Perhaps more than any other issue, health care underscores the deep divide between Republicans and Democrats over how much control the government should have in the lives of Americans.
Voter turnout for midterm elections is traditionally low, and health care by itself is unlikely to swing a race, but since it figures in the broader debate of big government spending, health care reform could increase interest in November’s elections and therefore motivate more people to hit the polls.
For that reason, the parties will not ignore it.
The Affordable Care Act passed into law in March and though you may not hear many politicians referring to it by name, they're bound to single out some of its many components.
The law provides and/or subsidizes health coverage for 32 million uninsured Americans and will cost about $940 billion over the next ten years.
Here's a quick review of who will pay the tab:
- Individuals making more than $200,000/year and couples more than $250,000/year. Unearned income (like interest or capital gains) will be subject to an additional 3.8 percent tax. Individuals without qualifying coverage will pay a maximum penalty of 2.5 percent of their income.
- Companies of 50 or more employees that do not offer health insurance, and whose employees have government-subsidized coverage, will pay fees: $2,000 for every full-time worker.
- Insurers of employer health plans that cost more than $27,500 annually for family coverage will pay a “Cadillac tax” on 40 percent of the cost of the plan that exceeds that amount.
- The health care industry, including drug and medical device manufacturers, will also be hit with fees estimated at $33 billion over ten years.
Where Voters Stand
Americans remain roughly divided on whether the Affordable Care Act is good or bad for the nation. But a tracking poll by the nonpartisan Kaiser Family Foundation shows that people have become more comfortable with the law since it passed, with 50 percent of the voting public now holding a favorable view, 35 percent saying they’d vote for a candidate who favors repeal, and the rest indifferent.
The Challenge for Democrats
The state of Missouri recently sent a strong symbolic vote against health care legislation to Washington in the form of “Proposition C,” which would bar the government from penalizing those who wish to remain uninsured. It’s the most polarizing provision of the Affordable Care Act, and other states are following suit with similar ballot measures.
Democrats must walk a fine line on health care. Candidates will likely avoid mentioning the bill as a political victory. Instead, they’ll engage voters on specific, popular fiscal advantages, such as the $250 Medicare rebate checks to seniors to cover the “donut hole” in prescription drug benefits.
They will also keep trying to convince Americans that the new law is a money-raiser that, according to the Joint Committee on Taxation, will reduce the federal deficit by $140 billion in the first 10 years.
The Republican Opportunity
Democrats have depicted the GOP as a party bent on obstruction rather than progress. Republican efforts to repeal or bash health care reform could strengthen this perception among voters and cause a backlash.
Nonetheless, health care reform will shape up to be an offensive weapon for Republicans in the midterm elections—one that could put Democrats on the defensive.
Republican voters are almost unanimously against health care reform, while a high percentage of Democratic and independent voters are on the fence—and thus fodder for anti-reform messages.
Right-wing candidates opposed to the President’s fiscal agenda will cite the Affordable Care Act as one more example of big government spending. A poll by Rasmusson Reports shows a majority of Americans believe that spending programs will hinder, not help the economy.
The Tea Party has played a major role in Republican primaries in Utah and Kentucky and is expected to lend financial support in other races.
The surprise victory of Tea Party-backed Scott Brown of Massachusetts in January dealt a near death-blow to the health care bill.
Although the party's positions may be extreme (it would repeal not only the health care law but Social Security and Medicare), it could tip the scales in close races, like that between Republican Sharron Angle of Nevada and the incumbent, Senate Majority Leader Harry Reid.