Figuring out the political implications of the healthcare victory

Both parties think they'll benefit from the new bill in the midterm elections


Joshua Tucker
March 22, 2010 6:23PM (UTC)

By now, anyone who follows politics closely knows that yesterday the House finally passed healthcare reform. I'll leave it to healthcare professionals and economists to explain the economic implications of the bill, but I want to take a stab here at the political implications of the bill. In general, I have been skeptical that passing healthcare reform would be any worse for the political fortunes of the Democratic Party in 2010 than not passing healthcare reform at this point (see here and here). Thus the following two pieces in the blogosphere caught my attention yesterday. The first was arguably the oddest headline I came across, which I found on Politico:

House Republicans Begin Victory Lap

Odd because this was not exactly what one expects to see after a party suffers a major defeat on a landmark piece of legislation. But of course the piece was about the now familiar story that healthcare reform would lead to huge Republican victories in the fall. Thus it was with great interest that I read the following piece from conservative blogger David Frum entitled Waterloo:

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Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s. It’s hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections. But:

(1) It’s a good bet that conservatives are over-optimistic about November – by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs.

(2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now.

Interestingly, Frum seemed to be picking up on exactly what I, and others, have been arguing (see here, here and here): the midterm elections in 2010 are likely above all else to be a function of the state of the economy, which, as Frum notes, may actually be looking better by November.

They will also, as John has noted, be a function of President Obama’s approval ratings, which have held relatively steady at around 50 percent for months, despite all the supposed angst in the country since then over healthcare reform. And, if President Clinton is correct, they may be going up now that healthcare reform has passed.

Meanwhile, let me take one last crack at interpreting the latest polls on support for healthcare reform. According to the most recent Gallup poll, as of early March, 48 percent of Americans wanted their representative in Congress to oppose the healthcare reform plan, 45 percent wanted their representative to support it, and 7 percent didn’t know their opinion. (That's worth noting again: as of early March, opposition to healthcare reform was running at 3 percent higher than support, or within the margin of error of the poll. So this was hardly a case where one party spoke for the people and another did not.) Let me posit one assumption: some fraction of that 48 percent that opposed the plan did so because they favored including either a public option or a single-payer system: in other words, they wanted reform to move healthcare policy further to the left than it actually did. I don’t know (does anyone?) what proportion of that 48 percent this is, but it surely is not zero. Let’s call this faction the "dissatisfied left." So with that in mind, let’s forget the economy, incumbency effects, etc. and pretend for a moment that the 2010 elections will be contested purely as a retrospective vote on healthcare reform:

  • Best case scenario for Republicans in 2010 : the dissatisfied left stays home (they are obviously not going to vote for Republicans), the remaining opponents of healthcare line up solidly behind Republicans, and a non-trivial proportion of these healthcare opponents turn out to be people who previously voted Democratic (or stayed home) and are disproportionately concentrated in swing districts in House races.
  • Worst case scenario for the Republicans in 2010: the dissatisfied left is energized by fact that Obama actually managed to pass a major piece of social legislation and/or the Republican response to the healthcare debate, turns out to be a non-trivial proportion of the 48 percent the oppose healthcare, and the remaining opponents of healthcare are simply Republicans who never voted for a Democrat in the past or never would have under any scenario in the future, and tend to be over-represented in heavily Republican districts.

Again, personally I think most of what we know about midterm elections in the U.S. suggests that the elections will not purely be a retrospective vote on a policy issue and instead will be a function of economic conditions and presidential approval, but even so, it is interesting to consider which of these scenarios is more likely to unfold.

Let the political implications of healthcare reform debate begin!

[Hat tip to Ben Smith at Politico for the Clinton reference.]

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Joshua A. Tucker is Associate Professor of Politics at New York University and a Truman National Security Fellow. The original version of this post appears on the Monkey Cage.


Joshua Tucker

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2010 Elections Healthcare Reform



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