Following the Republican victory in the mid-term elections, the two biggest interests of the Republican party appear to be “denying President Obama a second term”:http://abcnews.go.com/Politics/rep-john-boehner-president-obama-denial/story?id=12056138 and “repealing health care reform”:http://www.orlandosentinel.com/news/opinion/todaysbuzz/os-todays-buzz-repeal-health-care-reform-111210,0,6878749.story. I’ll have more to say about the former in a later post, but for now I wanted to tackle the question of whether repealing health care reform is likely to be a winning issue for the Republican party.
CNN had some really interesting data from a Kaiser Health Tracking Poll as part of its “elections issues coverage”:http://www.cnn.com/ELECTION/2010/pollcenter/issues/index.html#HEALTH_CARE. CNN presented the results of a series of questions separately, which I’ve taken and reworked into a single figure:
[Note that I can only report the numbers CNN posted, which do not add up to 100%. I assume the missing are some combination of don’t know or refuse to answer.]
What can we learn here? First, the Republicans are correct that there is a constituency for _the general concept_ of repealing health care reform, which the party certainly “exploited in the 2010 elections”:https://themonkeycage.org/2010/11/which_roll_call_votes_hurt_the.html. Although not a majority, a plurality of voters prefer to either see the bill repealed in its entirety (25%) or partially repealed (24%), as opposed to those who want to leave it as it is (19%) or expand it (21%). So clearly there is room for rhetoric regarding health care repeal to resonate with more voters than it alienates.
At the same time, though, there are strong majorities supporting multiple aspects of the reform, including providing more financial support for people to purchase health insurance (spending!), keeping the increased Medicare payroll tax (taxes!), and keeping coverage for pre-existing conditions. In fact, of the issues CNN reported on, only repealing the mandate to purchase health care insurance is supported by a majority if the respondents. But you know who likes the mandate to purchase health care insurance? “Insurance companies”:http://voices.washingtonpost.com/ezra-klein/2010/10/the_individual_mandates_proble.html!
So the more the Republicans push repealing health insurance, the more they may run into a buzz saw: either push to repeal parts of the bill that are popular with the public, or push to repeal the part of the bill that is popular with the health insurance industry (and we all know what the health insurance industry does to “bills it doesn’t like”:http://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993) and which arguably funds the whole rest of the reform. (I realize this is a gross simplification, but without a mandate the cost of policies would “undoubtedly go up significantly”:http://health.change.org/blog/view/why_we_need_a_health_insurance_mandate).
My assessment is that repealing health care reform is going to turn out to be a “lot like cutting spending”:https://themonkeycage.org/2010/02/corrected_graph_for_conflicted.html: everyone is in favor of cutting spending generally, but no one wants to cut spending for particular programs. Thus the Republicans face a dilemma. Politically, they are probably best served by continuing to rail against health care, but not actually trying to make unpopular changes to the program. However, that will open them up to charges of not actually fulfilling campaign promises. So the best strategy may be to overreach, propose plans that could never work (e.g., repealing mandates without doing anything else), count on the Senate to block or Obama to veto, and therefore keep the issue alive in its _general_ form for the 2012 elections. Gridlock anyone?
[ht to Marc Hanna for suggestions on the graph.]