Health reform's reality vs. its parody

By E.J. Dionne Jr.
Monday, October 4, 2010; A17

Here is another piece of conventional wisdom about this year's election that is being rendered patently false. It's been said over and over that no Democrats are running on the health-care bill. Actually, more and more of them are proudly campaigning on what the plan has achieved -- and they should.

In a fight for his political life in Wisconsin, Sen. Russ Feingold went on the air last week with an advertisement that explicitly defends provisions in the bill and attacks his opponent, Republican Ron Johnson, for wanting to repeal it.

The ad portrays two Wisconsin residents telling Johnson: "Hands off my health care." Their message is that repealing the health-care law would, as another voter says, "put insurance companies back in control."

Feingold's is one of the more powerful ads about the bill, but his isn't the only one. In an ad that focuses on holding corporations accountable, Rep. Steve Israel of New York touts the bill for stopping insurance companies from denying coverage because of preexisting conditions. In Nevada, Rep. Dina Titus has a TV ad praising the same provision.

And in his effort to win back a traditionally Democratic congressional seat in New Orleans, state Rep. Cedric Richmond has made incumbent Republican Joseph Cao's vote against the health-care bill a central issue in the campaign.

(More Post coverage of the 2010 midterm House and Senate races.)

Why the sudden willingness to run on health care? The key reason is that the law didn't begin to take effect until Sept. 23, and the first elements to kick in are very popular. They include the guarantee that children cannot be denied coverage because of preexisting conditions, a requirement that insurance companies allow kids to stay on their parents' health plans until age 26 and a ban on "rescissions" through which insurance companies could abruptly drop sick people from coverage.

Around the country, Democratic candidates are calling these parts of the bill a "Patient's Bill of Rights," as Rep. John Garamendi (D-Calif.), put it in a column in the Huffington Post.

The standard Republican account was nicely summarized by Karl Rove in Thursday's Wall Street Journal. Rove argued that for Democrats, the health-care bill "has become a reef on which many of their electoral hopes will founder." His op-ed called the bill "a fiscal disaster of epic proportions" and declared that because of it, Democrats are "going to get an electoral defeat they won't easily forget."

Not so fast, Karl. In fact, there are two "health-care bills" competing in this election. One is the parody Republicans have lovingly created that casts the health-care law as a big-government monstrosity with no redeeming features. The other is the law itself, an admittedly sprawling legislative compromise that nonetheless moves things in the right direction -- and most of whose individual elements voters support.

(Full Post coverage of the health reform debate.)

If Democrats say nothing about what the actual health-care law does, the parody is all that will stick in voters' minds. Its champions rarely talk about the measure as a whole because it will take longer than a brief election campaign to clean off all the mud that's been splattered on this baby, which is still tainted by the ugly, drawn-out process that produced it. Instead, like Feingold, Israel and Titus, the bill's backers break it apart to extol the specific things it does that few voters want to repeal.

They had better stay on the offensive long after the election, because many Republican candidates for governor and state legislative seats are already promising to undermine the law. This would have the effect of blocking efforts to extend insurance to some 30 million people. Do we really want to back away from that? Shouldn't this be an issue, too?

The truth is that this bill was a first step. There are many health-care battles ahead. If supporters of reform cave during the first round, as Rove is hoping, further progress will be impossible.

Yes, some Democrats in conservative districts voted against the bill and display this as a badge of their independence. But is that any surprise? This is exactly the sort of position moderate Republicans (when they existed) would take to survive in more liberal districts.

The real test is whether Democrats who supported the bill think they have an interest in defending a genuinely historic accomplishment. More and more, they are deciding that they do.


(For more on Obama's change agenda, read Dana Milbank's "A sadder but wiser Axelrod packs his bags." Harold Meyerson on the Democrats' midterm strategy: "Rallying the two poles of the Democratic base.")

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