Four years after Congress narrowly approved Obamacare, the already deafening argument over the law is getting louder.
Buoyed by winning races in which the Affordable Care Act is a central issue, Republicans say they now believe the health care reform package is morphing from a political annoyance into an Achilles’ heel for Democrats.
“Pretty much every race, from U.S. Senate to the city council, Obamacare is on people’s minds,” said Aaron Trost, a Republican consultant with clients across the country. “People are so angry about it, and they’re looking for an opportunity to vent.”
And some Democrats are concerned. They say Republicans are unfairly attacking implementation of a law the GOP has repeatedly tried to sabotage.
More worrisome for the Democrats is the potential growth of the issue into a broader critique of a federal government that many voters distrust, to their party’s disadvantage.
“It’s everywhere,” said Martin Hamburger, a Washington-based consultant who has worked with Democratic campaigns in the Kansas City area. “People are using it against Democrats even where it doesn’t make any sense.”
Susan MacManus, a professor of government and international affairs at the University of South Florida in Tampa, said Democrats are right to be nervous.
Voters “think Washington is broken and saying that works politically,” she said. “Unless there’s some big success with the law, Republicans are going to be able to pull up something that doesn’t work right and use it.”
On Tuesday, a highly touted and well-financed Democrat lost a special House election in Florida that largely turned on her perceived support of the ACA.
Partisans fiercely dispute the implications of the vote. Democrats say they narrowly lost a GOP-leaning district. Republicans say they won because Obamacare was essentially on the ballot.
In either case, the subject can be expected to dominate other campaigns in the weeks ahead.
It was a top issue in the primaries for the Kansas Legislature in 2012. It’s already a part of this year’s Kansas governor race. This month, Missouri Attorney General Chris Koster, a 2016 candidate for governor, strongly defended the law. Republicans savaged him for it.
Debating health care reform in the context of congressional races makes sense because Congress may be asked yet again to repeal or change the law. And the law is an issue at the state level, where lawmakers will consider expanding Medicaid or funding an insurance exchange.
But the first ad in an Alabama race for public service commissioner starts with an attack on Obamacare. Ed Martin, Missouri GOP chairman, says he has seen the law debated in school board races.
“It doesn’t leave people’s consciousness,” he said. “Everybody’s got it in their heads.”
Some Democrats aren’t surprised health care reform remains a major political issue four years after it was signed into law. Many of the most complicated and controversial parts of the measure didn’t take effect until this year, they point out.
At the same time, problems with the federal insurance exchange website have made headlines for months. Exemption waivers and court challenges don’t seem to quit.
Millions of voters remain confused about the law, unsure about the changes it has brought.
“The president’s health care law is not working,” Rep. Lynn Jenkins, a Kansas Republican, said Wednesday. “I know this, the American people know this and the administration knows this.”
Polling is mixed, as it has been since the law passed in 2010.
A Kaiser Foundation poll published in late February showed 47 percent of those surveyed viewed Obamacare unfavorably, while just 35 percent saw the measure in a positive light. A more recent Bloomberg poll, though, showed strong support for keeping the law and fixing its problems.
But the difficulties in implementing the ACA are just one part of the Democrats’ political challenge.
Many voters — polls and elections confirm — increasingly see Obamacare as a symbol of a larger problem with government. As the economy continues to struggle and the middle class squeeze grows tighter, the Affordable Care Act becomes a funnel for voter grievances, from poor snow removal to war in the Middle East.
And Democrats are usually seen as the party of government.
“It’s about a worldview,” Ed Martin said.
Democrats admit to some frustration that the attack is proving effective.
Explaining Obamacare is difficult in a bumper sticker or tweet, they say, while attacking it just as briefly is easy.
“Quite frankly, it’s red meat — Obama and Obamacare,” said Richard Martin, a Kansas City-based Democratic adviser and consultant.
Some Democrats say that’s unfair and unwise. Joan Wagnon, chairwoman of the Kansas Democratic party, called GOP efforts “dumb.”
“Anybody that just yells ‘Obamacare’ hasn’t really thought about anything,” she said.
But other Democrats say they have done a poor job of taking their case to voters. The party and outside groups have offered some public Obamacare events — demonstrations and commercials, for example. But most aim at implementing the law, not increasing its political support.
President Barack Obama recently appeared with comedian Zach Galifianakis in a hugely popular video designed to encourage younger Americans to sign up for health insurance.
It appears to have worked — tens of thousands who have viewed the video clip have clicked through to HealthCare.gov. Still, it isn’t clear that will translate into political support for Obamacare at the polls this year.
Some Democratic candidates have responded to the backlash by avoiding the issue as much as possible or by supporting changes to the law.
Other candidates are taking a more aggressive approach, embracing Obamacare as better than the country’s health insurance system before it became law.
“Here’s a heretical idea,” New Yorker columnist John Cassidy wrote Thursday. “Rather than parsing the individual elements of the law, and trying to persuade voters on an à la carte basis, what about raising the stakes and defending the reform in its entirety?”
Still other Democrats hope the passage of time will improve the public’s view of the ACA and the candidates linked with it.
“The Republicans’ goal in using Obamacare is to try and shorthand a place on the political spectrum for candidates,” said Mark Nevins, a Democratic consultant. “The longer the Affordable Care Act is in place, the less effective that shorthand becomes.”
But time is a luxury Democrats may not have. The midterm elections are now months away, with control of Congress up for grabs.
Candidates in those races, and others, must now be ready to defend the law — or condemn it.
“Voters are looking for reps who will fight to end the disaster of #Obamacare,” GOP chairman Reince Priebus tweeted Tuesday after the Florida results were in.
“Dems should not try to spin this loss,” longtime Democratic consultant Paul Begala tweeted that night. “We have to redouble our efforts for 2014.”