The first wave of big changes under the new health care law take effect today. As my colleague Kevin Drum points out, the changes include some of the provisions that Democrats thought would be the most popular with the public—including a requirement for insurance companies to cover all children, including those with pre-existing conditions, to offer free preventative care, and to allow those under 26 years to be covered by their parents' plans.
Democratic leaders are holding a smattering of press events today to celebrate the new provisions that are going into effect, and some pro-reform advocacy groups like the Progressive States Network are doing the same. But expect the cheerleading for health reform to die down as quickly as it's flared up. In the warm afterglow of health reform's passage six months ago, Democrats predicted that the law would help bolster the party's image before voters. Instead, the Democrats never came out in full force to defend health reform, and vulnerable members up for re-election began running away from reform.
While some anti-reform Democrats have used TV ads to advertise their opposition to the law, barely any pro-reform lawmakers have run ads in support of it. Meanwhile, Republicans have gotten a big boost from outside third-party groups, which have poured $23.6 million into TV ads overall, while their Democratic counterparts have only spent $4.8 million on TV. Progressive fundraising has been anemic, and groups like Health Care for America Now—an advocacy group that went all out during the reform debate—says that it will stay off the airwaves in individual races, focusing its efforts instead on phone calls to seniors.
Basically, the Democrats and their allies seem to have decided that the health reform is too toxic an issue for the party in an election year. Rather than make a big push in their messaging and ad buys to sell health reform, they've tried to keep the issue at an arm's length. The White House made something of a PR push in the beginning of the summer for the new law. But the party all but buried the issue since then, seeing how the majority of the public still disapproves of the law—by a margin of 56-39 percent, according to the latest Gallup poll.
The problem is, by running away from health reform, Democrats have also enabled their conservative opponents to continue perpetuating myths about the issue that are likely to hurt them politically. According to an AP poll, more than half the public believes—erroneously—that the law will raise taxes this year, and a quarter think that it will create "death panels" to decide who does or doesn't receive care. Knowing they have the upper hand on messaging, congressional Republicans have made repealing health care a central plank in the "Pledge to America" proposal released with great fanfare Thursday. The Democrats are trying to hit back with a PR push of their own, but it's going to be much harder for them to make a credible defense of health care, having tried to sweep it under the table for months.
With only weeks to go for the midterms, it's probably too late for the Democrats to make up for lost time and reverse the public's perception of health care by this year's midterm elections. But, as Chris Cillizza points out, President Obama will certainly have some explaining to do by the time 2012 rolls around. At a health care event in Falls Church, Virginia today, Obama admitted as much to voters: "Sometimes I fault myself for not being able to make the case more clearly to the country."