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Andrew Yamakawa Elrod interviews Gabriel Winant in Phenomenal World:

Andrew Elrod: The health insurance issue seems conspicuously absent from the election. What do you make of that?

Gabriel Winant: In some ways, both parties would find it convenient for the issue to be absent. But despite their efforts—partly to suppress it and partly to express subsections of the issue opportunistically—the social service industries nonetheless have a way of working themselves back toward the surface.

Just a few examples: JD Vance has talked about repealing Obamacare, without acknowledging that’s what he’s talking about. He’s floated the idea of separating more acute, sicker healthcare subscribers into their own insurance pools—which would basically repeal Obamacare’s pre-existing conditions regulation. But when pressed, he denies it, which is symptomatic of the general way that Republicans can’t generate a coherent popular line on healthcare. That arises from the pathologies of the sector itself. Republicans learned their lesson on Obamacare. It was politically remunerative to them for years to campaign against Obamacare when it was unpopular. The turning point was the struggle over “repeal and replace” in 2017—public opinion had changed. Enough people had become enrolled in Medicaid through its higher income eligibility and in other plans through the subsidies for the exchanges that Republicans can no longer actually campaign against it openly. They may translate it into questions about gender-affirming care or reproductive care—which is also a way of talking about it without talking about it. But unlike before, they’re not campaigning on private “health savings plans.”

The Democrats have a different problem: they’re accountable to conflicting constituencies, one of whom is the master, one of whom is not. If there were a primary process, the politically weaker left wing of the party would have had a chance to assert itself and extract some symbolic concessions, given the popularity of lowering healthcare premiums, rolling back hospital prices, and expanding Medicare and Medicaid coverage as voting issues. Harris would now be trying to back away from certain political concessions to the left.

More here.

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