healthcare industry and requires that plans provide medical service while limiting out-of-pocket expenses. The Heritage Plan mandated only catastrophic plans that wouldn’t cover basic medical treatment and would still entail huge expenditures for people afflicted by a medical emergency. The Affordable Care Act contained a historic expansion of Medicaid that will extend medical coverage to millions (and would have covered much more were it not for the Supreme Court), while the Heritage Plan would have diminished the federal role in Medicaid. The ACA preserves Medicare; the Heritage Plan, like the Paul Ryan plan favored by House Republicans, would have destroyed Medicare by replacing it with a voucher system…
[T]he argument that the ACA is the “Heritage Plan” is not only wrong but deeply pernicious. It understates the extent to which the ACA extends access to medical care, including through single-payer insurance where it’s politically viable. And it gives Republicans far, far too much credit. The Republican offer to the uninsured isn’t anything like the ACA. It’s “nothing.” And the Republican offer to Medicare and Medicaid recipients is to deny many of them access to healthcare that they now receive. Progressive frustration with the ACA is understandable, but let’s not pretend that anything about the law reflects the priorities of actually existing American conservatives.
—Scott Lemieux
No, Obamacare Wasn’t a “Republican” Proposal
While I read Lemieux with interest, and he writes about many important things not treated by others, the fact remains that he is a stuck-up bigot who almost always refuses to engage seriously with opinions that disagree with his own. I don’t trust his word on this matter.
I am interested in this topic like you Frank. But there are other writers on the Internet who disagree with him, many of whom I respect more than him. Have you found anyone other than Lemieux and the LGM crowd who make this case? If somebody other than ‘my opponents are all idiots’ Lemieux shows through cogent argumentation that L is in fact right, I’d love to see it, and I’m not being remotely sarcastic here. Being the smart numerate guy you are, perhaps there also is somewhere on the Internet that gives a vivid summary of the effect on Insurance costs for Americans since the ACA came in.
I realize I’m asking you to do my homework for me, but I know you care deeply about this issue. And I’m not even American, but Canadian like Mr. ‘my critics are all evil and/or stupid’.
I already have done that. I was researching something else and came upon a large number of people making this point. I don’t think it is controversial. I picked Lemieux because I thought he put it well. In general, when I’ve written about him in the past, I’ve agreed with him. What are you referring to? I don’t know that much about him.
Well, if you ask him, he has conclusive evidence that Thomas Frank is an idiot who does not even have a point; Glenn Greenwald is an idiot who does not even have a point; Matt Taibbi is an idiot who does not even have a point. It goes from there. It’s not always clear where he ends and the commentators start, but he gives the distinct impression that 2000 Nader voters are to blame for the Iraq War (and anyone who disagrees is an idiot). Etc.
In terms of other writers making the same point, I was not challenging you. I was asking you to direct me to them. Likely you have some other posts here that could do this. I haven’t always followed you daily so maybe you could tell me where to look, if you could be so kind.
There is a good article by D Brad Wright, Did the Heritage Foundation Invent ObamaCare? The problem seems to be that Obamacare is pretty much the same as Romneycare. At the time, Heritage tried to take credit for Romneycare. Of course, once Obamacare came into existence, Heritage distanced itself from it. This caused many of us to overstate the similarities because the hypocrisy was so typically Republican. And note: the one thing that people most hate about Obamacare is the individual mandate and that was very much in the Heritage plan. And it was in there in a much harsher and cruel way. Lemieux’s (and Wright’s) article is broadly making the point that saying Obamacare is the Heritage plan is giving conservatives far too much credit.
I now understand what you are saying about Lemieux. I deal with this a lot. There are many people I more or less like who are like this. Ed Kilgore is similar. In fact, most of the liberals I read have a problem with Thomas Frank even while I hungrily devour his Salon articles every Sunday. I don’t mind the disagreement, but I get really tired of the “me so wise” attitude. And probably my biggest argument here is that this attitude is what has caused (or just allowed) the Republicans to go crazy. You can’t moderate away extremism. Just the same, people like Kilgore are allies and have a lot of insight.
As for Nader, I wish people would stop talking about him. He didn’t lose the election for Gore; the Supreme Court lost the election for Gore. Although Gore is another example of Democratic moderation going wrong. When he ran in 1988, he was considered at the far right of the party. Since the DLC, he’s become one of the liberals. This is the fundamental problem with the Democratic Party.
Thanks for this, but this guy is talking about how Obama’s plan is similar to the Heritage’s, not how it is different. Lemieux says it is self-evident (everything he argues is if you just listen, he’ll tell you) the plans are not the same. Is there somebody (even Lemieux) who has done a side-by-side comparison?
@RJ – The article is explicitly about how the only thing that binds the two laws together is the mandate. There are no subsidies. The Heritage plan turned both Medicaid and Medicare into vouchers. I’m sure someone has done a side-by-side comparison. Lawyers, Guns, & Money did something like this, The ACA v the Heritage Plan: A Comparison in Chart Form.