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The Democratic Strategist

Political Strategy for a Permanent Democratic Majority

Public Opinion After Health Care Reform

One of those topics that sharply divides observers is the immediate impact on public opinion of enactment of health care reform legislation. Some reform supporters believe that when the public realizes a lot of the wild, made-up claims about the legislation were, well, made up, approval ratings for the President and congressional Democrats will rise. Some reform opponents think that since few Americans will see any tangible benefit from the legislation (in no small part because of the long phase-in period), buyer’s remorse could set in for those who have supported the bill.
Mark Blumenthal of Pollster.com trains his jeweler’s eye on this controversy, and finds there is no obvious answer to the question of “what happens now?” to public opinion. Those who are hoping for a major “bump” in presidential approval ratings will probably be disappointed, says Blumenthal, since those are rare barring “rally ’round the flag” moments of national crisis. Another complicating factor is that Americans don’t really understand many key provisions of the legislation. Will time correct misperceptions, or will the long phase-in period freeze perceptions as they are?
The one definite task for progressives, Blumenthal suggests, is to promote a balanced understanding of the legislation to offset not just conservative mendacity but the heavy focus of the debate on the left on issues like the public option. The provisions that will take effect most immediately, and that are most popular–such as bans on insurance company abuses like exclusions for pre-existing conditions–haven’t gotten nearly the attention they deserve.
All I’d add is that whatever the immediate effect on presidential approval ratings, most progressives are convinced that an outright failure to enact health care reform would be a complete political disaster for Democrats, as a similar failure arguably was for Democrats going into the 1994 fiasco. Assuming the bill is enacted, we’ll never know what would have happened otherwise. And the inability to “prove a negative” is a problem with many aspects of health care reform. Insurance premiums, for example, were due to go up sharply over the next few years in the absence of reform legislation. They will still go up sharply under this legislation (most cost savings will occur down the road), since it costs money to cover 30 or 40 million additional people, but will Americans blame reform itself for this development, which would have happened anyway? Certainly Republicans will make every effort to promote this misperception.
This reflects a broader problem facing the president and congressional Democrats (or anyone assuming power when a previous administration has so thoroughly botched its job): will they get credit for keeping bad times from growing worse, or will they be blamed for the bad times themselves? To cite one obvious example, the best defense for the deeply unpopular TARP initiative is that it was necessary to avoid a complete collapse in the nation’s, and perhaps the world’s, financial system. That is clearly what Barack Obama thought at the time; he certainly did not relish massive subsidies for the least popular people and institutions on the planet. But it’s hard to prove what would have happened in any other scenario. The best solution to this dilemma is to make conditions in the country actually improve. Given the mess Obama inherited, that may be tough to do by next November, or even by 2012. And that’s why progressives need to spend as much time as possible promoting genuine public understanding of the nation’s complex problems, with reminders of our downward trajectory under the previous administration.

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