Why Do Conservatives Hate the Affordable Care Act So Much?

It's been almost three years since Tea Partiers descended upon Greenwich Town Hall bent on disrupting Congressman Jim Himes' meeting on health care reform, even jeering a man who quoted the Bible in explaining his support for health care reforms. Why do conservatives hate the Affordable Care Act so much? After all, the basis for Obama's reforms, including the individual mandate, was created by Heritage Foundation analyst Stuart Butler in 1989. In 2006 Massachusetts Republican governor Mitt Romney signed reforms into law based on the same Heritage Foundation model. Governor Romney called that legislation "a giant leap forward" that would provide "every citizen with affordable, comprehensive health insurance." Romney's key adviser on the Massachusetts legislation, Professor Jonathan Gruber of MIT, also advised President Obama. Said Gruber, "The truth is that the Affordable Care Act is essentially based on what we accomplished in Massachusetts. It's the same basic structure applied nationally."

Those Massachusetts reforms worked. The percentage of insured residents went from 90% to over 98%, uncompensated care dropped 40%, premiums fell dramatically in the individual market, and administrative costs remained low.

No surprise, therefore, when Republican governor Jodi Rell made Connecticut the first state in the country to adopt expanded Medicaid under ACA. Rell stated she wanted "all Connecticut residents and businesses to get the full benefit of the national law and what it is intended to provide – quality and affordable health care for all.”

Yet Republicans, including Romney, vow to repeal the ACA. Republican state senator Scott Frantz (R-36) called it "anachronistic, out of touch and potentially devastating to the economy and to business."  Republican congressional candidate Steve Obsitnik warns of "potentially negative ramifications" of the Obama reforms, and that, "uncertainty about the future" will impact small businesses.  Greenwich Republican senatorial candidate Linda McMahon opposes the law, "because Connecticut small business owners have told me about the negative impact it has had on their ability to create jobs."

Let's remember what the bill provides. In addition to insuring more than 30 million currently uninsured Americans, the law creates a patient bill of rights and basic set of services, which barely half of Americans now receive. It forbids denial of coverage due to a pre-existing condition, affecting between 50-129 million Americans. It eliminates life-time limits and dollar limits on coverage, which affect two million Connecticut residents. It permits young people to remain on their parents' health insurance up to age  26. As of the end of last year, 23,000 young adults in Connecticut had taken advantage of this provision, and 3,400 in Fairfield's 4th congressional district. It eliminates the costly "donut hole" in Medicare drug coverage by 2020, but already provides 50% discounts for seniors on Medicare. It has already provided over 40,000 Connecticut seniors with $55 million for prescription drugs. 77,000 seniors in this district now receive preventive services without co-pays or deductibles.  The ACA also requires insurance companies to spend at least 80% of premium dollars on actual health benefits. 77,100 Connecticut families with private insurance coverage will soon benefit from $13 million in refunds.

The ACA also improves women's health care enormously, making available without cost or co-pays "well-women" visits, screenings for gestational diabetes, domestic violence screenings, breastfeeding supplies, contraceptive services, mammograms, cervical cancer screenings, prenatal care, flu and pneumonia shots, regular "well-baby" and "well-child" visits. Medicaid reforms give low-income women improved access to family planning services except abortion. It eliminates gender discrimination by forbidding insurance companies from charging women more for health insurance than men, a practice that was legal in 33 states. It requires maternity care to be included in all plans, and forbids insurers from using pregnancy as a pre-existing condition to deny health coverage.

Thanks to the ACA, 54,000 small businesses in the state are eligible for ACA tax credits to help provide their employees with health coverage.  Those credits total 35% of the cost of health insurance; but increase to 50% by 2014. That's important, because, according to Small Business for a Healthy Connecticut, small businesses pay on average 18% more for insurance premiums than large corporations. In the 4th congressional district 670 small businesses already receive those tax credits. 

Also, according to the CBO, ACA will reduce the federal deficit by a projected $210 billion over ten years. And according to the Commonwealth Fund, it will reduce health care spending by $590 billion between 2010–2019 and reduce premiums by nearly $2,000 per family.

Perhaps, like the Tea Partiers in Greenwich three years ago, when Republicans learn how beneficial the ACA really is, they'll calm down and give it a rousing ovation.