Fresh from their rout of the Democrats, the G.O.P. are promising to repeal President Obama’s healthcare reform. There are lots of things that can be improved in the law but there are also some features that will be popular with voters. To think about the risks of repeal, I find it useful to recall my favorite Rumsfeld quote:
“[A]s we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns — the ones we don’t know we don’t know.”
In the minds on most voters, the healthcare law in an unknown unknown – most of its provisions have not gone into effect and non-experts (and even experts?) have not read the bill fully. There was never a really serious discussion of the law in the main stream media so citizens just know various buzz words (“death panels”). The huge uncertainty made the law unpopular with voters and it gave Republicans an electoral advantage.
If the Republicans clamor to repeal the law, the Democrats can point to he features of the law that will be popular with voters (no denial of coverage for pre-existing conditions, kids can stay on their parents’ policies till they are twenty six..). The law will go from being an unknown unknown into known unknown/known known territory. There is only upside for Democrats from this change – uncertainty-averse voters can’t have a worse impression of the healthcare reform than they already have. They are judging the unknown unknown in its worst possible light. The risk for Republicans is that if voters find some parts of the law appealing, their assessment actually improves and the Republicans’ electoral advantage diminishes. Better to keep the details hidden.
There is a “middle of the road” strategy – repeal unpopular bits and keep the popular ones. I’m not sure if this is really viable either. It forces a serious discussion of the law. For example, if Republicans try to repeal the requirement to buy insurance coverage, there will be some discussion of the subsidies offered and the costs of getting rid of the provision (some people will not buy insurance and then free-ride on emergency care pushing up costs for everyone else). Even if the discussion is a mess, it can’t be worse than the shallow discussion we sat through last year.
My guess is that the usual promise of tax cuts seems to dominate healthcare repeal as a strategy for Republicans.