Remember the Health Care Debate? It's Back

With provisions of health care reform legislation set to take effect Thursday, President Obama has revisited the topic in the hopes of rallying those still undecided voters to his and his party’s side.

With provisions of health care reform legislation set to take effect Thursday, President Obama has revisited the topic in the hopes of rallying those still undecided voters to his and his party’s side.

On Wednesday, the President scheduled a health care-centric event, the first since June, in Northern Virginia. There he plans to appear with Health and Human Services Secretary Kathleen Sebelius and Rep. Jim Moran (D-VA), as well as 10 individuals (four of them under the age of 8) who will discuss how health care reform legislation will help them.

This is not the only outreach program the President has engaged in this week related to health care. On Tuesday, President Obama hosted a conference call with a variety of religious leaders and faith-based community organizations asking them to “get out and spread the word.” “The debate in Washington is over,” The President said. “I think all of you can be really important validators.” If the debate is over, why is there a need for “validators?”

The fact is that the debate over health care reform never ended but quietly simmered after the bill was passed through reconciliation in March. Republican lawmakers and GOP candidates for office have made “repeal and replace” a centerpiece of their governing platform (articles of which will be released Thursday and will likely dominate the rest of the week’s news cycle). If Republicans can achieve a governing majority after the midterms, but are unable to override a presidential veto to pass a repeal of health care reform, the plan appears to be to starve the program of funds and thus make most of its provisions moot. The amount of focus devoted to health care alone suggests that the debate is far from over.

Rising numbers of people opposing the signature legislative accomplishment of the 111th Congress, and now a majority favors the outright repeal of the bill. The latest Rasmussen Reports poll on the subject, conducted September 18-19, showed that 61 percent of those polled favor repeal – 50 percent strongly favor it.

The parts of the Patient Protection and Affordable Care Act that are set to go into effect on Thursday are some of the most popular provisions of the bill. Insurers will no longer be able to deny coverage due to pre-existing conditions, insurers cannot drop the insured if they get sick, a parent can now keep their offspring covered on their plan up to the age of 26 and health plans can no longer have lifetime limits on the dollar value of coverage. Most of the law’s provisions do not go into effect, however, until 2014.

House Speaker Nancy Pelosi (D-CA) insists those provisions that go into effect Thursday will be received positively. They may be enough to arrest the momentum that is swinging toward the Republicans as the November midterms approach. Some predict that these restrictions on insurance companies will necessarily cause premiums to increase for the majority of individuals who are not directly impacted by the new coverage requirements.

Democratic congressional leaders, including Speaker Pelosi, are touting the moderating effect that health care reform legislation’s implementation will have on the national discourse. With so much public rancor over the process and the substance of the bill, Democratic leaders and strategists believe that when these provisions come into effect and the sky does not fall, the public will understand that the overall impact of this legislation is positive.

There is merit to this argument; few people will be directly impacted by these provisions and for those that can take advantage of them, they will be impressed. Those individuals, however, were probably already in favor of health care reform in the first place. Furthermore, if premiums do not increase for the majority of the insured, there may be a general sigh of relief that the worst predictions about this legislation was just baseless political posturing by the opposition party. Democrats believe that such a revelation will bring out the base and win over independents as the midterm elections approach?

The flipside of that argument, however, is that this development reinvigorates the caustic health care debate (which Democrats did not benefit from) at the worst possible electoral moment. Just as the average voter is beginning to tune into midterm election politics, the healthcare debate is reborn. Less popular than it was when it was passed, health care reform legislation’s salesmen have never been able to connect the positive aspects of this bill with the average voter’s concerns. The law’s provisions that go into effect now will reignite the debate that so turned them off in the late winter / early spring when jobs should have been priority number one. Putting the focus back on health care’s yet-to-be-realized accomplishments will validate the Republican argument that this congress’ and this administration’s priorities are misplaced.

When this bill was passed into law, there was probably a good deal of sentiment among members of the administration that the bill would get more popular over time. To have the most popular provisions come into effect in early fall will be a net positive for Democrats at the polls. They did not expect the opposition they experienced at the time and they did not see the bill’s sustained unpopularity today.

It remains to be seen what impact health care reform’s rebirth will have on the public debate, but just as the President and some of the most embattled Democratic members of congress are bouncing in the polls, the debate over health care is the last one they needed to reanimate.

Noah Rothman is the online editor at C&E. Email him at

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