Why President Obama Is Doubling Down On Health Care
The Supreme Court is forcing his hand, and the contraception debate offers a political opening. But the legislation is still unpopular, and Republicans say they welcome the debate.
President Obama’s re-election campaign has launched an all-out defense of his landmark, and unpopular, health care overhaul, a move that marks a realization: The issue can’t be avoided.
President Obama’s aides promised Democrats they’d be rewarded in the 2010 midterms for what supporters call the Affordable Care Act and detractors label “ObamaCare.” When they were instead, as Obama said, shellacked in midterms, the White House sought repeatedly to change the subject and “pivoted” several times to the issue of jobs.
But a series of recent moves make clear that health care is back. An Obama campaign official told BuzzFeed the renewed focus is tied to the second anniversary of the health care bill later this week, but it’s also the product of necessity, and opportunity. The Supreme Court will hear arguments this week on the constitutionality of the individual mandate, forcing the legislation into the national conversation, and will rule on it in June. But in the debate over contraception this winter, the White House also sees an opportunity to rebrand the battle over the legislation as part of the “war on women” it accused Republicans of waging.
“The White House knows that they can’t run away from health care,” said former Clinton pollster Doug Schoen, a frequent Obama critic. ”Even if the bill remains unpopular as it does, they at least need to rally their core constituency to support it.”
The sheer complexity of legislation that began to take effect almost immediately, but whose most sweeping provisions don’t even begin this year, has offered Obama no real chance to put the issue in the past, or even to make a clear case for its success.
“The fact is, no Democrat, and especially the president, can avoid the debate. So it's time, past time, to re-engage and make our case as best we can,” said Jim Jordan, a Democratic consultant.
The White House initially made a series of arguments for the legislation: They suggested it would stop the growth in costs, that it is a solution to the economic crisis, and — most obviously — that it will expand the number of Americans who have health care.
The new case, though, is less factual, and more emotional. It emerged first in the 17-minute “documentary” the campaign released last week, narrated by Tom Hanks.
There, the president described what he said was his motive in pushing the legislation through over mounting opposition: The memory of his mother’s cancer, and her battles with insurance companies in her final years and months.
"Watching your mother die of something that could've been prevented, I don't think he wants to see anyone go through that," First Lady Michelle Obama adds, as the film cuts to a photograph of a young Obama with his mother.
Fully three-minutes of a film that covers the first four years of the Obama presidency is devoted to health care reform.
The campaign also commissioned a pair of “Face of Change” videos portraying ordinary Americans helped by the reform bill. One includes a North Carolina mother, Rebecca Freiert, retelling the story of having to reduce her infant son’s insurance coverage in the face of a $100 premium hike, which the Affordable Care Act reversed.
"Before the Affordable Care Act I felt totally helpless and I now feel like there's somebody looking out for us,” Freiert says in the video. “I'm very grateful that the President fought for health care reform."
The campaign has also returned to using the health care legislation — barely mentioned in two years in the mass emails that are its primary means of communications with supporters — to rally Obama’s base. In an email on Saturday, the campaign asked supporters to help “tell the story of health care reform” by sharing personal videos about what the Affordable Care Act has done for them.
“Folks are starting to see the real-life impact of reform,” says the email, signed by Obama’s deputy campaign manager, Jen O'Malley Dillon, going on to enumerate changes in the recipient’s home state: The number of people who no longer have a lifetime limit on coverage, the number of women who have expanded coverage for preventative services like mammograms, the expansion in free preventative care, and the number of young people able to stay longer on their parents’ insurance.
The return to health care has won a warm welcome from liberals who blame the White House for failing to sell the bill energetically enough in the first place.
“Polling shows that while people don't understand the overall law, as you explain each individual benefit people support it,” said Eddie Vale, the communications director for the progressive health care group Protect Your Care, formed to defend the law. “In the short term the Republicans have really overreached on trying to end Medicare and taking away contraception and that's given us a huge opportunity to go on offense on those issues and use them to defend the overall law.”
There is, however, an underlying political reality: The legislation remains as deeply unpopular as when it passed. Only 35 percent of Americans support the bill, according to an Associated Press poll earlier this month; 47 percent oppose it.
Many Democrats remain skittish.
“Since passage, and especially since the mid-terms, Democrats, including the president, just haven't wanted to touch the subject,” said Jordan, the Democratic consultant.
Republicans, however, see the Obama campaign’s move over the last week toward talking again about health care as a sign of political weakness, and an acknowledgement that at least part of the campaign will be fought on what polls still suggest is very much enemy turf.
“It’s definitely a winning issue for us,” said top aide to former Massachusetts Governor Mitt Romney. Obama is returning to the issue, the Romney aide said, “because he has base problems — he just can’t get them excited again.”
The part of the Democratic base that seems to be a particular target of this campaign is women. In response to question about the sudden ubiquity of health care chatter, an Obama campaign supporter referred BuzzFeed to a New York Times article headlined, “Obama Plans Big Effort to Build Support Among Women.”
“The White House will almost certainly try to segue to a more general discussion of access to health care, contraception etc, rather than just discussing once again the merits of health care,” predicted Schoen, the former Clinton pollster. “One thing is for sure, they can’t proceed as they did in 2010.”