Pat Dollard

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Financial Times:

Two days before their vote on landmark health reform last March, Barack Obama told skittish Democrats on Capitol Hill that passing landmark reform would be a “smart thing to do politically” because “good policy is good politics”.

“I am convinced that when you go out there and you are standing tall and you are saying I believe that this is the right thing to do … that ultimately the truth will win out,” the US president declared.

With weeks to go before the midterm elections, healthcare has emerged as one of the most important issues in campaigns across the country. Republicans hoping to win a majority in November have made the repeal and replacement of the controversial law a top priority.

Meanwhile, Democrats who voted against the bill hold their No vote as a badge of honour, and Democrats who supported it are largely silent about what the Obama administration considers one of its biggest accomplishments.

Right now, the issue looks like a big loser for Democrats such as John Boccieri, who was singled out by Mr Obama for “standing up proud” for his support of healthcare back in March. An Iraq war veteran and former baseball player who represents a conservative district in Ohio, Mr Boccieri is in a tight race against Jim Renacci, a Republican businessman and former mayor.

Far from touting the consumer benefits that have recently been implemented by the healthcare law – such as a new provision that allows parents to keep their children on their insurance until they are 26 – Mr Boccieri is trying to fend off criticism of his voting record by attacking Mr Renacci’s views on trade.

While he is not advertising his vote in support of healthcare, Mr Boccieri is receiving substantial financial support from labour unions who backed the new law. Mr Boccieri is one of three Democrats in the House who have attracted about 90 per cent of contributions by unions SEIU and AFSCME.

“I think Democrats realised that they have a better opportunity in going on the offensive against Republicans for either supporting repeal of healthcare or tax cuts for the wealthy,” says David Wasserman, an analyst for the non-partisan Cook Political Report.

“They decided long ago to bring back ghosts of the past – like privatisation of Social Security, because it polls better,” he said, referring to some conservatives’ view that the public pension scheme ought to be privatised, which is unpopular with retired people. To the extent that Democrats are talking about healthcare, they paint Republicans’ promise to repeal the law as a “quixotic journey” that will end in failure.

Democrats also see little chance of altering public opinion about the law this close to the election, says Thomas Mann, a congressional scholar at the Brookings Institution.

But while Democrats are grappling with the issue, there are reasons for Republicans, too, to worry about how promises to repeal the law could haunt them after November’s vote.

According to a Washington Post poll on Tuesday, 47 per cent of voters support healthcare changes, while 48 per cent oppose them. Only a slim majority of independents (53 per cent) oppose the healthcare law.

Some activist Republicans are pushing conservative candidates to pledge to repeal the healthcare law – a campaign promise that will be virtually impossible to fulfil with Mr Obama in the White House.

While such pledges are not politically significant now, they underline that activists want Republicans to get results and are paying attention. At the same time, it is far from clear whether more moderate Republicans and independent voters would support attempts by Republicans to delay implementation of the healthcare bill. “They risk their own base’s disillusionment in 2012,” says Mr Wasserman. “Parties are very short- sighted.”

Efforts to undermine the bill by a potential Republican majority in the House could also give Mr Obama a platform to criticise them for seeming to derail those provisions that the public generally supports, such as guaranteed insurance for individuals with pre-existing conditions.

“Obama will, I think, be able to pick them off on health reform one by one. What seems like a great political issue for Republicans will sour for them in a period of divided party government,” says Mr Mann.

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