Why has GOP found health care law such a potent weapon?

McClatchy NewspapersOctober 27, 2010 

WASHINGTON — The specter of "Obamacare" has become a powerful weapon for Republicans this campaign season, as the GOP uses the new health care law as its favorite symbol of big government gone amok.

"Health care reform is the signature accomplishment of the Obama administration," said Republican strategist Neil Newhouse. "For a lot of people, it epitomizes big government and wasteful spending. It's everything they hate about government rolled into one."

The message appears to be resonating, even though polls repeatedly show people like many provisions of the new health care law.

Nevertheless, the "Pledge to America," the House Republicans' book of promises, gets right to the point:

"We now know the new health care law will mean more financial pain for seniors, families and the federal government," it says, and urges repeal of the landmark law President Barack Obama signed seven months ago.

The law, the biggest changes to the health care system since Medicare was created 45 years ago, will require most people to get coverage by 2014. Republicans oppose such sweeping mandates and are challenging them in court.

Ads backing GOP candidates paint the law as emblematic of an out-of-control bureaucracy.

RevereAmerica, a group chaired by former New York Republican Gov. George Pataki, is running ads such as the one aimed at a New Hampshire congressional candidate:

"Liberal Democrat Ann McLane Kuster supports Obamacare. It's a bad plan and should be repealed and replaced, but Kuster supports it anyway."

Such ads are popping up in close races everywhere, even though polls have found people like some of the new law's individual pieces.

A McClatchy-Ipsos survey July 9-13 found that 70 percent want the government to order businesses to offer coverage to employees and 69 percent backed mandates for individuals. And a Bloomberg National Poll Oct. 7-10 found similarly strong support for requiring insurers to accept people with pre-existing conditions, eliminating lifetime caps on coverage and other provisions.

However, people recoil at the enormity and scope of the changes. A Pew Research/National Journal poll conducted Oct. 21-24 found that people favored repeal by a 49 percent to 39 percent margin.

The Bloomberg survey found people favored repeal by a 47 percent to 42 percent margin.

An analysis from the Kaiser Family Foundation found that while roughly half of the public holds a negative view of the health care law, they waver when they realize that some of the law's more popular provisions would be part of such a repeal.

Democrats are fighting back by pointing out some of the law's more popular provisions already have taken effect and are unlikely to be repealed. They also say the law is largely misunderstood, and as people become familiar with it, the opposition will cool.

Obama has an almost standard line in his stump speeches as he travels the nation campaigning for Democrats.

"Why would we go back to the health care policies that they believe in, where insurance companies could drop your insurance when you get sick?" he asks audiences. "Why would we put those folks back in the driver's seat?"

Among the provisions taking effect this year: A program for people with pre-existing conditions who have been uninsured at least six months, allowing young adults to stay on their parents' policies up to age 26, and barring health plans from placing lifetime limits on coverage and denying people coverage when they get sick. Also, $250 rebates are available to certain Medicare prescription drug beneficiaries.

Experts think such provisions are safe.

"You're going to ask seniors to send back $250, or tell a 25-year-old he's without health insurance next month?" asked Timothy Jost, a health law expert at Washington and Lee University in Lexington, Va. "That's pretty unlikely."

Even some Republicans concede that a full-scale repeal isn't likely, particularly since Obama would oppose it. Should a Republican president take office in 2013, more provisions will have become law by then, including more benefits for Medicare recipients and grants to small employers who create wellness programs.

"From a medical standpoint, the entire bill isn't bad," said Republican Joe Heck, a physician locked in a tight race for the seat in Nevada's 3rd Congressional District.

However, he said, there are changes that could be made, notably medical malpractice changes, a major part of the GOP pledge.

The pledge promises to make it illegal for insurers to deny anyone coverage because of pre-existing conditions, eliminate lifetime or annual spending caps and bar insurers from dropping coverage because of illness.

"We will incentivize states to develop innovative programs that lower premiums and reduce the number of uninsured Americans," it promises, and make it easier to buy coverage across state lines.

While voters are often hard-pressed to discuss the intricacies of the new law, many know they don't like it.

"The government should be governing. It should not be in this business," said John Pauley, a Wilmington, Del., contractor.

"That health care bill was written at the last minute, behind closed doors, and when it was debated, nobody listened," complained Rich Crain, a retired Mesquite, Nev., mortgage broker.

It's the Republican message, and it's become a familiar campaign mantra.

"There are so many things people have heard, so many things they think are true," said Jost of Washington and Lee. "It's very hard to fight this."

ON THE WEB

Kaiser Family Foundation analysis of public views of repeal

Health care law implementation timeline

Timothy Jost's health care blog

RevereAmerica website

Pledge to America

Bloomberg National Poll

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