Affordable Care Act

Voicing Our Values—To Defend the Affordable Care Act

This is an addendum to our book, Voicing Our Values: A Message Guide for Candidates. The purpose is to help lawmakers, candidates and activists understand how to talk to undecided voters about the Affordable Care Act (ACA)/ObamaCare. We encourage you to adapt the language to your own voice and personalize it with your own knowledge and experience.

For a PDF copy of Voicing Our Values—To Defend the Affordable Care Act, click here.

We should all understand the critical importance of persuading Americans that the Affordable Care Act is a success. The entire conservative philosophy is based on the idea that government cannot handle major challenges like quality, affordable health care for all. That is why right wingers are hysterical about the ACA and are willing to commit what seems like political suicide to prevent it from taking effect. Its success threatens to destroy their entire “government is the problem” narrative.

In the debate against these “repeal ObamaCare” extremists, keep two facts in mind:

  1. Persuadable voters know almost nothing about the ACA. Forty-two percent are unaware that the ACA is still the law of the land. Not coincidentally, Americans’ greatest source of information about it has been “friends and family”!
  2. Persuadable voters believe that the ACA is flawed and needs to be fixed. Only about 15 percent of voters would leave the law as-is. 25 percent would make “minor changes” and another 18 percent want “major changes.” (Remember, this is based on no real knowledge.) Only 36 percent want to repeal the ACA.

Say . . .

For years, our health care system was unfair. Insurance companies charged too much and their coverage was too full of holes. We needed a better system. The new health care law, called the Affordable Care Act, is intended to provide you and your family with the security of quality, affordable health care. For most Americans, the law has already strengthened your coverage—for example, now companies can’t kick you off coverage when you get seriously ill. The ACA isn’t perfect and we absolutely need to improve it. But it would be foolish to repeal it. Repeal would hurt you and your family by handing our health care system back to the insurance companies, allowing them to jack up rates, deny people coverage because of preexisting conditions, and drop coverage when someone gets sick. 

Why . . .

As we have explained before, start in agreement with your audience, use empathy, and express your values. Among persuadable voters, everyone will agree with these first three sentences. Then give a very brief explanation of the ACA, assuming your audience knows almost nothing.

Talk to people directly about their insurance. About 85 percent of Americans are insured, and among voters, 90 to 95 percent have health insurance. Persuadable voters are worried about their own coverage, not the uninsured. So focus on their concerns, not yours.

Make it clear that you recognize the ACA needs fixing and you will work to improve it. The Tea Party is preventing conservatives from saying they want to “fix” the law—their officeholders and candidates must embrace an unadulterated message of repeal. Reinforce that our side will do whatever it takes to make the ACA reforms work while our opponents will not. If asked what you would fix, this narrative polls very well:

Say . . .

So far, the ACA has cut what seniors spend on drugs, barred insurance companies from using pre-existing conditions, and helped young people stay on insurance. But there is a lot we need to fix. We need to make sure it is not a burden on small businesses, does not give insurance companies an excuse to raise rates, and we need to take even more steps to cut health care costs. 

Finally, be sure to reemphasize our strongest argument—we can’t put insurance companies back in charge. This narrative has been poll-tested and it works:

Say . . .

We must not put insurance companies back in charge of our health care, allowing them once again to deny coverage to people with pre-existing conditions, drop your coverage if you become sick, and impose lifetime limits.

And this one works: 

Say . . .

We must not put insurance companies back in charge of our health care, allowing them once again to discriminate against women by charging women higher rates than men, and by refusing to cover mammograms, screenings for cervical cancer, birth control, and other services.

And when progressives talk about the uninsured, this language works: 

Say . . .

We must not deny the security of health care coverage to 30 million hard-working Americans and their families earning less than $16,000 per year, including many female-headed families, children, and people with disabilities.

 

Don’t say . . .

Say . . .

Them

The poor, people in poverty

Give health insurance

You and your family

Hard-working Americans

Families, children, people with disabilities

Don’t deny the security of health care 

Why . . .

As we explain here, it is hard to move persuadable voters to support any policy that appears to benefit people other than themselves, their families, and their friends. So whenever possible, talk about how the ACA directly benefits your audience. When the conversation turns to the uninsured, avoid language about poverty because it evokes negative ideas about “welfare.” Say “hard-working” and “families, children and people with disabilities” because it suggests the recipients need and deserve basic medical coverage. And say “don’t deny them the security” instead of “give them the security” because persuadable voters are always more strongly moved by an argument about protecting people from being denied something than one about giving or providing that same right or benefit.

Right-wing argument: ObamaCare is a train wreck.

Say . . .

As you may know, right wingers have been doing everything possible to derail the Affordable Care Act from taking full effect on January 1. House Republicans actually voted more than 40 times to repeal the law and they shut down the government as part of that effort. The truth is, they know the law will work and everyone will see the benefits for themselves.

Right-wing argument: ObamaCare hasn’t helped Americans.

Say . . .

Actually, it has been a success. The ACA has provided millions of Americans free access to preventive services like check-ups and mammograms; slashed the costs that seniors pay for prescriptions; allowed millions of young adults to stay on their parents’ insurance; ended lifetime limits on coverage; and forced insurance companies to pay $1 billion in rebates to overcharged customers. In addition, a number of states are offering insurance at rates much lower­ than expected. The ACA will enable Americans to get the care they need, when they need it, at a price they can afford. It works! 

Right-wing argument: ObamaCare will increase health insurance costs. 

Say . . .

It’s the opposite; the law will save you money. As you know, health insurance companies have jacked up our premiums for years. The Affordable Care Act has many cost controls built into it, including a limit on the percentage that insurance companies can spend for overhead such as executive salaries and marketing. I think it’s pretty clear that if the ACA was repealed, and the insurance companies were put back in charge of our health care system, that’s when we’d be paying more. 

Right-wing argument: ObamaCare will increase the federal debt. 

Say . . .

It’s just the opposite. According to the nonpartisan Congressional Budget Office, the ACA reduces the deficit by $109 billion over the next 10 years and by more than $1 trillion over the following decade. The ACA is a very good deal for taxpayers. It works! 

Right-wing argument: ObamaCare’s Medicaid expansion will force states to raise taxes. 

Say . . .

In fact, states will save money by expanding Medicaid under the ACA. That’s because the savings from reducing services for the uninsured, like unreimbursed emergency room care, will exceed the costs. 

Right-wing argument: ObamaCare will drastically increase costs for young people.

Say . . .

Nonpartisan studies show that the law’s built-in subsidies make health insurance a good deal for young people. Loud cries of “rate shock” are just not true

Right-wing argument: ObamaCare cuts funds from Medicare, thereby hurting seniors. 

Say . . .

The Affordable Care Act prohibits cuts in guaranteed Medicare benefits. What it reduces is inefficiency, fraud and waste by private insurance companies that profit from Medicare. Saving this money has already strengthened the Medicare Trust Fund. The truth is, the ACA’s supporters are fighting to protect Medicare and the ACA’s opponents have been working for years to destroy Medicare by cutting benefits and privatizing the system. 

Right-wing argument: ObamaCare will cause employers to cut workers’ hours to less than 30 per week to avoid paying the mandate. 

Say . . .

First, the employer mandate has been delayed until 2015—there is plenty of time to address the concern that a few employers might be this unscrupulous. Second, this provision applies to only a tiny percentage of workers and studies show that it is extremely unlikely that the ACA would cause any real number of employees’ hours to be cut. 

Right-wing argument: ObamaCare will cause employers to stop offering health insurance. 

Say . . .

First, the employer mandate has been delayed until 2015—there is ample time to ensure this doesn't become a problem. Second, it applies only to large companies, so small businesses are not affected at all. Third, studies show that those large companies will continue to offer health coverage to their workers because they don’t want to lose talented employees. If they don’t get health insurance, the key employees are going to work someplace else. The best evidence is in Massachusetts where an employer mandate was implemented more than five years ago. The percentage of businesses offering insurance in Massachusetts did not decline, it increased. The law works.

Right-wing argument: Under ObamaCare, the IRS will have access to Americans’ confidential health records. 

Say . . .

This is completely false. It is one of a series of lies being told about the ACA—like “death panels.” The law’s opponents are trying to scare you for partisan political advantage. Don’t be scared. The Affordable Care Act is a good deal for you and your family. 

Right-wing argument: ObamaCare’s contraception policy violates freedom of religion. 

Say . . .

The law gives you and me the freedom to follow our own religious beliefs when it comes to contraception. Big corporations do not have any constitutional right to make religious decisions for employees—it is our freedom to decide religious issues for ourselves. Further, this policy has been in force for more than a year already and average Americans don’t have a problem with it. 

Right-wing argument: Under ObamaCare, young people can refuse to sign up now and just purchase health insurance when they need it. 

Say . . .

This is both false and dangerous. Just like private insurance, the ACA has an open enrollment period when Americans can sign up for health plans on the marketplace. Open enrollment runs until March 31. Young people risk financial ruin if they don’t sign up and end up in the hospital. Anyone who tells you that you should not enroll is interested in partisan politics, not what’s best for your health.

For a much more about how to talk about a wide variety of issues, see Voicing Our Values: A Message Guide for Candidates, which is available at www.progressivemajorityaction.org

Sources for more detailed information on the Affordable Care Act:

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