Replacing the ACA: What Women Want

Americans are angry about the manifest failure of Obamacare. Many have felt the impact directly, from the millions who lost their health plans after being promised they could keep them, to those facing sky-high deductibles and premiums, to those -- including some in the midst of cancer treatments -- who are losing access to their family doctors.

But at the same time, Americans want insurance that is secure and covers treatments they need. They want the uninsured and those with preexisting conditions to have access to coverage, and they know costs are rising dramatically. They know a safety net is needed for those who lose coverage, particularly those undergoing treatments for serious diseases.

Americans also know the uninsured, those on Medicare and Medicaid, and workers who have insurance through their jobs have different needs and require different solutions. And they know some ideas -- eliminating mandates on employers and individuals to give them greater flexibility, devolving power to the states when it comes to managing Medicaid, allowing patients to select their own coverage, cost transparency, and genuine competition on benefits and price -- show real promise.

Those who want to repeal and replace Obamacare need to understand what Americans -- and especially key demographics like politically independent women -- want from health-care policy. Toward that end, my organization, the Galen Institute, is conducting a series of focus groups, each comprising about a dozen women. We begin with a 20-minute summation of our ideas and goals, during which the participants communicate their response through "dial tests" in real time. Then the presenters go behind the two-way glass to watch as the moderator elicits feedback and reactions.

Women are very open to new ideas that could give them more choices when it comes to doctors, hospitals, and care. But the vein of compassion is strong, and our solutions will be buried if we don't show we care.

A young woman participating in the most recent focus group said she had had health insurance for her family through her husband's job, but "because of Obamacare," premiums soared: The policy's price tag rose from $400 to $900. The woman decided to keep her husband and children on the policy, but to go without herself. She's uninsured because of Obamacare, but -- and here is the most important message -- she said that's okay with her if it means a child with cancer now can get treatment who otherwise couldn't have. Most of the other women nodded in agreement.

These women understand the damage that Obamacare is doing, but they do not want to see people left behind. Talking of "repeal" alone won't work. If millions of people are getting health coverage now through Obamacare subsidies, our policies must have a safety net that continues to protect them.

We definitely have ideas to do that. People should be able to select the benefit packages that they want, not those they are forced by the government to buy. Americans would have a much broader choice of more affordable plans if there were genuine competition among health plans and insurers on benefits and price.

Health insurance should be portable so people don’t lose their policies when they lose or change jobs, and people should have guarantees that if they get sick, their premiums won’t soar.

Employers should have more, not less, flexibility to offer the coverage that suits their workers and their budgets without the threat of huge fines and penalties if they don’t comply with an avalanche of government regulations. And governors should be given more authority to structure their Medicaid programs to make sure their most vulnerable citizens have access to care.

A poll of voters in swing states taken by Public Opinion Strategies for Independent Women’s Voice found that 58 percent voters report that either they (21 percent), a member of their family (35 percent), or a friend (24 percent) have been affected by the ACA. Among the 58 percent who report an impact, negative impacts (60 percent) outnumber positive impacts (38 percent).

Voters will be looking for new solutions. But it doesn’t matter how right our policy ideas are if people don't understand them and if people don't think we care about how they have been harmed. Conservatives must explain our ideas in positive, human terms so people can see that freedom, not government, provides their ultimate security. Our ideas connect when we talk about the real needs of people, including the power of choice and competition to put the American people in charge of health reform that works for them.

Grace-Marie Turner is president of the Galen Institute, a think tank specializing in free-market ideas for health reform.