Why We Have Never Called the Affordable Care Act "Obamacare"

Back in December, a few members of our editorial team met over lunch to re-evaluate a few of our style rules. These are the small language, grammar and punctuation choices we mandate at Becker's. Few, if any, of these rules are of great concern to the broader public, but as word nerds, we discuss these decisions with utmost zeal.

We decided to make a couple of changes over that lunch. We switched our style from "payor" to "payer," a transition so subtle many readers may not have even noticed. Healthcare was kept as one word. We refused to adopt an Oxford comma, much to the dismay of our finance editor.

And then one question on the agenda made us pause a little longer: Should we start calling the healthcare reform law the Affordable Care Act or Obamacare?  

Becker's Hospital Review has used only one term for the healthcare reform law since day one: the Patient Protection and Affordable Care Act. It's a mouthful, sure. But we decided on it for a few reasons, all of which we stuck to when revisiting our decision in December.

Since most of our readers are hospital and health system executives, we tend to use a more formal voice in our writing. Referring to the law by its full name fit with that standard. Plus, our editorial team thought "Obamacare" was too politicized. Mitt Romney was the first politician to use the term during the 2007 presidential primaries. Needless to say, "Obamacare" was not used to drive an objective discussion at that time. Five years later, in a sign of embrace, the president himself began saying the term during his re-election campaign. This might suggest the term had matured on Capitol Hill, but even bipartisan usage hasn't fully erased its oppositional undertones. It remains politically charged.

So we stuck with the Patient Protection and Affordable Care Act, or the PPACA for short. It's not as grabby, fun or quick-to-type as Obamacare. It may have tangled our search engine optimization or placement on Google search results (since we've never used "Obamacare" in our reporting, I'm unable to compare or say that with certainty). But looking back, I'm glad we stuck with the official title and didn't help drive use of "Obamacare," which seems to be driving some erroneous thinking among the public.

A wince-inducing clip from "Jimmy Kimmel Live" went viral this week. In "man-on-the-street" interviews, several people talk about the Affordable Care Act and Obamacare as if they're different laws. What's worse? The names seem to have different connotations, as the majority of people expressed support for the Affordable Care Act while lambasting Obamacare.

I've heard the term Obamacare from all sides — friends who are nurses and work in hospitals, executives, newscasters and lawmakers. You'd think a term this widely used wouldn't be so misunderstood, but this particular law has a way of shooting holes in these types of good-natured assumptions. (Perhaps you remember CNN's big flop when announcing the Supreme Court ruling in July 2012. Or how 44 percent of Americans were unsure whether the PPACA was a law in August 2013.)

Obamacare isn't even used correctly, at times. Oct. 1 brought on headlines like: "How to sign up for Obamacare." What? Sign up for a law? Oh, sign up for coverage under the health insurance exchanges created by the Affordable Care Act, you mean! Using Obamacare interchangeably when referring to the law and the health insurance marketplaces might explain why 57 percent of people mistakenly thought the PPACA created a new government-run health plan, or "public option," to be offered along with private plans, according to a Kaiser poll from March.

I'm proud of our magazine's decision to stick to the official name, and I'd like to see other media outlets and influential communicators reign in their unfettered use of "Obamacare." The term has taken on a life of its own, and I'm not sure when that happened. Maybe it was doomed to misperception from the start. Or maybe the media should have spent more time and effort, in the very beginning, explaining Obamacare is simply a nickname for the healthcare reform law — not a bill, not an insurance exchange and not a different version of the Affordable Care Act.

I'm surprised with The Associated Press. Its Stylebook, the authoritative manual for most all communications professionals, lacks an entry and style rule on what to call the healthcare reform law. Given the gaping schisms in public understanding and usage, I'd say it's time to set things straight and ensure the media is equipping readers with accurate terms and definitions to drive discussions.

Just as the AP Stylebook included a rule for journalists to stop using the term "illegal immigrant" in 2013, I hope the 2014 edition includes a similar note about Obamacare, bringing an end to what has become a linguistic nightmare.

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