A crucial component of the Republican Party's assault on the Affordable Care Act always has been ignorance--that is, the promotion of ignorance about the ACA's benefits among the general population.
Now, from the consulting firm McKinsey & Co., comes hard evidence that the campaign worked, bigtime. In its latest national survey to determine how the healthcare reform act has been working, McKinsey found that the perceived cost of health insurance still was the No. 1 reason given by respondents for not enrolling.
Here's the stunning discovery: "About 90 percent of all those citing perceived affordability challenges were subsidy-eligible, and among these subsidy-eligible respondents, awareness of the subsidies has remained low." About two-thirds of the respondents who were subsidy-eligible but didn't sign up for health insurance were unaware of their eligibility.
McKinsey has reported before that awareness of the financial assistance available under Obamacare made a big difference, and its latest survey reinforces that finding: Among the previously uninsured, those who knew about the subsidies were almost three times as likely to have enrolled as those who didn't know.
Who's responsible for this low level of knowledge? As Jonathan Cohn acknowledges, "the administration deserves some blame for this shortfall" in information. However, he adds, "(the ACA's) adversaries deserve more."
Not since Alf Landon ran for president in 1936 by slandering Social Security--with the assistance of Big Business--has a major party done so much to undermine a duly passed and Supreme Court-endorsed law of the land. (Landon lost in a landslide to Franklin Roosevelt, Social Security's godfather, which should give his GOP heirs some pause.)
The GOP's campaign to keep its constituents in the dark about the benefits of the Affordable Care Act has been unrelenting. It has encompassed overheated rhetoric, disinformation, outright lies and intimidation. It has been waged at the federal and state levels.
And it has been unapologetic. Remember the public effort by GOP Sens. Mitch McConnell and John Cornyn to warn the National Football League not to help the government reach out to the act's beneficiaries? They advised the NFL not to "take sides" in a "polarized public debate," smoothly glossing over the fact that they were the chief polarizers.
The NFL, which had happily lent its name from everything from the United Way to the Susan G. Komen breast cancer campaign, decided in this case that "courage" meant that it should sit down and shut up.
Have you heard of any another case in which elected government officials actively discouraged citizens from learning about a government benefit program? Me neither. The McKinsey findings show what the harvest has been. As media consultant and blogger Andrew Sprung observes, "Those who deliberately spread disinformation about the ACA and actively encouraged the uninsured to remain in that blessed state of freedom can be really proud of themselves."