Why Democrats can win on Obamacare and still lose in the midterms

There's some good news for Democrats in the latest Kaiser Family Foundation Health Tracking Poll: The public mostly agrees with them on what to do next with Obamacare.

But here's the bad news: The debate over Obamacare as it is playing out in battleground House and Senate races is about much more than what's next. It also involves the past.

The Kaiser poll (basically the gold standard on health-care polling) shows that more than half of Americans (56 percent) would like to see Congress keep the health-care law in place, including a plurality (48 percent) who say that the law should be kept and improved. Most Democrats in the swing races that will decide the battle for Congress have adopted some version of that keep-it-but-fix-it position, so the poll is good news for congressional Democrats.

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Repeal, by comparison is not popular. Just 31 percent say Congress should repeal the law, including just 12 percent who say it should be replaced with a GOP alternative.

Now, this isn't a new revelation. Polls have been showing for months that fixing the law rather than repealing and replacing it is what most people want. And it explains why we have seen GOP leaders in Congress largely abandon the strategy of taking numerous symbolic votes to repeal the law as they have done dozens of times already.

The reality is that if the entire health-care debate were about what to do moving forward, Democrats would be in a strong position headed toward November.

Except that it's not.

Republican candidates and allied groups are putting serious money behind reminding voters about how we got here. They have run so-called "Lie of the Year" ads singling out President Obama for his oft-repeated if-you-like-your-health-plan-you-can-keep-it line. They are trying to tether Democrats who voted for or supported the law to Obama's line (See Americans For Prosperity's ads against Democrats running for the Senate in Iowa and Michigan and Ending Spending's ad against New Hampshire Democratic Sen. Jeanne Shaheen.)

The GOP is also targeting Democratic incumbents by simply reminding voters they voted for or supported the law, which remains unpopular overall. The Kaiser poll found that 47 percent of Americans say they hold an unfavorable view of the law, compared to the 35 percent who say they have a favorable impression. In four of the GOP's seven best Senate pickup opportunities (Arkansas, Alaska, Louisiana and North Carolina) Democratic incumbents who voted for the law will be on the ballot.

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There's also the reality that midterm elections tend to be about which party is better able to turn out its base. Few issues rile up the GOP base like opposition to the heath-care law, which continues to be a topic of heavy and visible debate in many campaigns. Just look at how large the appetite for repeal is among Republicans in the Kaiser poll.

The fact that the Obamacare discussion has become broader than the repeal-versus-keep-it debate doesn't mean Republican candidates can ignore the argument for repeal in the campaign. Indeed, not pushing for repeal could be problematic for them with a GOP base still hungry for repeal.​ But pushing it too hard could alienate moderates, presenting the GOP with a tricky tightrope walk.

Just look at Republican Senate candidates Terri Lynn Land in Michigan and Jack Kingston in Georgia, who late last year had to beef up their support for repeal after appearing too soft on it initially. Meanwhile, North Carolina Republican Senate contender Thom Tillis has come under scrutiny for not embracing a leading GOP alternative to Obamacare even though he advocates repeal.

The fundamental question for voters in this year's midterms may be this: Which is more important -- whether a politician supported or opposed Obamacare or what he or she wants to do about it now?

Republicans are banking that the former still carries a lot of weight while Democrats are leaning heavily on the latter. Given how much money Republicans have and will continue to spend making their case, though, it's hard to envision Democrats turning the debate into strictly a referendum on what's next.

Sean Sullivan has covered national politics for The Washington Post since 2012.
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