There’s a seeming paradox in the way Americans view the health care law that President Obama and the Democrats passed two years ago this month.
Most people tell pollsters they like the parts of the law that have gone into effect: health insurance for people with pre-existing conditions, a clause that allows children to stay on their parents’ health plans until the age of 26, and discounts for prescription drugs on Medicare. And, as time goes by, Americans seem less worried that the law will have a negative effect on their own medical care; in an AP-GfK poll released last week, most people said they expect their health care will stay pretty much the same – a big change from two years ago, when many expected dire consequences.
But the law itself isn’t any more popular than the day it passed. In that same poll, only 35 percent of respondents said they support the law; 47 percent said they oppose it. A USA Today/Gallup poll last month found the public closely divided on whether the law should be scrapped, with 47 percent in favor of repeal and 44 percent opposed.
Those are good numbers for Republicans. With persistence and skill, they have succeeded in convincing a big chunk of the public that the law amounts to a “government takeover” of health care and that it will send health care costs through the roof.
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For Obama, the numbers are at the least a disappointment, and they could make for serious trouble in November.
In the 2010 congressional elections, the health care law was a loser for many Democrats and a big motivational device for tea party Republicans. A team of political scientists including Brendan Nyhan of Dartmouth College recently estimated that the issue may have cost the Democrats as many as 25 House seats.
Obama is hoping that the passage of time – and the implementation of those early voter-friendly provisions – will make the law less toxic. For two years, the administration has waged a quiet campaign to promote the law, pointing out its modest successes while mostly avoiding the larger questions.
But it’s a debate Obama can’t duck forever.
On March 26, the U.S. Supreme Court is scheduled to begin hearing arguments over the law’s constitutionality, which will bring the issue back to center stage.
And the presidential campaign is certain to keep it there. Every Republican hopeful, including Mitt Romney, has promised to seek the law’s repeal, which makes health care one of the clearest lines dividing the Republican and Democratic candidates.
Obama already has been rehearsing his approach. When he’s speaking at Democratic fundraisers, he defends the law. Before more general audiences, he tends to focus on the perils of repeal.
“They (the Republicans) want to go back to the days when insurance companies could deny your coverage or jack up your rates whenever and however they pleased,” he told the United Auto Workers last month.
There’s one other tactic we can expect Obama to try. He will change the subject to health care issues where the Democrats have an advantage: the Republicans’ wildly unpopular Medicare plan.
Thus, the debate may end in a draw, with one helping Republicans and the other helping Democrats.
But it must be a bitter irony for the president that his greatest legislative achievement, a promise kept from his 2008 campaign, has become an albatross.