In healthcare debate, words matter, in their connotations and their number
By Tom Baxter
Recently, the indispensable Georgia Health News published six questions it submitted to the Stacey Abrams and Brian Kemp campaigns, and their full written responses. Abrams’ combined answers came to 885 words, Kemp’s to 297.
How much you say doesn’t matter as much as what you say, but in this case the word count speaks volumes about the way Georgia’s Democratic and Republican candidates for governor have positioned themselves on health care issues.
Abrams is one of several Democrats around the country who have made health care their top issue. Her answers, and the health care plan she released later, have a lot of details and take firm stands. Her answers never mention Kemp.
Kemp, on the other hand, spends several of the few words he has to say about health care criticizing Abrams’ “radical plan” which will “literally bankrupt our state while making it harder for hard-working Georgians to receive the care they need.” His answers are heavy on campaign boilerplate and light on details.
The Republican nominee is expected to release his health care plan in the next few days, and that should flesh out his positions somewhat. But he’s playing defense on this issue and likely will be throughout the fall campaign.
Last week the Kemp campaign moved a little on the question of state innovation waivers, which allow states to create their own health insurance programs so long as they provide the same protections as the Affordable Care Act. Kemp is open to something like the Wisconsin waiver program, which sets up a reinsurance program to cap insurance costs. Abrams has already proposed something similar, which is one of the benefits of saying three times as much on an issue as your opponent.
“The word waiver, what that means, whether it’s a waiver, flexibility, allowing the states to be an incubator – if somebody is talking about that on the federal level, I’m glad to talk to them,” Kemp told the AJC.
Yes, the word, such a critical part of every political discussion of health care in the United States. The state innovation waivers are a provision of the Affordable Care Act, which is also known as Obamacare, except the waivers have given state legislators the chance to say it’s something else and still receive federal funds.
This morning’s email brought a come-on from something called Trumpcare Medicare. I didn’t click the onscreen button to learn more about this scam, but the changing vocabulary of con artists is worth noting. Very slowly, an old word is losing its punch and a new one is being created, before what it is describing exactly exists.
Georgia has remained politically frozen over that word, Obamacare, for a decade, so that slight movement by the Kemp campaign signals a significant shift. As Abrams likes to point out, the state has been losing $8 million a day in federal funds throughout that period, while Gov. Nathan Deal and now Kemp have argued that the program would bust the state budget in the long run.
This would, in fact, have been a lot of long run. In hindsight, after a decade in which rural hospitals have struggled to survive and demands on services for the old and poor have been strained to the breaking point, it’s hard to argue the state wouldn’t have been better off taking the money, up to now.
As for the future, the Trump administration remains committed to dismantling Obamacare and the Republican attorneys general of 20 states including Georgia have sued to have it declared unconstitutional. In the long run, to use the aforementioned words, these efforts may be successful.
But in the meantime the sky-high rates being offered in Georgia’s ACA insurance market actually went down a tad this year, even as the percentage of those without insurance has crept upward. We’ll be working within the framework of the existing law for at least the immediate future, and given the frustrations congressional Republicans have had in fashioning an alternative, that could turn into a long time. It’s really more a question of what words we’ll use to describe it.