The call from the White House came late in the week. Rep. Paul Ryan was vowing to slash Medicaid in his 2012 budget proposal, the administration strategists explained, and they wanted to have a powerful response ready, complete with poignant stories of Americans who might lose their health coverage under the Republican plan.
Within minutes, Elizabeth Prescott was on the case. The coordinator of a vast database of real-life stories maintained by the advocacy group Families USA, Prescott worked through the weekend poring over hundreds of files. Among them were heart-wrenching tales of hardship faced by people whose care is dependent on Medicaid, the joint federal-state health insurance program for the poor and disabled.
By the next Monday morning, Prescott was ready to e-mail the White House the first batch of five people from five different states. But Prescott needed more, so she set to work calling smaller health-care advocacy and legal aid groups across the country in search of as many compelling cases as possible to counter the chairman of the House Budget Committee.
With Republicans determined to disrupt implementation of the new health-care law and promote their own fixes to Medicaid and Medicare, and Democrats hopeful of swaying a stubbornly divided public to embrace the law as it takes effect between now and 2014, no one expects the fight to let up anytime soon. And for Democrats and supporters of the law, the weapon of choice is the compelling individual story, a tool honed by former President Ronald Reagan that has been archived and analyzed, computerized and systematized to new levels for this battle.
“When it comes to health-care issues, individual stories are even more powerful than usual because people worry about possible illnesses in their own family,” said Robert Blendon, a polling analyst with the Harvard School of Public Health. “When they hear about something that has gone wrong for someone else, it’s not an abstract policy issue. It’s something that could happen in their own lives.”
Republicans and other opponents of the health-care overhaul also strive to put a human face on their arguments. During the health-care debate, they ran a television ad featuring a Canadian critiquing her country’s government-run health system. And now that they control the House of Representatives, Republicans have tapped business groups hostile to the law to provide a steady stream of employers to testify at hearings about the burdens the law might impose on them.
Still it’s the Democrats and other supporters of the law who have made the personal narrative a centerpiece of their political strategy by relentlessly publicizing the cases of ordinary Americans who stand to lose if the law is modified or repealed. Democratic members of Congress routinely cite such constituents by name in speeches and news conferences on the issue. The White House’s Web site features a clickable map of video testimonials titled “50 states 50 stories” and asks viewers to share their accounts on the theme “How is the Affordable Care Act helping you?”