Politics

03.14.14

What Florida Really Tells Us About Obamacare

Forget the conventional wisdom—the health-care issue actually helped Alex Sink a little. Democrats must learn from it.

Was it really Obamacare that sunk Sink? I mean of course Alex Sink, the Democratic Florida congressional candidate who lost to Republican David Jolly on Tuesday. After the results were announced, Washington’s conventional wisdom congealed immediately: This was all about Obamacare, and it’s going to doom the Democrats come November.

Not so fast, says Geoff Garin, the pollster who did Sink’s polling in the race. Garin argues in a memo he released the day of the voting that “the issue ultimately provided more of a lift than a drag to her campaign.” He followed up by telling me yesterday: “She would have done worse if she’d neglected to hit back and engage the issue.” There’s a lesson in there for Democrats as they march toward November.

Garin put two key questions to the district’s voters. The first paraphrased the criticisms of Sink on Obamacare: Sink supports this law that will take away $716 billion from Medicare, and that caused 300,000 Floridians to lose their coverage and 2,500 patients at a district cancer center to have to change doctors. The second paraphrased criticisms of Jolly’s health-care position: He wants to totally repeal the law instead of fix it, a position that would let insurers again discriminate against the already ill and charge women more than they charge men for coverage. Repeal would also cut expanded prescription-drug coverage for Medicare recipients.

Respondents were asked to say whether this information gave them “very major doubts” about the candidates, “fairly major” doubts, “just some” doubts, or “no real” doubts. Results: While 43 percent now entertained very major doubts about Sink, 50 percent said they had very major doubts about Jolly. And 35 percent had no real doubts about Sink while only 26 percent had no real doubts about Jolly.

If that polling is accurate, then “more lift than drag” is accurate and fair. Guy Molyneux, a partner of Garin’s who oversaw some Obamacare polling for a couple of unions in January, echoed the point that there are at least three things Democrats can say about the law and the Republicans’ repeal zeal that poll really well. People broadly understand, Molyneux told me, that the law protects against discrimination based on pre-existing conditions, and they approve of that strongly. They also know that insurers can no longer drop sick people on whim, and they like that. And they’re getting to know that the law prevents insurers from charging women more than men, and they like that, too; even men.

“Our challenge,” Molyneux told me, “is to show that there’s nothing behind the curtain there.”

There’s one more thing that people don’t yet know very well, but the polling indicates that it could be a strong debating point, too: Under the law, insurers have to publicly justify any rate increases greater than 10 percent. This is called rate review, and it and the medical-loss ratio provisions of the law (explained here) are the two main planks that guard against willy-nilly rate hikes. A Heath and Human Services study from last September found that nearly 7 million citizens had saved more than $1 billion because of rate review, and moreover, that insurance companies were seeking increases of 10 percent far less frequently than before the law because of the added oversight.

Since everybody and his brother assumes that the Affordable Care Act is going to increase their rates, seems to me it’d be awfully useful for the Democrats to develop a sharp talking point or two explaining to people that the law actually helps prevent crazy premium increases.

This all makes the Obamacare story a lot more complicated than “disaster for Dems.” It just doesn’t have to be. Republicans know this, too. Why are they, or some of them, suddenly talking about replacing the law? Precisely to try to insulate themselves from the effective Democratic attack that they’d give carte blanche to insurance companies to go back to their old ways.

It’s worth dwelling on this for a paragraph—it’s important to understand. It was in the spring of 2010 that the GOP unveiled “repeal and replace.” They stuck with that through the election. Then, once they’d retaken the House, they dropped “replace” and went for “repeal” only. Now that a midterm election is coming again, though, they’re starting to put “replace” back in their rhetoric. But it’s as hollow this time as it was then. “Our challenge,” Molyneux told me, “is to show that there’s nothing behind the curtain there.”

Lord knows, the Democrats have more problems than health care staring them in the face for the fall. The turnout question is the biggest one, although they say they’re making efforts this time that have no precedent in a midterm election. And Obama’s bad approval numbers—worse still in many of the states with high-profile Senate contests—are a huge factor. “If Obama’s still at 41 percent in mid-October, we’re in a world of hurt,” Molyneux says. And finally, but far from least, the economy. An awful, awful number from this week’s NBC/Wall Street Journal poll: Fully 57 percent of those surveyed said they think we’re still in a recession.

So yeah, there’s a lot for Democrats to worry about. But in most of the contested states—not Louisiana, probably not Arkansas, but the others—they can make Obamacare a net wash if they can be clear about the implications of “repeal” and call out their GOP opponents on “replace.” And maybe as a bonus show they have some fight in them, and give those unmotivated young and Latino voters some good reasons to go to the polls.