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.