Obamacare

Obamacare Is Still A Liability for Democrats

As the midterm election approaches, promises to campaign on the Affordable Care Act remain unfulfilled.

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Remember when Democrats were going to run on Obamacare? In March of 2010, just a few days before the final version of the law passed in the House, a triumphant White House Communications Director Dan Pfeiffer told The New York Times that, "if and when this is passed, Democrats will run aggressively on this." The law would be a hit, well-liked and broadly popular, and Democrats would use it to their advantage.

The law passed, but the aggressive campaign never happened. Later that year, in fact, several Democrats ran ads against the health law.

Even still, Democrats kept promising that the pro-Obamacare campaigns were soon to come. In June of 2013, Politico reported that the party's 2014 strategy would be to "own Obamacare." With the coverage expansion in place, an anonymous senior Democratic official told Politico, Democrats would no longer have to run from the law. "In 2014, Democrats can talk about the positives," the official said.

The botched launch of the exchanges last fall torpedoed hopes of a big Democratic push on Obamacare. But Democratic leadership continued to insist that party legislators were sticking by the law. "Democrats stand tall in support of the Affordable Care Act," House Minority Leader Nancy Pelosi said in November, 2013, when asked how the health law would affect the midterms.

Pelosi could still be found playing up Democratic support for the law this year. "I'm very proud of our House Democrats and how they have not only embraced the Affordable Care Act, because they helped create it, but how proud they are of it," she said in March. Obama echoed the line a month later, saying that "Democrats should forcefully defend and be proud of" the law's accomplishments.

The reality? Just 36 percent of Democrats have voiced clear support for Obamacare this year, according to a Brookings Institution analysis. That's hardly standing tall.

Others have argued that Democratic support matters less because Obamacare has receded as an issue. Relative to last fall, when Obamacare's website failures and plan cancellations dominated the news cycle, that's not wrong. But "receded" does not mean "disappeared." 

The truth is that Obamacare has been a major issue all along, and Democrats have been on the defensive. Just this year, more than 160,000 political advertisements have aired attacking Obamacare. Less than 10,000 have run in favor of the law. That's how proud Democrats really are.

Obamacare remains a political liability for Democrats for a variety of reasons, including premiums. Overall the story on premiums is complicated, with benchmark plans dropping slightly, on average, but low-cost plans rising by 14 percent. Some of the bigger hikes, however, are in states with tight Senate races—Iowa, Louisiana, and Alaska.

Hundreds of thousands of health plan cancellations are on the way this year, thanks to the law, some delayed from last year. An analysis by Senate Republican staff recently found that Obamacare would eventually raise the deficit, contrary to a key claim made by the law's supporters at passage.

And the law's Medicare cuts, which it relies on to fund part of its coverage expansion, remain controversial as well, and Democrats have tried to distance themselves. Sen. Jeanne Shaheen (D-N.H.) and other Democratic candidates have attempted to claim that the law does not cut Medicare. But that's not how the law was designed (although it's likely that not all of the cuts that the law calls for will go actually into effect).

Even the coverage expansion has not helped Democrats: Some 27 percent of Americans believe the law has hurt them or their families, according to Gallup, up 19 percent since the beginning of the year, when the law's major coverage expansion provisions kicked in. A majority don't think the law has had much effect one way or the other.

Democrats cannot run on Obamacare, but most can't quite run outright campaigns against it either. Instead, they have settled on a fence-straddling approach—praising the popular elements but insisting that the law needs to be fixed.

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Unlike Obamacare itself, the strategy has the virtue of majority public support. Polls consistently show that, given the choice to repeal, fix, or keep the law as is, about sixty percent of Americans would prefer to fix the law.

The problem for Democrats is that, despite their pledges to fix the law, they have offered little in the way of meaningful tweaks. As The Washington Examiner's Byron York noted last week, when Shaheen was asked in a debate about her ideas, she the only proposal she could name was a committee to study website problems. It was all but an admission that she had no fixes.

Somewhat more substantive is the proposal from Sens. Mark Warner (D-Va.) and Mark Begich (D-Alaska) to add a lower tier of less expensive plans to the system. The basic concept of expanding the range of available products on the exchanges is not without merit, but this version would come with problems. As Ramesh Ponnuru notes, it would create a less expensive insurance product focused on covering routine expenses—exactly the kind of insurance we should want to discourage. That low-cost option, meanwhile, would attract healthy people, and could destabilize existing coverage.

In the larger scheme, though, this hardly matters. The fix-it strategy is not actually intended to fix Obamacare. It is a rhetorical ploy intended to voice support for the parts that people like while opposing the parts that people don't. It is a new take on an old line. Democrats have long noted that many parts of the law are popular, and hoped that this would eventually build public support for the law. The problem, as always, is that Obamacare's various mechanisms interlock in such a way that they cannot be easily separated. 

Republicans are finding this out too, of course, and being tripped up by it. Last week, Ohio's Republican Governor, John Kasich, argued that the Medicaid expansion funded by the law was not "really connected to Obamacare." Kentucky Senator Mitch McConnell has, only slightly more plausibly, attempted to claim the same about the state's Obamacare-funded health exchange. This will increasingly become a problem for Republicans.

But right now it is mostly a problem for Democrats, who for more than four years have hoped to campaign on Obamacare and its self-evident virtues. But those virtues never materialized—and, as a result, neither have the campaigns.