IMPLICATIONS OF SURVEY RESULTS Although the election of 2014 is not of wide public interest, the outcome matters in terms of health care. This is the case because Republican and Democratic voters are so separated in their views on the future of the ACA that these divisions will have an impact after the election. The leaders of the majority party in the House and Senate are likely to reflect the views of their partys adherents. On one side, Republicans favor scaling back or repealing the legislation, positions that have been shown by other studies to have been taken by a majority of Republican candidates in 2014 primary races.8 On the other side, Democrats favor moving ahead with this law. Of important note for the 2016 election, the plurality of Democratic likely voters favor expanding the current scope of the ACA, rather than just implementing the current law. Regardless of the outcome of the election, the ACA cannot be repealed unless President Obama concurs, which is highly unlikely. However, what a Republican majority could possibly accomplish through multiple budgetary bills is to reduce federal support for health insurance subsidies, Medicaid expansions, public health grants, innovation investments, program administrative information, and outlays for outreach. Also, honoring Republican candidates commitments, substantial efforts would probably be made to postpone employer and individual health insurance mandates and reduce the ACAs taxes on employers, insurers, and health care companies. The budgetary process would provide the focus for these efforts. Though proposals to provide a new Republican substitute for the ACA are likely to be debated, it is unlikely that one could be passed in the Congress and signed by the President after the election. However, a Democratic majority in the Senate would probably result in the implementation of the next phase of the ACA with more resources being available. Such an outcome would be likely to create a political environment in which more of the 23 states that are not participating in the optional Medicaid expansion component of the law would agree to move ahead. It would also provide encouragement for 2016 Democratic presidential hopefuls who are presenting their views on an expanded ACA. Even though health care is only one of a number of top issues in the 2014 election, the majority party in Congress will claim it has a mandate for its priorities on what is still a controversial national health care issue. Of the most importance in the health care field, these deep divisions foretell continuing conflicts over the shape and direction of U.S. health care policy in the future.
Posted on: Mon, 17 Nov 2014 00:20:13 +0000
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