After processing the impact of an unexpected election defeat that cost them a critical Senate vote, Democratic leaders in Congress and the White House are vowing to restart the health reform push by reclaiming public support. Passage of a comprehensive health care measure in the spring will likely hinge on a surge of public support for the legislation, without which Democratic moderates may reject the bill.
The campaign to build public support comes after political will in Congress to pass comprehensive health care evaporated following the stunning January election of Sen. Scott Brown (R-Mass.) to a seat long held by the late Sen. Edward Kennedy (D) in one of the most Democratic states in the union. Brown campaigned as the decisive vote to defeat the health care bill. Brown's election led congressional leaders to drop a measure that combined the House- and Senate-passed bills, as many moderate and conservative Democrats became concerned that a shift in public mood against the bill might endanger their own re-election chances.
Democratic leaders now hope that an outside jolt stemming from a groundswell of public support for large-scale health care overhaul will refocus wavering congressional Democrats and get them to support a measure to bring at least some reform to a system most Americans acknowledge is in need of major repair.
"No legislative procedure is going to work until the public is shown that this is not the horrible bill that they have been led to believe," David Kendall told Psychiatric News. Kendall is a senior fellow for health policy at Third Way, an organization advocating for health care reform.
Among the newest efforts to boost public support for the overhaul was President Obama's release on February 22 of his own $950 billion health care proposal, which sought to bridge the significant gaps between the House- and Senate-passed bills. However, the measure drew Republican opposition, as have all other congressional reform proposals, and tepid support from House Democrats, because Obama's approach closely hews to the Senate one to which many House members object.
The Obama plan was the centerpiece of a February 25 "summit" at which Obama brought together leading Republicans and Democrats for a nationally televised display of bipartisan effort to forge a health reform agreement. Republicans roundly rejected the event as a "photo-op," however, and the Obama proposal as lacking public support.
"Americans have said in every way they know how, including in town halls, polls, and elections, that they don't want this bill and they want us to start over," said Sen. Lamar Alexander (R-Tenn.), at the summit.
Meanwhile, Democrats announced a strategy days before the event to pass the legislation without Republican votes, assuming a boost in public support can bring around nervous Democratic moderates in the House.
The Obama administration also sought to stir the public's support for health care reform with several high-profile denunciations of huge insurance-premium rate hikes in California and elsewhere. Kathleen Sebelius, secretary of Health and Human Services, joined the fray with the release of a report that detailed double-digit insurance-premium hikes for individual plans in six states across the country, including insurers' requests for rate increases of 56 percent in Michigan and 24 percent in Connecticut. The denunciations of insurers were coupled with Democrats' support of a new provision in the Obama health care proposal that would establish the first national price-control mechanism for health insurance rates—many states already have such a body overseeing insurance rates, but this idea too drew immediate condemnation from Republican congressional leaders.
The push for public support came as Americans' enthusiasm for quick passage of the Democrats' legislation continued to wane. A nationwide poll by the Kaiser Family Foundation released in February found that only 32 percent supported quick passage of comprehensive legislation similar to the versions that passed the House and Senate. Meanwhile, 41 percent wanted Congress to either put off action until later in the year or drop it altogether.
The Kaiser poll may point to another option that some advocates began to discuss after the Massachusetts election: passage of some key provisions that have broad public support.
Several federal lobbyists said this approach is possible but would frustrate Democratic leaders and many health care groups that have invested so many resources and so much time in a comprehensive approach. Stand-alone, small-scale reform bills could, for example, include funding for insurance pools that provide coverage to people with chronic illnesses—including serious mental illnesses—who are either unable to afford insurance or are denied coverage because of their pre-existing conditions.
The Kaiser poll is posted at <www.kff.org/kaiserpolls/8051.cfm>.