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On 6-Month Birthday of Health Law, Will Patient Protections Win It Some Love?

4 years ago
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Like it or not, Americans are getting new health insurance benefits this week.

Who among us would say no to free preventive care? To banishing lifetime limits on coverage? To making sure little kids with medical problems can get insurance, and big kids with no insurance -- up to age 26 – can stay on the family plan?

Democrats are betting the answer is nearly no one, so they're planning to spotlight the new protections in a series of events this week at the White House and on Capitol Hill. It seems like a no-brainer. These are some of the most appealing and least controversial elements of the Affordable Care Act, signed by President Barack Obama exactly six months ago Thursday. Drawing attention to them isn't going to reverse Democrats' electoral fortunes on a dime, but it can't hurt, right?

As a fan of the new law, I hope not. But who knows how this week of celebration will play? The most far-reaching aspects of health reform don't take effect until 2014, yet already Republicans are saying it has failed and insurance companies are saying (wrongly, the administration says) that it's the reason they are proposing big increases in premiums. Several polls show the public split evenly between approval and disapproval of the overall law. But it fares worse in other polls, which show majorities in favor of the GOP pledge to repeal or "defund" it if they take control of the House.

Aside from a few Democrats who are bragging in ads about their votes against the health bill, the party's general approach on the campaign trail is, talk about creating jobs and strengthening Social Security, and fight back hard if you get attacked on health care, but don't bring it up first. That's why this week of pro-activity, highlighting a section of the new law that Democrats call the patient's bill of rights, is a departure.

Obama's activities include a call Tuesday with faith leaders to discuss "the heart and compassion" of health reform, as reflected in the patient's bill of rights. On Wednesday he holds a White House event to highlight how the law already is improving the health care system, with a heavy focus on people who are benefitting from it. Obama also will meet with 40 state insurance commissioners to discuss their role in policing premium increases and enforcing the new consumer protections.

The observances won't be limited to the White House. The administration so far counts nearly 200 events by outside groups to celebrate the six-month anniversary of the landmark legislation (some are listed here). House and Senate Democrats will mark the date Thursday at an event with Health and Human Services Secretary Kathleen Sebelius. Individual senators are arranging conference calls with groups in their home states, and House leaders will be circulating fact sheets about the new benefits to members and the public.

And then they'll go back to talking about the economy. The strategic consensus seems to be that it's great if the White House wants to take the lead on this, and maybe congressional candidates will benefit. Brendan Daly, a spokesman for Speaker Nancy Pelosi, said he doesn't expect members to put up TV ads touting health reform, "but it's helpful to have in the narrative these popular parts of bill."

Democratic pollster John Anzalone, who is working on several Senate races and more than a dozen House races this year, said Obama is right to highlight the patient protections. They poll "incredibly well," he said, and some people might change their views of the new law if they learn they have nothing to fear from it or that it might be helpful to them.

He said his research also shows that while supporting the new law might be a negative for Democrats, Republicans are vulnerable to the counterargument that they stood with the insurance industry and didn't want reforms, such as those in the patient's bill of rights. "Democrats have the ability to push back . . . with very strong contrasts," Anzalone said. "You might see that dynamic. You might see it in advertising. Some of these guys are going to defend themselves."

The White House and to some extent congressional Democrats already are fighting back hard. This month, writing on the White House blog, spokeswoman Stephanie Cutter has taken aim twice at GOP plans to defund the Affordable Care Act. She also wrote that the law was not responsible for "unjust" premium increases -- that they were planned long before it was passed. She said any increases due to the act would be "minimal" -- 1 to 2 percent -- and largely offset by free preventive services and other benefits.

The chairmen of the Senate Finance and Commerce committees, Max Baucus and Jay Rockefeller, reiterated those numbers Monday in a letter to the five largest insurance companies and warned they would get on the case of any insurer that blames rising premiums on the new law. "This level of misinformation is not acceptable," the pair wrote. They promised to "closely examine any potentially misleading communications to consumers."

The president himself talked about health reform throughout the day Monday. "If your child, heaven forbid, had a pre-existing condition, before I took office you were out of luck in terms of being able to get health insurance for that child. Now insurance companies have to give you health insurance for that child. And by the way, that health insurance company can't drop you if you get sick," he said during a midday town meeting on CNBC.

Later, he brought up the law repeatedly, and proudly, at a series of fundraising events for Rep. Joe Sestak, the Democrats' Senate nominee in Pennsylvania: The protections that stop insurance companies "from jacking up your premiums at will or denying you coverage because you get sick." . . . The woman who had thanked him that day because "I've got two young people graduating from college. My children right now, they don't have health insurance, but because of your bill, they're going to be able to stay on my health insurance until they're 26 years old.". . . The guarantees that adults and children with pre-existing conditions can still get insurance coverage "because in a country as wealthy as ours, with the values that we have, nobody should go bankrupt just because they get sick."

The litany is not going to change the minds of people who believe the government shouldn't be so involved in health care, who believe the law won't keep costs down, who are allergic to the idea of requiring almost everyone to buy health insurance (a 2014 provision that, as it happens, was sought by the insurance industry on the theory that a raft of new, healthier, cheaper-to-cover customers would offset the cost of lifting all those coverage caps and accepting people with pre-existing medical problems).

The most effective counterweight to all of that is reality -- how the new law affects real people and real life. That's the standard by which people judge the economy and the president who presides over it. Unfortunately, that standard won't be available on the health front until about 2015.

There is always the chance that elevating the issue will inflame the opposition. But still, I hope Obama keeps at his health advocacy. It might jolt his sleeping base awake, perhaps even reduce negative perceptions of the new law a bit among some who are unsure about it. And really, what's the choice? As Anzalone put it, "If you have an issue like this, you have to own it."

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Filed Under: Analysis

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