Why healthcare reform could work for Democrats now

Passing the healthcare bill may mean it's no longer weighing down Democrats -- and GOP repeal plans may help, too

Published March 23, 2010 11:01AM (EDT)

About six weeks before the November elections, insurance companies will be legally prohibited from dropping coverage for patients when they get sick. They'll be required to offer policies to children with preexisting medical conditions. Parents will be able to keep their kids on their own insurance until those kids turn 26. And lifetime caps on how much an insurance provider will pay for your care will go out the window.

All that will take effect six months after President Obama signs the healthcare reform bill into law -- which he's doing Tuesday morning at the White House, thanks to the House passage Sunday night of the landmark legislation. Many of the bill's changes to the healthcare system are years off -- but not all of them. Some of the most popular provisions in the legislation will be active far sooner, just in time for the elections.

Which is why some Democrats are practically begging Republicans to make repealing the healthcare law the centerpiece of the fall campaign, the way top GOP leaders have promised to do. Sure, polls now show voters are upset with the way the legislative process worked, and in some districts, they're really angry about it. But the legislation will probably never be as unpopular once it's law as it was when it was being endlessly debated. When no one from the federal government shows up to kill Granny the day after the law is enacted, after all, it's going to be a lot harder to scare people about "death panels."

"You saw it with the Republicans, when they passed the prescription drug plan," said Democratic pollster John Anzalone. "There was a net opposition when that was voted in, and then within six months -- way before any benefits started to accrue -- there was a net support for it ... [The healthcare bill] is never going to get any less popular. It only has room to improve."

Some of the opposition to the bill isn't even the kind of opposition the GOP is banking on in November. Thirteen percent of the people against the bill in a CNN poll out Monday said they thought it wasn't liberal enough; those voters aren't likely to get on board for repealing it. The same poll showed 51 percent of respondents trust President Obama to handle major changes in the healthcare system, compared to 39 percent who trust Republicans in Congress.

But the GOP is already revving up the repeal platform. Rep. Mark Kirk, the Republican candidate for Senate in Illinois, promised last week -- even before the bill passed -- to "lead the effort" to get rid of it. Not wanting to waste a moment, Rep. Michele Bachmann, R-Minn., introduced legislation Monday to repeal the bill; clocking in comfortably at under a page (in fact, only 75 words!), Bachmann's legislation is obviously far more American than the 2,074-page version the Democrats cooked up. Nearly 200 Republican candidates, and 49 GOP lawmakers, have already signed a pledge by the anti-tax Club for Growth to "rescue America from government-run healthcare."

Forget for a moment that repealing the bill next year would require Republicans to pick up 41 seats in the House to get a majority (possible, but not likely) and 19 seats in the Senate to get the repeal legislation past a filibuster (impossible, with only 16 Democratic-held seats up for grabs this fall), as well as do something about the guy in the White House who would veto the plan. It would also require the GOP to tell seniors they no longer get the $250 rebate, which they will get this year, to offset the Medicare prescription drug "donut hole"; convince small businesses to give up tax credits, also available this year, that offset up to 35 percent of the cost of healthcare premiums for their workers; persuade parents that insurance companies should be able to deny coverage for kids with preexisting conditions; and get everyone in the country on board with bringing back absurdly low annual limits on what insurance companies will pay for. Plus tell 30 million uninsured Americans that they won't be getting access to healthcare in a few years, as planned. All that might be a tough sell even at a tea party convention.

"It frames them as just an angry 'no' party," said Democratic strategist Chris Kofinis. "Repeal is not a solution to healthcare problems."

That's not to say Republicans will be playing defense this fall. Some Democrats -- like freshman Rep. Betsy Markey, of Colorado -- could well lose their seats because of the vote. And if the White House and key Democratic allies don't do a good job of explaining what the bill will do, voters will still listen to GOP attacks.

"I think it's comical that the Democrats think they can sell the benefits of healthcare reform only after the debate is over," said Republican strategist Alex Conant. "Remember, it's not as if this legislation was popular before all the backroom deals were made -- to the contrary, its unpopularity was why they needed to make the backroom deals! If they can't sell this when people are paying close attention, then how do they expect to sell it when people's attention shifts to the economy?"

Still, the White House isn't planning to sit back just because the House passed the bill. (For one thing, the Senate still needs to pass a budget reconciliation measure to amend the bill.) Obama will head to Iowa City, Iowa -- where he rolled out his healthcare policy in 2007, in the early days of the presidential campaign -- on Thursday, to talk about the bill's benefits. And aides say they're ready to defend it.

"If people want to campaign on taking tax cuts away from small businesses, taking assistance away from seniors getting prescription drugs, and want to take away a mother knowing that their child can't be discriminated against by an insurance company -- if that's the platform that others want to run on, taking that away from families and small businesses, then we'll have a robust campaign on that," press secretary Robert Gibbs said Monday.

By Mike Madden

Mike Madden is Salon's Washington correspondent. A complete listing of his articles is here. Follow him on Twitter here.

MORE FROM Mike Madden

Related Topics ------------------------------------------

2010 Elections Barack Obama Democratic Party Healthcare Reform Republican Party