This week marks the second anniversary of the enactment of President Obama’s health care law, but don’t look for the president to mark the occasion at an elaborate event — a seemingly odd omission, considering that the Supreme Court will in days hear arguments from those hoping to wipe his signature domestic-policy achievement off the books.
But it’s part of a theme. When it comes to defending the law or trying to goose its popularity, the White House is intentionally keeping the president off the stage, leaving the selling of its benefits to proxies such as Health and Human Services Secretary Kathleen Sebelius, health care reform groups, and Obama’s reelection campaign.
So far, the evidence doesn’t indicate that the strategy is working. Although polls continue to show that voters like some aspects of the law — such as the provision that bars discrimination based on preexisting medical conditions — little broad-based support exists for the entire package, especially for its requirement that all Americans purchase health insurance.
Thus, while Obama jetted across the country this week touting his energy agenda, Sebelius defended the law in places such as Houston and Miami. Almost since the law was passed, the president has shown little interest in mixing it up with Republicans over the measure or, for that matter, trying to win over doubters.
In this year’s State of the Union address, Obama devoted one sentence to the health care law, although he didn’t hail its passage or even mention it by name. Consequently, it barely showed up in subsequent speeches and vanished entirely amid fevered West Wing anxiety over the political implications of higher gas prices.
But White House Communications Director Dan Pfeiffer, on whose shoulders the task of selling the law has fallen, denied that Obama is ducking the health care fight or giving it short shrift. “Since passing it, we have been very careful in our discussions of the law to depoliticize the debate as much as possible,” Pfeiffer said. “That limits our biggest resources, the president and the vice president, who are inherently political.”
Pfeiffer defends the low-wattage advocacy as a decision to elevate government obligation over campaigning. Obama’s emphasis, he said, remains on those who stand to benefit from the law now, while the politicians and lawyers fight over its future in a separate sphere. He said he’s proud that no stories have surfaced about confused consumers uncertain what the law does or how it works when they try to obtain new benefits. “It has to work well,” Pfeiffer said. “It has to be durable.”
He and other Obama aides know that the law has critics and that even close friends of the White House aren’t enthusiastic about the sales campaign. “It has been a communications challenge, and we’re going to plow forward with it,” senior adviser David Axelrod said on MSNBC.
Neera Tanden, president of the Center for American Progress, a center-left think tank, called the Supreme Court arguments an opportunity for the White House to reframe the debate. Tanden, formerly a senior health care adviser to Sebelius, told National Journal that the “weird atmosphere” around the law is due in part to a soft sell from Obama, public confusion about the law, and voters’ focus on the economy. “The challenge is, talking about health care is a distraction right now to the jobs issue,” Tanden said, “and politicians operate in the marketplace.”
But Howard Dean, a former presidential candidate, defended the administration. White House officials are “doing the best they can with a very complicated law,” he said. “The only advice I have is to look at the parts of it that poll really well and talk about those without mentioning the bill itself.”
Indeed, HHS has been trying to broadcast the law’s achievements on a granular level. In the past few days, the department has released a report showing that 45 million women have received free preventive services such as mammograms under the health reform law; statistics indicating that drug discounts have saved 5.1 million seniors an estimated $3.2 billion; and data proving that nearly 50,000 people with preexisting health conditions got coverage.
Obama’s reelection campaign this week sent out e-mails championing the law, but they likely went only to those who are inclined to view it favorably. Compare and contrast that with the GOP candidates’ castigation of the law as a government takeover of health care — and the messaging challenge becomes starkly clear.
Polls show that the White House, at least right now, has lost the perception war in the minds of the middle-class voters whom Obama will need in the general election. Simply put: Despite the White House’s best efforts to argue that the health care law will control costs and reduce the deficit, many voters view it as an entitlement that won’t benefit them. That’s particularly true of whites. Two years ago, when Obama signed the law, 52 percent of white voters said that it would actually make their health care worse, according to Gallup.
And those sentiments remain. In a recent Kaiser Family Foundation survey, two-thirds of Americans said they don’t expect the law to affect their lives in a positive way, and they believe that, in the end, it will largely benefit lower-income Americans and the uninsured. Even more troubling for the administration, six in 10 said they don’t have enough information to understand how the law will affect them personally.
Pfeiffer contends that the president can’t do much about those perceptions between now and Election Day. “We don’t have any illusions we are going to fundamentally shift public opinion on this in the short term,” he said.