Healthcare Business News
Capitol Hill

Reform Update: Obamacare not seen as flashpoint in midterm elections

By Paul Demko
Posted: August 1, 2014 - 4:00 pm ET

Congress is all but done for the summer. That means attention will now pivot toward the fall elections.

Four years ago during the August recess, legislators encountered voters in their home districts angry about the recent passage of the Patient Protection and Affordable Care Act. Republicans rode that backlash against the federal healthcare law to an electoral rout that resulted in a takeover of the House.

“The Affordable Care Act became the symbol of Democratic power in Washington gone too far too fast,” said Nathan Gonzales, deputy editor of the Rothenberg Political Report.

Advertisement | View Media Kit


The healthcare law remains broadly unpopular. In fact, disapproval of the federal healthcare law ticked up notably in the latest tracking poll conducted by the Kaiser Family Foundation. More than half of respondents, 53%, indicated that they held an unfavorable view of the law, up from 45% in the previous month. That's the highest level of opposition recorded since the tracking poll began more than four years ago. The share of respondents supporting the law also dropped slightly, from 39% to 37%, although that's a statistically meaningless change.

Those grim polling numbers suggest Democrats could be headed for another drubbing in the congressional elections. This year's top prize is control of the Senate. Democrats are on the defensive, with 21 of the 36 seats up for grabs currently controlled by their caucus. Republicans need to flip six seats to take control of the chamber. Only about a dozen contests are deemed truly competitive.

But Kaiser's survey results are more complex than the simple favorable-unfavorable matrix might suggest. Most notably, 60% support improving the law, compared with just 35% who want to scrap it completely, suggesting repeated efforts to repeal the law by House Republicans might not have been the savviest course of action politically. The polling data also indicates that healthcare issues aren't foremost on the public's mind. Of the 11 issues vetted by respondents, healthcare ranked next to last in terms of areas that the president and Congress should be spending more time on, ranking behind the economy, immigration, climate change and the conflict in Iraq.

But in a nonpresidential election year, in which turnout is expected to be low, the key question is which party's voters are motivated to head to the polls. Ford O'Connell, a Republican operative who worked on John McCain's 2008 presidential campaign, points out that polling data has consistently shown an intensity advantage for Republicans, meaning they are more motivated to vote. The continuing animosity toward Obamacare could help in driving such voters to the polls.

“There's no real defining issue for the 2014 election,” O'Connell said. “Obamacare is a symptom of a bigger thing where GOP voters think the country is headed in the wrong direction.”

Democrats have shown some willingness to embrace the ACA as a campaign issue—or at least certain elements of it. In some states with tight congressional or gubernatorial contests they're attacking Republicans for failing to expand Medicaid as called for under the federal healthcare law.

Jennifer Hayes Clark, an assistant professor of political science at the University of Houston, argues that Democrats could benefit politically from the U.S. Supreme Court's recent ruling that companies can deny employees contraceptive coverage on religious grounds. “The issue of mandatory coverage of contraceptives has taken center stage and Democrats will seize upon the Hobby Lobby ruling in their upcoming campaigns to appeal to women voters,” Clark said.

But the latest Kaiser data likely obscures a more basic truth: The numbers on Obamacare have been largely crystallized along party lines for months, if not years. That means it will be difficult for candidates of either party to use the issue to sway votes on the campaign trail this fall.

“I think the Affordable Care Act to a large degree is already kind of baked into the cake politically,” said Kyle Kondik, managing editor of Sabato's Crystal Ball, a political tipsheet published by the University of Virginia Center for Politics. “Most voters who are going to be moved by the Affordable Care Act have probably already been moved.”

Healthcare interests back Roberts in primary fight

Senate Republicans have so far successfully fought off challenges from their right flank during the primary season. But a pair of veteran legislators—Sens. Pat Roberts of Kansas and Lamar Alexander of Tennessee—face intra-party contests next week. Roberts is thought to be more at risk, facing off against radiologist Dr. Milton Wolf. The American Hospital Association has spent more than $200,000 on advertisements backing the incumbent. Other healthcare interests have also been funneling money his way in the closing days of the campaign. Since the filing deadline for the second quarter passed on July 15, seven healthcare PACs have contributed $15,000 to Roberts' campaign, according to Federal Election Commission reports. That includes $5,000 from the American Academy of Pediatric Dentistry PAC and $2,000 from the American Pharmacists Association PAC.

Key committee chair faces surprisingly tough re-election fight

Rep. Fred Upton (R-Mich.), chair of the House Energy and Commerce Committee, which has primary oversight of healthcare issues, is facing his most vigorous electoral opposition in years, notes Politico's Morning Score. “First, Upton must avoid what would be a surprise primary loss next week to Jim Bussler—something Upton is undoubtedly taking seriously following Eric Cantor's stunning primary defeat earlier this summer,” notes reporter Alex Guillen. “Upton then faces Democrat Paul Clements, who has raised more money than any Democrat ever to challenge Upton, according to his campaign. Clements just released his first ad, touting clean energy and college aid, but Upton maintains a significant fundraising advantage.”

Follow Paul Demko on Twitter: @MHPDemko

What do you think?

Share your opinion. Send a letter to the Editor or Post a comment below.

Post a comment

Loading Comments Loading comments...



Switch to the new Modern Healthcare Daily News app

For the best experience of on your iPad, switch to the new Modern Healthcare app — it's optimized for your device but there is no need to download.