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Health insurance extension not guaranteed to bring new votes to Democrats

By Perry Bacon Jr.
Washington Post Staff Writer
Thursday, March 25, 2010; 1:14 PM

Despite breaking a decades-old legislative impasse with a bill that will eventually extend health insurance to more than 30 million people, it's unlikely that the efforts of President Obama and congressional Democrats will soon yield them a huge new base of enthusiastic supporters.

There is no question that sweeping pieces of legislation that fundamentally impact everyday life have far-reaching political impacts. Franklin D. Roosevelt's "New Deal" programs, which included Social Security, helped connect a generation of voters to the Democratic Party. The expansions of civil rights to African Americans in the 1960s under Democratic presidents spurred a political realignment that helped move Southern whites to the GOP and further cemented the alliance of black voters and Democratic politicians.

But those changes did not come immediately, and experts have their doubts about the idea that the newly insured will become a long-term Democratic voting bloc. Most people who would get coverage under the legislation would not do so until at least 2014, two years after Obama will have sought a second term.

In 2003, Republicans predicted voters would reward them for passing a new prescription drug benefit for seniors but found themselves voted out of power in Congress three years later as the electorate concentrated on the Iraq War and other issues, even as Medicare Part D remained popular.

Like other voters, the uninsured don't necessarily choose candidates based on health care or any single issue, and some lean toward the GOP. Many of those who will get insurance over the next few years come from populations which historically cast ballots in lower percentages than other voters in both midterm and even presidential elections: adults between ages 19 and 29 and people with below-average incomes. Almost a third of people currently uninsured are not registered to vote and a fifth are children.

And in some ways, the uninsured are already part of the Obama coalition. Recent Washington Post-ABC News polls found 57 percent of the uninsured either favor or lean toward the Democratic Party, and 32 percent favor the GOP. A New York Times analysis last year showed the uninsured tend to live in states that vote Republican for president (27 percent of people in Texas are uninsured, the highest of any state) but in congressional districts within those states that are Democratic.

In the near term, "I don't expect to see some big segment of new voters attaching themselves to the Democratic Party, because of health care," said Mark Mellman, a Democratic pollster. "In the long term, if the health-care reform works, it does have the potential to be transformative for a lot of people, not just the uninsured. But that's not going to happen overnight. It's not as simple as sending them a check like Social Security."

He said the uninsured come from such Obama-leaning groups that in some ways passing the bill was "preaching to the choir."

With the 2010 elections just months away, Republicans say they don't expect the health-care bill to help Democrats at all in the short term. Not only do many Republican-leaning voters strongly oppose the health-care legislation, but polls over the past year have consistently shown voters want Congress and the president to do more on the economy, even as Democrats have obsessed about health care.

Obama "was on the wrong topic," said David Winston, a Republican pollster and top adviser to GOP leaders in Congress. "Health care is certainly an important issue, but what I'm seeing is, [for voters,] jobs is the number one issue. For a lot of [the uninsured], if they had a job, their health-care situation would be taken care of."

Democrats plan to spend this year highlighting some of the immediate benefits of the legislation. One of the key targets will be young voters, who turned out big for Obama in 2008 but might not be as enthusiastic about this fall's House and Senate elections. Democrats hope a provision in the law that kicks in this year allowing young adults to stay on their parents insurance coverage until they are 26 will prove popular and help inspire greater turnout among young people. And Democrats hope some of the policies targeted at people who already have insurance will also benefit the party politically.

"The challenge in 2010 for Democrats is, for the people who were very excited about Obama, whether or not delivering on health care can be translated into returning them to the voting box," said Richard Kirsch, who runs a group that backed the health-care effort called Health Care for America Now.

In the long term, analysts say Democrats must sell the program effectively enough that GOP efforts to repeal it in the next several years aren't successful and then make sure voters actually like the reform when it actually goes into effect.

"If it works for everyone, it could bring some benefits," said Robert Blendon, a Harvard professor who specializes in health-care policy. "If there are problems with it, it could turn out not to be the net gain they thought it could."

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