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Voters Fear What They Don't Understand About Healthcare

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By Bob Cesca: A couple of weeks ago, I wrote about the disconnect among senior citizens regarding the healthcare law and who they're intending to support in the election. Once again, seniors are benefiting from the Affordable Care Act more than any other demographic group (around 14 million of them alone have received new preventative care coverage), yet they don't like the ACA and intend to vote for Romney over President Obama. A Romney victory would mean the repeal of the ACA and, along with it, the re-opening of the Medicare Part-D donut hole, forcing seniors to once again pay out of pocket for prescription medicine several months out of the year. It would mean the end of preventative care coverage and an array of other benefits that would deeply impact the health and financial stability of seniors.

And this is evidently what they want.

Or do they?

It turns out that most Americans don't even know what's in the law. And as we've all observed too often, Americans notoriously fear what they don't understand. For example, evolution and African American presidents from Hawaii.

Seriously, a new poll indicates that Americans are totally flummoxed by the law.

Many Americans do not have a clear understanding of what’s in the health care law. About one-in-five (18%) say they understand the law very well and 49% say they understand it somewhat well; nearly a third (31%) say they understand it not too well or not at all well.

These numbers are precisely in line with conversations I've had with friends who happen to be on the periphery of the political debate. They just don't know.

Some of them think it's basically a single-payer government program that eliminates private insurers. Some of them think the public option is still in there. Most of these same people have employer-based coverage and won't be impacted by the law much at all, while others, my uninsured non-political friends, are just clueless about the array of benefits they will personally receive when the law begins to get serious next year and especially the year after that -- 2014. (Incidentally, I once overheard someone griping about the individual mandate, insisting that they will refuse to be forced into government insurance in place of their existing employer-based insurance policy. Ugh.)

Not shockingly, none of these people support the law, and that bears out in polling. 51 percent of Americans won't be happy if the Supreme Court upholds the law, while 51 percent will be unhappy if just the mandate is ruled unconstitutional.

And you know what? It's no wonder. The Democrats and especially the Obama administration have done a terrible job educating the public about the law, possibly for fear of standing too closely to something that's perceived as unpopular. So they don't seriously pitch it.

They don't talk about the fact that it will reduce the deficit. They don't talk about how tens of millions of Americans will be able to afford healthcare through the exchanges -- the marketplaces which uninsured Americans can use to purchase affordable coverage. They don't talk about the ban on pre-existing conditions. They certainly don't talk about the required coverage -- without copays or deductibles -- of preventative and reproductive care since the Republicans turned that part of the law into a war against vaginas. They don't talk about how insurance companies are being forced to spend more of your premiums on medical care, rather than pedantic commercials and CEO bonuses. They don't talk about the expansion of Medicaid, they don't talk about the thousands in subsidies for middle class families to pay for insurance, they don't talk about the ban on lifetime limits in coverage (if you're covered, and you get cancer and use up your lifetime alotted amount of coverage, it used to be that you would lose your coverage entirely -- not any more) and they don't talk about the tens of millions of young people who will continue to receive coverage under their parent's plan. On and on and on.

There are no ridiculous death panels. The government won't be mandating that you avoid sausage or beer. The IRS won't be marching its armies of accountants through the streets rounding up uninsured people. And, by the way, if you don't get insurance and refuse to pay the tax penalty, there's no enforcement mechanism or punishment for not paying. But you should buy insurance instead of freeloading off the system. I digress.

Here's a handy-dandy interactive timeline of what's in the law and when it goes into effect.

Fact: uninsured people will be covered under a similar plan that ultra-far-right paleoconservative Ayn Rand fetishist Ron Paul receives from the government.

Fact: the ACA will only improve the quality, availability and affordability of healthcare.

At some point, the Democrats need to stand up and say those words. But they're not. They're running away from the law even though the bulletpoints are obvious winners for them. To be fair, Health and Human Services is running a series of TV commercials explaining the benefits of the law. And while the spots will reach some viewers, it's wasted money and time. President Obama should air a one hour prime time "master class" on the ACA. He could invite some Republicans to grill him about various provisions, just like those Question Time sessions he held a few times.

Unless something like this happens the law will be repealed as soon as Republican X is elected alongside a congressional majority. Educating the public about the law will stop the "repeal and replace" effort in its tracks -- chiefly because most Americans are clueless about what's being repealed.

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