President Obama recently told Oprah Winfrey that he doesn't get very good Christmas presents. This is great training for a budding politician, because faking enthusiasm for a bad gift is one of the few times you can practice insincerity. Oh, tube socks! I really needed tube socks! This could be another bummer year for the president. He's going to get a present—health care reform will pass the Senate—but it's not likely to be exactly the kind he wanted.
In one sense, health care reform, like any gift, is welcome. And it's certainly better than the alternative. "If it doesn't pass, it will look like Democrats can't get anything done," Democratic pollster Celinda Lake says. A strategist working for Democrats on several 2010 campaigns says it would be "a political catastrophe if nothing passes." The president would look weak, which would depress Democratic voters and keep them from going to the polls in 2010. House members, who have already had to vote on health care reform, would be doubly unlucky: They would be vulnerable to being painted as profligate spenders who wanted to put government in charge of health care, yet they would be unable to brag that at least they helped insure 30 million people.
Perhaps this is why the White House spokesman today suggested that former Gov. Howard Dean was daffy. Dean has suggested killing the Senate bill. Spokesman Robert Gibbs responded, "I don't think any rational person would say killing a bill makes any sense at this point." (Gibbs has a point. Starting over isn't going to rearrange the makeup of the Senate, which is driving the compromises that Dean doesn't like. There's also no evidence that forcing people to watch legislators truss the haggis one more time will improve their view of health care reform.)
The political question then becomes: If we accept that passage is better than failure, how much better is it? If voters are thrilled when health care reform passes, it will of course help the president: He will be in a better position to push through his agenda next year, and to help Democrats keep their sizeable majorities in Congress.
Right now, however, the picture looks grim. First, the president's opponents are much more energized than his supporters. According to the just-released Battleground poll, more than three-quarters of Republicans and independents say they are extremely likely to vote, with fewer than two-thirds of Democrats extremely likely to vote, including 58 percent of African-American voters. "Looking at the enthusiasm numbers makes your blood run cold," said the Democratic strategist.
Enthusiasm for health care reform specifically, and among Democrats in general, is low. Day by day, public opinion about health care reform seems to get worse. In a recent NBC poll, just 32 percent of respondents said they believe the president's health care plan is a "good idea"; 47 percent said it's a "bad idea," the highest that number has been. According to a recent ABC News poll, majorities now for the first time disapprove of Obama's work on health care (53 percent) and oppose the health care reform package making its way through Congress (51 percent).
Those numbers suggest that people won't be greeting the Senate bill like a free Wii. "The problem with health care reform is that whatever passes will be met with mixed results," says Lake. Part of this results from the fact that people don't think there's anything in the bill for them. In the Battleground poll conducted by Lake and Republican pollster Ed Goeas, when people were asked their priorities for health care reform and the president's priorities, the two were wildly divergent: 28 percent said their priorities matched the president's, while 64 percent said they did not. In the ABC/Washington Post poll, more than half of those polled, 53 percent, see higher costs for themselves if the proposed changes go into effect than if the current system remains intact.
Even among the president's base, people are ambivalent. More people will be happy if something passes, even without a public option, than if nothing passes. But for 2010, the president needs his base to be more than happy. He needs them to be ecstatic. In the NBC poll, most of the increase in those who thought reform was a "bad idea" comes from some of the president's core support groups, folks upset about the lost public option. Lately, this has taken a public form. In addition to Dean, there are liberals like Rep. Anthony Weiner and Sen. Russ Feingold, who say the president has not been assertive enough. (If the president isn't enthusiastic in pushing the bill, voters are also likely to be less enthusiastic.)
Plus, people want the president to work on the economy. Every poll out this week continues the long-term trend: The economy is their No. 1 concern, and people want to see results in their wallets not just on the graphs. If health care reform passes, that might be nice. But for those voters who won't get coverage because of it, the direct benefit will be hard to grasp. That's why the White House and Democratic strategists are gearing up for a concerted effort to sell the benefits of health care reform after it passes. This will include arguments for what's in the bill—and the argument that improvements will be made between the bill's passage and implementation in 2014.
The question is whether the president can be more successful in making the case for health care after it passes than beforehand. So far, the more he has talked about it, the worse reform has fared in the public mind and the worse the public has felt about his handling of the issue. Afterward, of course, the president wouldn't have to contend with the distracting sideshow of Congress. And angry progressives may lose their momentary ire, focus on the Republicans they don't like, and get back in the mood to go to the polls.
The hope is that public opinion about health care reform might flip as quickly as it has since the president announced his decision to send 30,000 more troops to Afghanistan. In the NBC poll, 55 percent say they support increasing the U.S. troop levels, an 8-point jump since October. Obama's approval ratings as commander in chief have gone up (7 points in the ABC poll), his strongest showing in seven categories tested.
There are other alternatives to shrink the enthusiasm gap. The president and Congress could pass other measures that progressives would like, from immigration reform to legislation that makes it easier for unions to organize. It's tough to bank on legislative accomplishment, though.
The alternative, say Democrats involved in races, will be to attack Republicans more directly and thoroughly for their obstructionism. If the enthusiasm gap remains big, then the president may have to engage in that fight directly. That will carry risks since voters like to see the president in the bipartisan spirit he campaigned on (even if that spirit is unrequited). It will be hard to both attack and extol the opposition—almost as hard as pretending you're thrilled to get a gift when you're really not.
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