At Tuesday’s press conference, President Obama delivered an unfocused eight-minute defense of his central legislative accomplishment in office – the Affordable Care Act. In the face of intraparty criticism that implementation of his health care law will be a “train wreck,” new polls showing support for the law near all-time lows, and even the Democratic nominee in next week’s House special election calling the law “extremely problematic”– there’s plenty of evidence piling up to believe health care will be a political millstone for Democrats in 2014.
In fact, the legacy of the Iraq war to Republicans during the Bush administration offers a useful reference to how the implementation of Obama’s health care law could play out politically for his party. Like the Democrats’ partisan relationship with the health care law, support for the Iraq war was a prerequisite for being a Republican during the Bush years. Opposition from the rare gadfly, like Ron Paul or Walter Jones, nearly drummed them out of the party. Among Democrats, outspoken antipathy to the war was most intense among the base – the netroots and antiwar activists at the fringes of the party. For a while, most Democrats didn’t want to sound too critical of the war effort for risk of being painted as part of the anti-war movement.
Support for the war dropped as officials struggled to implement nation-building after the fall of Saddam Hussein. As casualties piled up and the violence worsened, the fringe position of the liberal base gradually became more palatable. No longer were war-critiquing Democrats seen as soft on national security. In the 2006 midterms, Democrats effectively campaigned on an anti-war message to take back the majority in the House and Senate for the first time in 12 years, capitalizing on war weariness. Eventually a number of Republicans split from the party to save their political hide.
While the debate over Obama’s health care law isn’t a life-or-death battle, health care affects voter livelihood (and their voting decisions) like few other issues do. And there are clear signs that if premiums go up, businesses are forced to change how they insure their employees, and implementation of the law is uneven, the potential for political consequences are significant. In the 2010 midterms, Democrats suffered a historic landslide when the debate over health care was abstract. The stakes could be even higher when voters have first-hand experience with its effects. (Just look at the fevered reaction from Hill staffers affected by the law for a sampling of how intense voter anger could become.)
In both examples, the presidential sales pitch ended up being overhyped, with promises made that couldn’t realistically be achieved. At its heart, the mission to oust Saddam Hussein was about preventing a dangerous tyrant from using weapons of mass destruction – but administration officials advocated everything from democracy promotion to preventing an alliance between Iraq and al-Qaida as part of its overall argument. When events turned south, failure to achieve many of the items on the checklist proved politically embarrassing.
Obama’s health care law was designed to expand access to the uninsured. It’s a noble goal, if not necessarily a smart political priority. (It’s more popular to advocate for improved health care, not expanded access.) But to win support for the law, Obama claimed it would lower costs, improve the quality of care and not force anyone off their current health care plan. That’s not shaping up to be the case. Premiums are rising, employer uncertainty is growing and voters aren’t viewing the law favorably – with many not even aware of the frontloaded benefits already in place. And even on the access side, the law of unintended consequences is kicking in: Some large retail companies are cutting back employee hours so they won’t have to offer health insurance. That’s not good for the economy or health care access.
The conventional wisdom today is that the incessant conservative drumbeat against ObamaCare, is confined to the base and that the more “mainstream” position would be to accept and improve the legislation. (Conservative New York Times columnist Ross Douthat makes a persuasive case on the policy side of that argument this week.) But politically speaking, it sounds awfully similar to the advice moderate Democrats advocated as public support for the Iraq war dipped – change strategy in Iraq, but don’t advocate for withdrawal. What became the winning political position, and what propelled Barack Obama into the presidency over Hillary Clinton, was an unequivocal opposition to the war.
Likewise, the advocates for repeal may now hold the upper hand politically, especially if there’s blowback as the health care law gets implemented. Every problem with health care, fairly or unfairly, will be blamed on Democrats. Like Republicans with Iraq, Democrats own the issue, and the headwinds coming with it in future elections.
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