To kick off Homecoming/Family Weekend the University hosted a panel on healthcare reform in the Powell Family Cinema last Friday, Nov. 1. The event, hosted by Assistant Professor of Government Erika Franklin Fowler and Assistant Professor of Economics Damien Sheehan-Connor, featured healthcare policy experts Don H. Taylor Jr., Austin Frakt, and Sarah Gollust, who discussed the Affordable Care Act (ACA).

The seminar opened with a clip from the late-night show Jimmy Kimmel Live! in which strangers were asked which they preferred, the Affordable Care Act or Obamacare. Without understanding that these two policies are one and the same, most interviewees chose the Affordable Care Act, resenting Obamacare for being “forceful,” “anti-American,” and “socialist.” The comedic clip set the stage for the panelists’ discussion of perceptions and effects of the law.

Each panelist presented a short speech on the ACA and afterward John Dankosky, News Director of WNPR, a Connecticut radio station, hosted a question-and-answer session.

One of the panelists, Sarah Gollust, Assistant Professor of Public Health Administration and Policy at the University of Minnesota School of Public Health, focused on the public opinion of the law.

“The gap between Democrats who favor the law and Republicans is about fifty percentage points,” Gollust said. “These are really stark and stable divides that have continued since the law has passed…. The opinions of experts and elites have been divided since the beginning, so there’s no shortage of views the public can rely on. If someone calls them up and ask if they favor or oppose health reform, as Jimmy Kimmel did, people kind of have a sense of who’s on either side. These are the heuristics that they use to come to their decision.”

Gollust stressed that the media has played a major role in covering the law, yet has not done much to shape public opinion of the law.

“We’ve seen for three and a half years media coverage of this law and what it’s supposed to do, and yet the proportion of people who don’t know and don’t have an opinion has stayed flat or even grown a little bit,” Gollust said. “When the law was passed, there were about 10 percent or 12 percent who said they didn’t have an opinion, and now we’re seeing about 20 percent don’t have an opinion of the law.”

Austin Frakt, an associate Professor of Health Policy and Management at Boston University School of Medicine, addressed concerns during the question-and-answer period that the ACA actually made healthcare less affordable for some people.

“The Affordable Care Act is at least a step in the right direction to making it more affordable,” Frakt said. “There will be no shortage of people the media can find or that you can find who will say my premiums are going up, this plan I’m forced to buy is more expensive. Those are anecdotes, and they’re real, but they’re not the entirety. Everyone’s experience is going to be different.”

Don H. Taylor, Jr., an associate professor at Duke University’s Sanford School of Public Policy and Duke Medical Center, addressed the role that partisanship and politics had on getting health reform to work.

“We’re at a difficult point, but I think we’ve got to see the policy through,” Taylor said. “Eventually, we need a political view that allows somehow for health reform and health policy, to focus on the policy. It’s always going to be political, but it needs to go at least [on the] back burner a bit if we’re ever going to do the hardest things.”

Taylor began his presentation with a question: he asked the audience how they wanted their children or their grandchildren to get health insurance, establishing the idea that the ACA was only the beginning of healthcare reform.

Taylor then focused the remainder of his speech on the Supreme Court’s ruling on the ACA and its ramifications.

“The Supreme Court decision in 2012 was a really big one,” Taylor said. “I think no one predicted what would happen. Essentially the individual mandate was allowed to stand, but the Medicaid expansion became voluntary.”

As a result of the Supreme Court decision, some states have chosen not to expand Medicaid benefits. In 2016, states expanding Medicaid are receiving a total of around $30 billion from the federal government, while states refusing Medicaid expansion are forgoing close to $35 billion of government-provided healthcare. Taylor discussed the ramifications of opting out of Medicaid expansion.

“This is really a tremendous redistribution from mostly poor, mostly red states to mostly wealthy, mostly blue states,” Taylor said. “With the Supreme Court decision it really has allowed states to sit out a large part of the ACA. We now have to work harder to move health reform ahead because so much of the ACA is being thwarted.”

The choice by many states to opt out of Medicaid funding, enabled by the Supreme Court decision, perturbed attendee Alison Mann ’17.

“Learning how all these red states, particularly in the south, that are basically turning down money from the federal government because their representatives don’t support the ACA was especially interesting,” Mann said. “They’re really disadvantaging their own people.”

The pervading theme behind Taylor’s speech, as well as the rest of the panel, was that the ACA is only the beginning of widespread healthcare reform. Taylor offered his solution to the healthcare reform debate, in contrast to the Supreme Court decision.

“If you think about it the other way around, what if the individual mandate had been struck down and the Medicaid expansion had been allowed to go forward as is, and the rest of the Affordable Care Act fell away?” Taylor said. “In one sense, within a year or two we would have a universal insurance coverage up to 133 percent of the poverty level…. You could argue that would have been a better place to end up than what we have ended up with.”

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