OP-ED

More Evidence Obamacare is Good For White People

Dear White People Poster

The latest Gallup and Healthways poll doesn’t phrase it this way, but its findings that the Affordable Care Act “appears to be meeting its goal of reducing the percentage of Americans without health insurance” is more evidence Obamacare is good for white people.

In an interview with National Public Radio at the end of last year, President Obama was asked whether he and the Democrats had lost support among white voters. He denied it, comparing his share of the white vote favorably to that John Kerry in 2004 and pointing to the Affordable Care Act (ACA) as a program that benefited working-class white voters without many realizing it. I’d written much the same thing about Obamacare in a THCB blog post a couple of weeks before the 2012 presidential election. But as with other issues related to race, it’s a topic that the president has only reluctantly discussed, even when good policy is also good politics.

In response to NPR questions about race, Obama noted that some of the biggest beneficiaries of the ACA live in places like “Mitch McConnell’s state,” home to relatively few blacks or Hispanics. Coincidentally, a front page story in the print New York Times documented Kentucky’s experience with the law – which, the president wryly noted, Kentuckians do not call “Obamacare” – the same day the NPR interview aired.

And now Gallup, in a poll designed to mimic the national demographics on race, gender and ethnicity, has found that the national rate of uninsurance has dropped significantly. The regions with the largest decline in the rate of uninsurance were the Midwest and the South. The latter, of course, is the GOP’s stronghold region.

A large gain in the number of number of whites with health insurance was exactly what an Urban Institute analysis was predicting nearly three years ago. It suggested full implementation of the ACA would mean that 12.3 million more white people would gain health insurance.

“Based on the income levels involved, these newly insured will be working-class Americans more familiar with NASCAR than NPR, and, in rural areas, with grain elevators more than car elevators,” I wrote, drawing on several analyses. Fifty-three percent would be male. On the other hand, if Obamacare were repealed and replaced by the plan endorsed by the GOP’s Romney-Ryan ticket, I calculated nearly 25 million fewer whites would have health insurance.

So why is there a perception that minorities are the big Obamacare beneficiaries? While there are many more uninsured whites than blacks, a higher percentage of blacks and Hispanics are likely to be uninsured. On a proportional basis, then, the insurance coverage aspects of Obamacare have a larger effect on minority individuals. That, in turn, allows Obama opponents to play into the perceived victimization of whites.

The Public Religion Research Institute’s 2012 Race, Class and Culture Survey (not mentioned by Obama or NPR) found that 60 percent of non-college educated whites believe that blacks and other minorities get too good a deal from the government. A Fall, 2014 poll by the same group found that 58 percent of working-class whites believe that discrimination against whites has become as big a problem as discrimination against blacks and other minorities.

I closed my blog post in 2012 with a blunt assessment of the perception problem:

The numbers show that the [ACA] is a good deal for white folks, particularly those who are working class. But it’s also very good for many other Americans that too many of their fellow countrymen still view largely as “other” and less as “American.” The larger question is whether coloring in the facts about Obamacare will do anything to override white voter questions about the color of the man who made it possible.

As we now know, the Obama administration’s defense of all aspects of the ACA was be less than robust. Public support has slipped, according to the latest Kaiser Family Foundation poll, even as the law’s positive impact continues to grow. The new GOP majority in the Senate and swollen majority in the House will face little political blowback from the stepped-up attacks on the Obamacare bogeyman that can be expected in the weeks to come.

A newly released report by the Urban Institute updating its 2012 analysis of the racial and ethnic impact of the ACA emphasizes what Obama could have said. The ACA will narrow the uninsurance gap between whites and minorities such as Latinos and American Indians/Alaska Natives. However, since a “disproportionately large share of blacks” live in states that took advantage of the Supreme Court ruling permitting them to not expand Medicaid, the gap between black and white uninsurance rates remains.

If just five “non-expansion” states (Florida, Texas, Georgia, North Carolina and Indiana) were to expand their Medicaid program, the number of blacks with health insurance nationwide would jump by 30 percent, or 900,000 individuals. But those same five states expanding Medicaid would also cause the number of insured whites nationwide to increase by 25 percent, researchers say, or 3.3 million people. That’s more than three and a half times more whites than blacks gaining better access to care.

Although the report doesn’t mention it, three of those five states (Florida, Texas and Indiana) are home to politicians mentioned as potential 2016 GOP presidential candidates. (Florida’s GOP Sen. Marco Rubio might want to examine the breakdown among Hispanic beneficiaries of the ACA for Cuban-Americans.)

Those who oppose “give-away(s) to a selective group based on race,” as a white supremacist group Majority Whip Steve Scalise addressed in 2002 put it (he says he didn’t know their beliefs) will never be fans of the first black president. But when you color in the facts, they show today, as they did in 2012, that Obamacare is a clear win for working-class white people.

Unfortunately, unless those individuals listen to NPR or read health policy journals, most may never know it.

Livongo’s Post Ad Banner 728*90

Categories: OP-ED, THCB

Tagged as: , ,

23
Leave a Reply

9 Comment threads
14 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
9 Comment authors
GRACIELAmike johnsonallanPerryBob Hertz Recent comment authors
newest oldest most voted
mike johnson
Guest
mike johnson

Groan, race again. The Medical Industrial Complex screws all consumers, in different ways.

ACA protects and subsidizes expensive, bad medicine in a failed system, from a onsumer point of view. But not the Medical Industrial Complex. Cancer, diabetes and heart care could easily be 10x less, and more successful with unfettered free speech and competition. Many good, cheap answers are discarded, outlawed or ignored by MIC.

allan
Guest
allan

What a silly op-ed that is meant to appeal to the silly side of us. Poor facts and most definitely a poor analysis. A Mixed up interpretation that Health insurance is the same as healthcare and that Medicaid is is the same as private insurance even for those that previously had private insurance but are now forced into Medicaid.

Michael Millenson
Guest

Since we are not in Alice in Wonderland here, words and statistics have meaning: Medicare and Medicaid are both insurance programs, whatever their underwriting criteria. And even if some commenters confuse moral hazard with underwriting. As for who benefits from the ACA, the easy answer is: the entire country. Read the entire law, which includes many Republican ideas (as I’ve written) about improving the health care delivery system. Not to mention health insurance. Having said that, if the uninsurance rate had been just 3%, the law wouldn’t have passed. It’s a free country: you can make up your own statistics.… Read more »

Peter1
Guest
Peter1

When will the benefits of lower premiums start – sans subsidies?

Aurthur
Guest
Aurthur

Medicaid is a means tested, tax payer funded, government entitlement with most enrollees paying nothing, ever. This is a welfare program. That is all.

Perry
Guest
Perry
Peter1
Guest
Peter1

So do Harvard Profs want to go back to the “good ole days” when a large population could not afford coverage and we were broken up into profitable risk groups?

The “solution” is not going back but attacking the cost of care – for everyone.

Perry
Guest
Perry

“The “solution” is not going back but attacking the cost of care – for everyone.”

On that we both agree, I just don’t know if we’re going there with the current situation.

Perry
Guest
Perry
Bob Hertz
Guest

What strikes me about the reception of the ACA is that some of the people who benefit from it turn right around and vote Republican. They vote for a Mitch McConnell even as they are helped by the ACA. A New York Times article from 2012 captures this phenomenon pretty well: http://www.nytimes.com/2012/02/12/us/even-critics-of-safety-net-increasingly-depend-on-it.html?pagewanted=all Part of the reason is probably a question of style. Some men will avoid voting for a Hillary Clinton just because of who she is. When you get down to Medicaid, the recipients do not vote for anyone in great numbers. I remember when Tenn Care enrolled about… Read more »

Aurthur
Guest
Aurthur

SO, what, in your opinion, explains why the any of the 97% that do not benefit from PPACA vote for democrats?

Michael Millenson
Guest

Medicare has no underwriting, and it’s insurance — not sure why Medicaid would not be. Nor why insurance has nothing to do with care — I think we ended that argument when Blue Cross began in Dallas (not exactly Socialist territory) with the teachers in the 1920s.

MD as HELL
Guest
MD as HELL

Medicare is not insurance.

Having insurance does not get you care if no one takes it.

Having insurance does not get you care if you cannot pony up the deductible and co-pay and pay the remaining 40%. If money was the previous barrier, then this does not eliminate it.

You do get a lot of free stuff that you do not need.

You do get to pay a lot for nothing.

It is not insurance if you know you will use it while alive.

Peter1
Guest
Peter1

“Having insurance does not get you care if you cannot pony up the deductible and co-pay and pay the remaining 40%.”

Would that include private insurance with also – co-pays and deductibles?

Aurthur
Guest
Aurthur

Actually, Medicare does have underwriting of sorts. To qualify for Medicare, you have to generally pay into the program for a required period of time. Also, your Medicare benefits are further qualified by age requirements for the most part or disability requirements or end stage renal. So, there is a pre-existing limitation period that often is 40 plus years.

Remember when the government labeled social security as social security insurance. Pretty much the same bs.

MD as HELL
Guest
MD as HELL

Nothing like meeting a goal that has nothing to do with care.

It is not insurance if you plan on using it while you are alive.

Aurthur
Guest
Aurthur

“It suggested full implementation of the ACA would mean that 12.3 million more white people would gain health insurance.’ Complete garbage! Medicaid is not insurance, it is welfare. With no medical underwriting or other risk management, any PPACA policy is not insurance. You can continue to spew “the Affordable Care Act “appears to be meeting its goal of reducing the percentage of Americans without health insurance”, but it is just as false as the statement that the administration’s policies that are wrecking havoc on the economy to the point where over 10 million US citizens have stopped even looking for… Read more »

Peter1
Guest
Peter1

“With no medical underwriting or other risk management, any PPACA policy is not insurance.”

It is insurance. Private insurance is doing the medical underwriting (that’s why premiums are so high) with subsidies for that medically underwritten insurance helping those who cannot afford our glorious private medically underwritten system.

Aurthur
Guest
Aurthur

Guaranteed issue with no pre-existing condition limitation is not insurance. A pre-existing condition in not an unknown risk. Most people on Medicaid do not pay premiums, therefore no insurance. Pretty basic stuff…

http://www.appuonline.com/insurance/basics.html

Peter1
Guest
Peter1

“Guaranteed issue with no pre-existing condition limitation is not insurance.”

Would that apply to employer group?

GRACIELA
Guest

I don’ want to say I’m a minoriry, white, black or from north or south,or political party i fan with.but Obama care has harmed significantly a high percentage of civilians who were already struggling to make a doctor’s visit payment without insurance, and now they have to pay hundreds of dollars per month in insurance premium or penalties, when their income is not conpensating to cover the cost for it. Potentially some people may rather be without insurance or have to pay penalty for not having insurance rather then pay those high premiums, THIS IS REDICULUS!!!! WHO ARE THE BENEFITED… Read more »

Peter1
Guest
Peter1

“now they have to pay hundreds of dollars per month in insurance premium or penalties, when their income is not conpensating to cover the cost for it.”

Sudsidies GRACIELA. People are getting subsidies to help pay for premiums. What income group are you referring to?

Peter1
Guest
Peter1

Great article Michael. “The Public Religion Research Institute’s 2012 Race, Class and Culture Survey (not mentioned by Obama or NPR) found that 60 percent of non-college educated whites believe that blacks and other minorities get too good a deal from the government. A Fall, 2014 poll by the same group found that 58 percent of working-class whites believe that discrimination against whites has become as big a problem as discrimination against blacks and other minorities.” The GOPs cultural base, where guns are more important than health care. The south has always played off poor whites against poor blacks if an… Read more »