How The Upcoming Elections Might Shift The National Health Care Landscape

By Richard Knox

Here’s a solid prediction about next Tuesday’s elections: They’ll be crucial to the future of universal health care in America — or at least its near-term future.

For those who believe universal coverage is a good thing, prospects aren’t good, judging from an analysis of 27 national polls scoured by researchers at the Harvard School of Public Health.

Taken altogether, the polls show increasingly negative views of the four-year-old Affordable Care Act among likely Republican and independent voters. That could tip control of the U.S. Senate to the Republicans, enabling them to attack the ACA through the budgetary process — crippling it even if they can’t repeal it without President Obama’s signature.

In this March 23, 2010, file photo, President Obama signs the Affordable Care Act. (J. Scott Applewhite/AP)

In this March 23, 2010, file photo, President Obama signs the Affordable Care Act. (J. Scott Applewhite/AP)

Six states with too-close-to-call U.S. Senate races are unfriendly territory for the Affordable Care Act, the 2010 law that aims to insure nearly all Americans.

In contrast to Massachusetts — where 57 percent support the ACA — fewer than half the voters like the health care law in New Hampshire, Colorado, North Carolina, Louisiana, Kentucky and Arkansas.

“These are states where President Obama is very unpopular,” says study author Robert Blendon. “And Obamacare is not popular in those states.”

The problem, for the president and ACA supporters, is greatly worsened by low turnout. Fewer than 6 in 10 voters are expected to cast ballots, and the polls show likely voters are less inclined to support the ACA than the public at large.

“In a low-turnout election, the voters are disproportionately the core of either party,” Blendon says. “And views on what should happen with the ACA are very polarized” between the two major parties.

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Slate: Pelosi Won! An Alternative Perspective

Did Pelosi lose the battle and win the war?

Here’s a refreshing take on last week’s elections from William Saletan at Slate. He argues that passage of the health care law “is more important than the election,” and that while legislators may come and go, the new law, for the most part, is forever. It may not help when you listen to Tim Pawlenty rage about Obamacare, but it does widen the lens through which one can interpret last week’s vote:

In the national exit poll, voters were split on health care. Unemployment is at nearly 10 percent. Democrats lost a lot of seats that were never really theirs, and those who voted against the bill lost at a higher rate than did those who voted for it. But if health care did cost the party its majority, so what? The bill was more important than the election.

I realize that sounds crazy. We’ve become so obsessed with who wins or loses in politics that we’ve forgotten what the winning and losing are about. Partisans fixate on punishing their enemies in the next campaign. Reporters, in the name of objectivity, refuse to judge anything but the Election Day score card. Politicians rationalize their self-preservation by imagining themselves as dynasty builders. They think this is the big picture.

They’re wrong. The big picture isn’t about winning or keeping power. It’s about using it. I’ve made this argument before, but David Frum, the former speechwriter to President Bush, has made it better. In March, when Democrats secured enough votes to pass the bill, he castigated fellow conservatives who looked forward to punishing Pelosi and President Obama “with a big win in the November 2010 elections.” Frum observed:

Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now. … No illusions please: This bill will not be repealed. Even if Republicans scored a 1994 style landslide in November, how many votes could we muster to re-open the “doughnut hole” and charge seniors more for prescription drugs? How many votes to re-allow insurers to rescind policies when they discover a pre-existing condition? How many votes to banish 25 year olds from their parents’ insurance coverage?

Exactly. A party that loses a House seat can win it back two years later, as Republicans just proved. But a party that loses a legislative fight against a middle-class health care entitlement never restores the old order.

Take A Deep Breath — And Don’t Blame Health Reform

Voters are angry, but health reform is not to blame.

There’s a book my 4-year-old loves that’s called, When Sophie Gets Angry, Really, Really Angry about a little girl who explodes in a full-blown rage following a dispute with her sister.

Given some of the angry, CAPITAL-LETTERED comments on our post yesterday about health reform and the midterm elections, I’d like to urge readers to follow Sophie’s lead: calm down, take a deep breath, maybe a walk, and remember (this part isn’t in the book): the goal of health reform is to make people feel better, not raise their blood pressure.

The U.S. health reform law is not to blame for our current global economic travails, nor, more locally, for the spikes in insurance premiums, as Julie Rovner points out in her NPR piece yesterday.

For a little rationality and context, I suggest everyone read Hendrik Hertzberg in The New Yorker before Tuesday. His “Recession Election” piece makes the point that Barack Obama didn’t create the current economic mess with any particular policy, including health reform, but he is the target of voter anger nonetheless:

(Obama’s) supporters are worried, sometimes dispirited; his enemies are full of passionate intensity. The Republicans offer plenty of rage and resentment, but nothing of substance beyond fulminations about a deficit that their proposals — more and bigger tax cuts for the comfortable, the gutting of health care reform– would exacerbate. President Obama and the Democrats kept the Great Recession from becoming a second Great Depression. But the presense of pain is more keenly felt than the absense of agony.

Six Questions About Health Reform And The Midterm Elections

Midterm elections next week will likely have a huge impact on the future of health reform

Writing in The New England Journal of Medicine this week, Robert Blendon and John Benson, of the Harvard School of Public Health, look at the role that health care reform is playing in the run-up to the midterm elections next week from the perspective of voters. Analyzing the results of 17 different independent polls, they focused on six key questions (note: parenthetical remarks are mine):

1. What is the mood of the country at the time of the election? (Bad)

2. What’s the potential role of health care as a voting issue? (Don’t talk about it, and it’s fine.)

3. Does the public approve or disapprove of the current national health care reform legislation? (Disapprove, but they don’t necessarily get it)

4. What do voters want the next Congress to do about the legislation? (Just get them a job!)

5. What are the differences in views of the health care law between those voting Democratic and those voting Republican? (You have to ask?)

6. What are the implications for health care reform under Democratic or GOP control? (Very, very big, with very little overlap.)

Seriously, though, depending on how many seats Democrats lose, the implications could be massive, the authors conclude and even now, “the polling results suggest that there is considerable political uncertainty about the future of the health care law,” with such a deeply divided, and entrenched electorate. They write:

Even if the Republicans were to win control of one or both houses of Congress, they would not be able to repeal the health care law, because President Barack Obama would veto such a measure. What the Republicans in Congress could do, however, is to vote not to fund the substantial annual appropriations for implementation activities for the law. As part of an effort to reduce the deficit, the Republicans could also introduce budgetary bills that would scale down the size of future outlays for the law, affecting many of its current provisions.

On the other side, were the Democrats to increase their majorities in both houses of Congress, they would clearly continue the implementation of this major piece of legislation. At the same time, some Democrats are likely to introduce legislation to expand aspects of the federal government’s regulation of the health care sector and possibly to add a public option to compete with private health plans sometime in the future.

South Boston’s Lynch Wins Despite Opposing Health Overhaul

Politico.com reports:

Massachusetts Rep. Stephen Lynch decisively defeated former organized labor official Mac D’Alessandro, surviving a Democratic primary challenge that focused on his opposition to the health care bill.

D’Alessandro, who had the backing of liberal groups ranging from Moveon.org to Democracy for America to USAction, slammed Lynch for his no vote – and went so far as to cast the fourth-term South Boston lawmaker as a closet Republican. In one campaign mailer, D’Alessandro portrayed Lynch with elephant ears.

Initial reaction: Well, yes, health care reform is not popular enough that opposing it would be a liability — even in Massachusetts, or maybe especially in Massachusetts…

Read more: http://www.politico.com/news/stories/0910/42196.html#ixzz0zbIUrrrR