Obama, Democrats Recasting Health Care to Blunt Attacks

Heidi Heitkamp, a North Dakota Democratic Senate candidate, has been buried by more than 2,000 Republican-sponsored television ads criticizing her for supporting President Barack Obama’s health-care law.

Yet, Heitkamp, who is running in a Republican-leaning state, isn’t ducking; she’s punching back with an ad citing the law’s most popular provisions, including prohibiting insurance companies from refusing coverage because of pre-existing conditions. “I would never vote to take away a senior’s health care or limit anyone’s care,” she says.

According to the latest polls, the race is tied between Heitkamp and House Representative Rick Berg for the seat being vacated by retiring Democrat Kent Conrad.

Heitkamp’s aggressive strategy marks a change from two years ago, when an avalanche of Republican attacks on the 2010 Patient Protection and Affordable Care Act went mostly unanswered and Democrats lost their U.S. House majority and saw their Senate ranks shrink.

“We had a gale-force wind blowing against us on the issue of health care,” said New York Representative Steve Israel, chairman of the Democrats’ House re-election effort. “We now have a gentle breeze at our backs.”

With a Supreme Court ruling upholding the law’s constitutionality and a Republican plan to privatize Medicare to use as a political counter-punch, Democrats are trying to neutralize the health-care issue -- if not turn it to their advantage.

Law Requirements

The law requires most individuals to obtain health insurance, forces insurers to cover people with pre-existing conditions, and allows parents to cover their children until age 26. It also removes lifetime caps from policies and provides cash incentives for states to extend Medicaid benefits.

The Obama campaign has spent the last four months calling voters, sending mail and posting web ads to promote the most popular parts of the law to women and seniors.

The Health and Human Services Department is airing a $20 million national advertising effort -- an informational blitz authorized as part of the law -- to inform Americans about their new benefits and services.

Embracing the Name

And the president is embracing the Republicans’ derogatory nickname for the measure: Obamacare. “I don’t mind the name because I really do care,” the president has said at recent campaign events.

Representative Greg Walden of Oregon, deputy chairman of the National Republican Congressional Committee, said Democrats have more to lose from campaigning on the law.

“Democrats wanting to defend Obamacare is a lot like running head first into a bed of roses,” Walden said in an e-mailed statement. “The flowers are pretty and the aroma is sweet, but then you’re tangled in all of the thorns and say to yourself ‘maybe I shouldn’t have run in here.’”

House Speaker John Boehner of Ohio and Majority Leader Eric Cantor of Virginia, who’ve long made repealing and replacing the law their number-one priority, held a 33rd repeal vote on July 11. Yet, along with presidential candidate Mitt Romney, they haven’t offered any alternatives and are largely trying to steer the spotlight to the economy and jobs.

Voter Sentiment

Polls taken immediately following the court’s ruling show there may be a political risk to continuing the repeal drive. More than 7 in 10 Americans called the health-care overhaul either “not a major issue” or “just one of many issues,” according to a USA Today/Gallup poll taken as a snapshot right after the court’s June 28 decision.

In a June 28 Kaiser Family Foundation survey, 51 percent of independents who don’t lean toward any party and 26 percent of Republicans said opponents should stop their efforts to block it and move on to other national problems, such as jobs.

To be sure, outside Republican groups aren’t relenting in the aftermath the court’s decision finding the law’s requirement that most individuals purchase insurance is constitutional.

In the past 30 days, there have been 33,751 negative ads in the presidential election against the Obama plan, compared to 18,647 buys the previous 30 days, according to Kantar Media’s CMAG, a company that tracks advertising.

Joseph Antos, a health-policy expert at the American Enterprise Institute, a Washington-based group that supports a smaller role for the federal government, expressed skepticism that Democrats will be able to materially change attitudes about the law.

Big Theme

“Their big theme has been, ‘We just have to explain to people what they need to know and then they’ll like it,’” said Antos. “The needle on approval hasn’t moved.”

The real effect of the court ruling has been convincing some skittish Democrats to drop those reservations, said Robert Blendon, public opinion expert at Harvard University’s School of Public Health. “There’s no reason for a Democrat not to fight back,” he said.

Democrats also benefit from the fact that Romney’s signature, as governor, on a similar Massachusetts health care law complicates his ability to attack on the issue, said Antos.

“How would he explain what he did in Massachusetts without getting tied up in knots rhetorically?” said Antos. “The Romney side doesn’t seem to want to talk about it for obvious reasons.”

Heitkamp, who’s kept her distance from the president because she hails from a state that traditionally votes Republican in presidential elections and backed Arizona Senator John McCain over Obama by 8 percentage points in 2008, also embraces the law. She says that while it’s imperfect, it beats what Republicans would do.

Cancer Struggle

Her Republican opponent, Berg, “voted to go back to letting insurance companies deny coverage to kids, or for pre-existing conditions,” she said in her ad. Mentioning her own struggle with breast cancer, she says, “When you live through that, political attack ads seem silly.”

Health care has been the number-one topic of attack ads against Heitkamp, 56, since the start of her campaign, according to CMAG data. Not only has Heitkamp hit back with her own health-care-themed ad, she and her allies are now managing to outpace Republicans in the battle of negative ads.

According to CMAG, Democrats have sponsored 2,368 negative spots to Republicans’ 2,108, most of which have been sponsored by Crossroads Grassroots Policy Strategies, the nonprofit aligned with former President George W. Bush strategist Karl Rove.

Dead Heat

Heitkamp is in a dead heat with her competitor, Berg, according to a June 4 Mason-Dixon Polling and Research survey. In the poll Heitkamp’s support stood at 47 percent, while Berg had 46 percent.

Democrats also see favorable signals from a June victory in a special election in Arizona’s Republican-leaning eighth House district as evidence that the issue has lost some of its sting.

Democrat Ron Barber beat Republican Jesse Kelly after the race became a referendum on Obama’s health law and Democrats cast Kelly as hostile to Social Security and Medicare.

In an internal memo, Democrats called the on-air advertising “a preview of the 2012 message battle between Democrats and Republicans.”

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