The Obamacare repeal effort is just getting underway and already the political wordplay is dizzying. On the GOP side, the rhetoric has gone from “repeal and replace” to “insurance for everybody” to “repair and rebuild.” Meanwhile, Democrats continually warn that the Republicans are trying to “rip apart our health care system.”

To help you keep pace with the debate, we’ve assembled this handy glossary of buzzwords and talking points. Enjoy.

From the Republicans:

Repair and rebuild

This is the GOP’s attempt to describe its legislative strategy for Obamacare, and an evolution of the phrase “repeal and replace.” As Politico reported Thursday, it is the mantra of Oregon Representative Greg Walden, who is leading the offensive against Obamacare in the House. It is meant to soften the GOP’s tone and suggest the replacement effort will be carefully staged and surgical. It also opens the door to delay tactics if things don’t quickly shape up in the GOP’s favor.  

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We won’t pull the rug out

This is the GOP’s favorite metaphor. Congressman Tom Price, Trump’s pick to lead HHS, trotted it out this week at a courtesy hearing to offer assurance that Republicans will preserve access to health care. It’s a rhetorical bulwark against efforts by Democrats to portray the Republican plans as callous and catastrophic.

Insurance for everybody

That’s how President-elect Donald Trump described his plan to replace Obamacare to the Washington Post. Other Republicans have deliberately avoided making such a sweeping promise, and Trump himself has already walked it back. It stands as an example of how quickly rhetoric gets floated, seized upon, and then just as quickly jettisoned.

Universal access

This is the GOP term that emerged in mid-December to describe lawmakers’ ultimate destination for insurance coverage. Republicans are essentially promising to elevate the use of catastrophic coverage and other products to provide access to varying levels of coverage and different price points. But whether these plans will be affordable remains to be seen.

Obamacare only affects 7 percent of the market

GOP lawmakers use this talking point to downplay the consequences of repealing the health law. Most people get insurance through their employers, Medicare, or Medicaid, they point out. Individual coverage only represents a small fraction of the market. However, that 7 percent accounts for more than 15 million people, and many provisions of the Affordable Care Act apply to employer-sponsored plans as well.

We must eject the rampaging goat

In describing the negative impact of Obamacare, Representative Drew Ferguson, a Republican from Georgia, went where no one expected: a goat metaphor. Ferguson said the goat (Obamacare) “has been messin’ in and destroying my house” for six years. His conclusion? Well, he wants the goat out so he can clean up and renovate. The metaphor carries no special relevance, other than displaying the lengths to which lawmakers will go to make their point.

From the Democrats:

‘Make America Sick Again’

A play on Donald Trump’s campaign slogan, this phrase emerged in early January as Democrats held rallies to generate support for Obamacare. Judging by the nation’s $3.2 trillion tab for health care costs in 2015, a number expected to jump as high as $3.6 trillion this year, it seems clear a lot of us are pretty sick already. But you get the point.

You break it, you own it

This one dates back to just days after Trump’s victory; it’s an enduring mantra for Democrats. It is meant to back Republicans into a political corner, and make clear the GOP will take the blame for any bad fallout from tinkering with Obamacare.

Trumpcare

This portmanteau, an obvious take on Obamacare, was suggested by President Obama himself. It turns the tables on what has often been a pejorative way of describing the Affordable Care Act. It also suggests that, for good or for bad, Donald Trump will own whatever replacement plan emerges.

They want to rip apart our health care system

Democrats use this talking point as a rhetorical sword against GOP repeal plans. It is meant to stoke fear that Republicans will dismantle Obamacare without a clear plan to replace it, leaving millions in the lurch.

I can’t buy a $10 million house

Bernie Sanders deployed this metaphor to make the point that promising universal access to health care doesn’t mean everyone will, in fact, get health care. Or as he put it: “I have access to buying a $10 million home. I don’t have the money to do that.” Its intent is to portray the GOP as out of step with the insurance needs of average citizens.

#savemyhealthcare 

This is the Democrats’ favorite health-related Twitter hashtag, featuring testimonials of those who say the law has benefited them. There’s also #The27Percent, representing a group of Americans under 65 with preexisting conditions who are worried about losing coverage in a repeal.

Eliminating health care coverage for 32 million people

It is the Democratic statistic of the week and comes from a Congressional Budget Office report requested by Senate Minority Leader Charles Schumer. The CBO indeed estimated that the number of uninsured would rise to 32 million by 2026 if the ACA is repealed. Republicans say that’s meaningless because it doesn’t take into account a GOP replacement plan.

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  • The debate over repealing the ACA is literally on my mind day and night. How can the Republicans justify that the ACA was a failure? Like any other new program, some parts need adjusting. Repeating the mantra “Obamacare was a failure” does not make the mantra true. This repeal idea is predicated on a failure-hoax and, to my mind, it is simply proposed out of spite. Where did the spite come from?….action on the part of the President when the dithering Congress could not come to compromise. Let the spite and the anger on both sides of the question continue and they will eat us up. Jealousy, spite, retaliation lead to war between and amongst the elected officials while citizens suffer, not the elected officials. Is this how our culture dies?

  • First of all I believe the ACA should be fixed, not repealed. However, neither the ACA nor any other plan I’ve read about gets to the root cause of the rise in health care costs. Does anyone know? Have nonpartisan studies been done to find out what the causes are? If that’s not done, then there is no way to curb the costs. Even the ACA leaves it to the insurance industry to set pricing of the health care plans. If that continues, the cost of health care will continue to rise. After all, the insurance and medical industries are trying to make money for their stockholders…even if they are considered “nonprofits.” Has Statnews publish any studies regarding the causes of the rise in health care costs, and if so, where? Thanks.

    • Totally agree! I’d like to see thorough investigation of why health care costs in the US are so high (and keep rising) comparing to other developed countries. I think they need to follow the money. I wonder where all this money goes and what are the root causes of this low cost-effectiveness.

      * I work in a pharmaceutical industry but apparently it doesn’t go to my paycheck. 🙂

  • On 9/01/05, I gave input on the ACA to 3 aides, representing 2 Sr. Democratic Senators prepping for the 1900+ page ACA Bill. Remember that this was a typical Bill, with many proposals and money being set a side for things that had nothing to do with Health Care. I was worried, that I was speaking with aides, who had never worked in healthcare and I as I explained my experience and ideas, the comment was, “We didn’t know people were doing these things” and then I gave examples of Kaiser, Geisinger, and the hospital I worked in, etc. My focus was improving patient care/outcomes, measuring clinical outcomes and how we did it. I worried about how my discussion was being noted and how the abbreviated notes and discussion would be shared with these 2 Senators. What we need to realize as we work in healthcare and as users of healthcare, is that the ACA/Obamacare is and should be a continual work in progress, as every Bill should be evaluated, not just implemented and forgotten. If something doesn’t work, we need to change it. If it’s too expensive (which my daughter and many friends have said who have tried to enroll or have enrolled, we need to address it and with people that can explain it). There are parts of ACA that are working, so build off that after speaking to consumers who use it. Politicians have their own health care model, so they don’t know and there should be updates every 6-12 months on going, to measure effectiveness, concerns, cost, satisfaction, etc. We wouldn’t implement a program in our businesses and never go back and measure results, customer satisfaction, cost, ROI, etc. Repair/Evaluate, then continue to Build is the right approach. But, measure the impact of the changes on cost of healthcare, access, satisfaction, etc.

    • Fred Pane, your daughter and others who never tried to purchase insurance on their own will of course see the ACA payments as too expensive. I wanted to purchase insurance when I was young and relatively healthy and did not get the insurance through my employer and was surprised that it wasn’t even available at any cost. You could only purchase it through COBRA when you were let go from an employer. At least now there is an available outlet and people are given the lower cost given to group purchasers even though it is still high, it is better than nothing.

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