clock menu more-arrow no yes

Trump says Democrats broke Obamacare. Voters: actually, you did.

This is the web version of VoxCare, a daily newsletter from Vox on the latest twists and turns in America’s health care debate. Like what you’re reading? Sign up to get VoxCare in your inbox here.

President Trump on Wednesday traveled to Ohio, which is now struggling to keep health insurers selling on its Affordable Care Act marketplace. Anthem announced it would quit that marketplace Tuesday, leaving 20 counties there with no plans signed up to sell in 2018.

This pushed Trump to make a declaration on his trip to Ohio. "The Democrats are destroying health care in this country," the president said in remarks delivered on the tarmac next to Air Force One.

It is clear, at this point, that Trump blames Democrats for building a law that didn't work — and standing in the way of efforts to fix that law.

Most voters, however, don't agree with him. The Kaiser Family Foundation fielded a poll in April focused on this exact question. They asked voters whom they would blame if the Affordable Care Act stopped working. Sixty-one percent said it would be Republicans' fault if the law doesn't work.

"People think that the current government is the government in charge, and they own it," Kaiser Family Foundation president Drew Altman told me when that poll came out.

Kaiser's polling suggests that Trump's argument will be met with skepticism among American voters, who generally think the party in charge is responsible for making the health care system function well.

It is true that these numbers look a bit different when you break them down by political party. A slim majority — 56 percent — of Republicans would say Democrats are responsible for any problems going forward, while 34 percent would blame Republicans (the rest either said they didn't know or refused to answer the question).

"That is a majority of the GOP who still view it as the responsibility of Democrats, but it is a small majority," Altman says. "In the world of ACA polling, that is not a high number. Usually Obamacare disapproval is in the 70s or 80s among Republicans."

The Affordable Care Act tends to be a polarizing issue. That same poll, for example, found that 78 percent of Republican voters disapprove of Obamacare. This means there is a sizable number of Republican voters who both oppose Obamacare and think the Trump administration is now to blame for its problems.

Trump wants to blame the woes of Obamacare on Democrats because they passed the law. But when Altman and I talked about this last, he said he expects things to play out differently. Republicans are now stuck with what he termed the "Pottery Barn theory" of health care: You break it, you buy it.

Watch this: What happens when you treat health care like a soap opera

Cable news treated a major health care vote like an episode of House of Cards. That kind of coverage might make for entertaining television, but it badly warps the way viewers at home understand what's at stake in the fight over health care. My colleague Carlos Maza has an excellent video up today that explores what this looks like in practice — and what it means for public understanding of the health care debate. Watch it!

Quote of the Day

What Obamacare enrollees who voted for Trump think now. I went back to Kentucky last month to follow up with voters who use Affordable Care Act programs and supported Trump in the 2016 election. I found that they were generally disappointed with the American Health Care Act but also didn't think it was enough to change their vote in future elections. Read the full story here.

Kliff’s Notes

Your daily top health care reads, with research help from Caitlin Davis

Today's top news

  • "McConnell whips Senate GOP back in line on Obamacare repeal": “After two weeks of increasingly dour assessments from Republicans on the party’s stalled health care efforts, Senate Republicans emerged from more than two hours of meeting with a fresh burst of optimism that they could actually pass a bill to repeal and replace the health law.” —Burgess Everett, Jennifer Haberkorn, and Adam Cancryn, Politico
  • "Senate Republicans Are Closer Than Ever to Repealing Obamacare": “Senators still lack an actual bill, and the compromises needed to pass the Senate could imperil the legislation in the House, which will also have to back it. But Tuesday was a pivotal day for discussions in the upper chamber ― and seemingly a positive one ― as Republicans try to build a 50-vote coalition to repeal Obamacare.” —Matt Fuller and Sam Stein, Huffington Post
  • "GOP Senators’ Medicaid Clash Jeopardizes Health Deal": “States that expanded Medicaid under the law are anxious not to see people lose health coverage or state budgets squeezed. States that didn’t expand Medicaid are reluctant to see other states benefit financially for making a choice they considered irresponsible. There are about an equal numbers of red states in each camp.” —Kristina Peterson, Stephanie Armour, and Louise Radnofsky, Wall Street Journal
  • "White House touts the ACA’s demise even as insurers seek help in stabilizing its marketplace": “Behind the scenes, the increasing fragility of the law’s insurance marketplaces has created an increasingly difficult dilemma for the president’s top advisers. The issue is whether to take any steps to allay the concerns of skittish insurers, some of which are either hiking up rates or pulling out altogether, or let things deteriorate even further — even at the risk of being blamed.” —Juliet Eilperin and Abby Phillip, Washington Post

Analysis and longer reads

  • "Why Not Try 'Medicare for All'? Glad You Asked": “If we followed Clinton’s plan, and lowered the Medicare eligibility age, one effect would be to take some pressure off Obamacare’s exchanges, by moving the sicker and older patients out of the pool. But that cost has to go somewhere, and where it’s likely to end up is in hospitals, as their patient load shifts dramatically toward lower-reimbursed Medicare patients.” —Megan McArdle, Bloomberg
  • "GOP Medicaid Cuts Hit Rural America Hardest, Report Finds": “'There is no doubt that children and families in small towns would be disproportionately harmed by cuts to Medicaid,' said Joan Alker, executive director of the Georgetown University Center for Children and Families. According to the center’s new report, Medicaid covered 45 percent of children and 16 percent of adults in small towns and rural areas in 2015. Those figures are lower in metropolitan areas — 38 percent of children and 15 percent of adults.” —Phil Galewitz, Kaiser Health News

Join the conversation

Are you an Obamacare enrollee interested in what happens next? Join our Facebook community for conversation and updates.

Sign up for the newsletter Sign up for The Weeds

Get our essential policy newsletter delivered Fridays.