Terri Lynn Land during a Michigan Political Leadership Program in Livonia, Mich, March 6, 2014.
Jose Juarez/AP Photo

Michigan’s Land shows how not to talk about healthcare

Updated
The leading Republican candidate in Michigan’s open U.S. Senate race is Terri Lynn Land, a former member of the Republican National Committee, and by all appearances, she’s running a competitive race.
 
That’ll likely remain true so long as no one asks her or her staff anything about health care policy.
 
Last month, for example, Land called for the total repeal of the Affordable Care Act, while also endorsing Medicaid expansion under the Affordable Care Act. After having a few weeks to think about that, she added yesterday that “Obamacare does not work” and Medicaid expansion, as endorsed by Michigan’s Republican governor, is “what’s best for Michigan families.”
 
I can’t find anyone who understands what this position is supposed to mean.
 
Occasionally, however, a candidate is easily confused by policy details, and to get a better sense of his or her policy vision, we must turn to a candidate’s staffers who can offer more depth. This week, for example, the Land campaign held a conference call with reporters to mark the fourth anniversary of the ACA, and fielded a question about what happens to those with preexisting conditions if Land is elected and her party successfully repeals the law. A spokesperson for the candidate told reporters:
“The problem with Obamacare is that it allows people to wait until they’re very sick to purchase insurance, which creates significant and unknown risks to insurers and then the insurance companies would pass that cost on to consumers. So the way that Terri’s plan, and then this can be on the record, the way that Terri’s plan addresses preexisting conditions is continuous coverage and portability.”
As a substantive matter, this is gibberish. The Land campaign organized a conference call to talk about health care policy but never got around to learning some of the basics about health care policy.
 
And that’s a problem.
 
Brian Beutler made the case that the Land campaign isn’t just wrong; it’s pushing a line that’s “potentially dangerous.”
It’s true that the ACA requires insurers to sell to all eligible beneficiaries, regardless of their health status, and prohibits them from charging sick people more than healthy people. Anyone who’s shopped on the exchange should have noticed that, because of these provisions, the application contains no medical underwriting. But the law also establishes annual open-enrollment periods. The one we’re in now is an unusually long six months, but future open-enrollment periods will be significantly shorter. And unless you happen to get sick during an open enrollment period, you can’t just wait to get sick to enroll. Anyone who decides to skip Obamacare, and then gets sick or injured in April, will be on the hook until Nov. 15, when the open enrollment period for coverage starting in 2015 begins.
 
Land’s ideas, by contrast, would guarantee coverage for people who have insurance and sick people who can afford it, but would lock people who allow their coverage to lapse, even if for financial reasons, and those who can’t afford it in the first place, out of the system permanently.
If the Republican candidate wants to defend her position, great. If she wants to explain why she wants to repeal the Affordable Care Act, she’s welcome to make her pitch.
 
But in this case, Terri Lynn Land doesn’t seem prepared to do either.
 

Affordable Care Act, Michigan and Obamacare

Michigan's Land shows how not to talk about healthcare

Updated