Democrats Need to Get Specific to Make Obamacare a Winner

If Republicans can keep discussion around the Affordable Care Act vague, they’ll win in the midterms. The party of health care should collect stories of success and confront the party of no.

The big electoral question hanging over Democrats, of course, is what to do about Obamacare this fall. The pundits say: It’s death! The Democrats are gonna get killed. The Democratic consultants advise their candidates to be as mealy-mouthed as they can possibly get away with being and change the topic as quickly as possible.

The pundits might end up being right after all the votes are counted. But I say the quickest way for Democrats to guarantee that the pundits end up being right is to take their consultants’ advice and pussy-foot around the issue. Democrats who do that will be hoping they sound “reasonable,” but what they’ll really be sounding, and everyone will hear it, is timorous, callow, and totally without conviction. If Democrats are going to say they support the ACA at all—and most of them are going to have to—they might as well do it in a full-throttle and in-your-face way. And they can. The material is there if they just have the onions to use it.

I was struck recently by the contrast in the way two well-known Florida Democrats are approaching the issue. Charlie Crist is the ex-Republican governor who’s now seeking his old office as a Democrat and, after calling himself a proud conservative just a few years ago, is suddenly to the left to me. Alex Sink is Democrat who lost to Crist’s successor, incumbent GOP governor Rick Scott, and is now trying to get to Congress in a special election in a district just north of Tampa Bay. Their approaches are day and night with respect to Obamacare,

Crist has his issues, Lord knows, and Floridians may well question how deeply he believes all this. But be that as it may, here was Crist to Chuck Todd on MSNBC earlier this month: “About a million of my fellow Floridians are not getting health care today. And I am told by friends at SEIU that means that six people in Florida die every day as a result of that. Every day.” Whoa, Todd said; that’s kind of a heavy charge. People are dying because of Rick Scott and his failure to push for Medicaid money under Obamacare? “That’s right. Well think about it…If people are sick, and they aren’t getting health care, what happens? They usually get sicker. Or they die.” The state would be losing, Crist noted, $51 billion in federal money over next 10 years. In other venues, Crist has been similarly full-throated, and less melodramatic, in saying that it’s a tragedy for his state not to take that money.

In contrast, according to an NPR report Tuesday morning, here was Sink speaking to some voters in the district: “This, uhhhhh, Affordable Care Act has not been perfect any stretch of the…imagination, but my position is it should not be repealed because we cannot go back to where we were before.”

In fairness to Sink, the NPR sound bite ended there, so it’s possible she spent the next 10 minutes stoutly defending the law’s good points. But one doubts it. That tremulous “uhhhh,” which lasted more than a full second, gave the game away. She’s desperate to say as little about the whole thing as possible. She’s running in a district that is historically Republican, although it got changed around a lot in the last redistricting and is now rated only as R +1, i.e. basically an evenly matched district. She’s slightly ahead of her GOP opponent in most polls, and the voting is just three weeks away, so she clearly and perhaps understandably just wants the current equilibrium to hold and March 11 to come as fast as possible.

Even so…there is, believe it or not, much that’s good that Sink and all Democrats could be saying about the ACA, especially to an elderly population like that of Pinellas County, Florida. It closes the donut hole in prescription drug coverage. It opens up a vast new array of preventive screenings available to seniors covered by Medicare, making early detection of serious conditions newly possible. New preventive care isn’t limited to seniors, either—according to healthcareforflorida.org, 4.7 million Floridians have access under the ACA to various preventive treatments that weren’t available before. The website also notes that 5.6 million Floridians had insurance coverage with lifetime caps, which have been eliminated under the ACA.

How hard can it be to find real-life seniors and other Floridians who are reaping some of these benefits, writing them up some scripts, and having them talk into a camera for 30 seconds? It can’t be hard at all. These people exist—millions of actual Floridians and people from the other 49 states who are right now benefiting from aspects of the law. Conversely, many millions of other folks exist in states like Florida who haven’t benefited because their state didn’t take the Medicaid dough. Take two people with virtually identical incomes in similar life circumstances, one lives in a state that took the money, and the other in Florida, and compare their situations. I’ll cheerfully bet you that the person in the former state, who now has subsidized insurance and can take her daughter to the doctor instead of the emergency room, is the happier of the two.

Democrats in Florida and across the country should be collecting these stories by the hundreds and making these commercials and preparing to get right in their Republican opponents’ faces with them. Republicans prevail as long the argument stays on the level of the vague and theoretical. The very word “Obamacare.” The president’s own bad polling numbers in many of the states where there are close races. The general idea of “big government.” When the ACA discussion is about these platitudes, and Democrats are just left trying to defend the law on vague terms while praying for the chance to move on to the next subject, the Democrat will lose every time.

Democrats can win, though, by arguing with specifics, and by touting them unapologetically. The mother in their state whose child can now continue to get treatment because the lifetime cap was lifted. Tell us, Governor Scott: do you really want that child’s coverage to be cut off? Do you?

Republicans understand: You may be defending an untenable position, but even if you are—indeed especially when you are—that’s when you have to be your most aggressive and fulminate as if anyone who reached any conclusion other than yours had to be either an idiot or a traitor. Democrats need to learn some of that balls-to-the-wall mojo. And in this case what they’re defending is plenty tenable. But they have to believe it is, and say so, and put the people who want insurance companies to go back to having the power to x-out customers with pre-existing conditions on the defensive. That’s a fight they can’t lose, if they’re gutsy enough to have it.