How badly will health care reform hurt Democrats in November? That's the question being raised in headlines around the country. "Democrats could pay a price," warns the Washington Post. "A Major Victory, but at What Cost?" asks the New York Times. "After healthcare vote, Democrats turn to damage control," says the Los Angeles Times. They "face a potentially devastating backlash in the midterms," says Politico.
Maybe. But why not ask the opposite? How badly will opposition to health care reform hurt Republicans?
There are good reasons to think Democrats will suffer. Midterms are generally bad for the incumbent party. Polls have been grim. The Tea Party has become more angry and visible than the left. Americans often rebel against major legislation, at least temporarily, especially when it extends the reach of government. And much of the anxiety about November is coming from Democrats themselves.
But there are also significant factors on the other side. Health care now becomes a policy story rather than a legislative sausage-grinding story. Tales of death panels and warnings about losing your doctor can now be falsified. (That's what happened to the early scare stories about Social Security and Medicare.) And Republicans who denounce the program and promise to repeal it will no longer be bashing an abstraction. They will be proposing to take away existing, tangible benefits.
In his speech to House Democrats on Saturday, President Obama listed some of the bill's most popular elements: tax credits to small business to provide insurance, a ban on insurance exclusion for pre-existing conditions, a ban on lifetime coverage caps, and letting twentysomethings stay on their parents' policies. Obama argued that these provisions make the bill easier to defend. But his political advisers are hinting at a more aggressive strategy: portraying Republicans who oppose the legislation as opposing all of its benefits.
In the Bush administration, this was standard practice. Any Democrat who resisted any component of a bill was accused of opposing the bill's objective. If you complained about labor provisions of the bill to establish a federal department of homeland security, Republicans said you were against homeland security. If you objected to part of the "Patriot Act," they said you were unpatriotic. If you criticized Bush's execution of the Iraq war, they said you were undermining our troops.
Obama has avoided this scorched-earth style of politics. But his advisers seem ready to try it. "Let them tell a child with a pre-existing condition, 'We don't think you should be covered,' " David Axelrod said of Republicans last night. On This Week, David Plouffe added:
We're going to go out there and not just talk about what we're for, but what the Republicans are voting against. They are siding with the insurance companies over people who are denied coverage for pre-existing conditions, siding with the insurance companies over saving seniors money. So this isn't just about us being a pinata here in the election. Elections are about choices. They are voting against an enormous tax cut for health care for 40 million middle-class families and 4 million small businesses.
That's the way Karl Rove used to talk about Democrats, using votes on big, complicated measures to caricature their motives. Now Rove is on the receiving end of this treatment. On This Week, he erupted at Plouffe's charge that Republicans had gone AWOL on health care. "Republicans have offered a positive alternative on health care," he fumed. It was a poignant plea, reminiscent of what Democrats said about homeland security in 2002 as Rove pitilessly mowed them down.
This is the risk Republicans have taken by voting unanimously against health care reform. They've bet their whole party against it. If the public hates the program, they'll be rewarded at the polls. But if the public likes it, they're in trouble. And if the public fears it might be taken away, they could suffer a beating, as they did in 1996 when voters feared cuts in Medicare.