Tuesday, April 5, 2011
The Presidentís Health Care Predicament
A piece I wrote a few days ago for Kaiser Health News explains why President Obama cannot use the health care law, his signature legislative achievement, as the basis for his reelection campaign. Here's an excerpt:
Having spent so much political capital to secure its passage, one might think that the health law would feature prominently in the president's planned reelection campaign. Certainly other presidents have used early legislative successes, even on controversial measures, to make the case that their policies were working. President Bill Clinton's tax and spending-reduction measure of 1993 was highly controversial and polarizing. It contributed heavily to the loss of Democratic control of Congress in 1994. But Clinton also used it as the foundation of his economic message throughout his presidency, and especially in 1996, when he tied the economic recovery then underway to its passage.
But Obama is not likely to follow that model, because, unlike Clinton's budget program, the health law provides almost nothing that the president can claim he delivered for voters.
The main selling point of the law -- that it will cover everyone, or nearly everyone, with health insurance, at least according to official estimates -- won't be tested until at least 2014, when the "big bang" reforms kick in. That's when the individual mandate, the employer requirements, the Medicaid expansion and exchange subsidies, and the new insurance rules regarding benefit packages and premium-setting all go into effect. Until those changes are actually implemented, they are simply theoretical selling points that may or may not work out as planned. That's not going to cut it with an electorate focused on results in the here and now.
You can read the whole piece here.