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.
The Los Angeles Times thinks Democrats fear a repeat of what happened to LBJ, "who, upon signing the 1964 Civil Rights Act, said his party had lost the South for a generation."* But health care reform helps a majority, not just minorities. If middle-class whites embrace the Democratic Party as blacks did after civil rights, what's left of the GOP?
Critics argue that health care reform, once enacted, won't generate the breadth of support that Social Security and Medicare generated, because those bills passed with significant Republican support. But why assume that lockstep Republican opposition will discredit the health care program? Maybe the opposite will happen: Lockstep opposition will discredit Republicans.
The same can be asked about partisanship. "Mr. Obama has lost something," says the New York Times. "Gone is the promise on which he rode to victory less than a year and a half ago—the promise of a 'postpartisan' Washington in which rationality and calm discourse replaced partisan bickering." But why is this Obama's loss? Maybe it's the GOP's.
Hours before House Republicans voted 178-0 against the bill, their leader, John Boehner, summarized their platform for the midterm elections. "We will have an effort to repeal the bill," he pledged. Today, that sounds like a good message. We'll see how it looks in November.
Correction, March 22, 2010: The article originally quoted Newt Gingrich, via the Washington Post, as saying that Democrats "will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years" when he signed the civil rights bills of the 1960s. After Slate's article was published, the Post issued a clarification in which Gingrich said he was referring to cultural and economic factors beyond civil rights. Accordingly, I've attributed the argument about civil rights to another source that made the same point. (Return to the corrected sentence.)