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Senators Take Home Different Messages on Health Bill

By Alex Wayne, CQ Staff

December 23, 2009 – Senate Democrats are poised to accomplish something this week that Congress seldom attempts: passing partisan legislation in the face of what appears to be substantial public opposition.

That makes it incumbent on Democratic leaders to convince Americans that the health care overhaul bill (HR 3590) is good for them. With recent polls showing substantial public anxiety over the health plan, and with President Obama largely staying above the fray, rank-and-file lawmakers already are busily scripting narratives portraying the public as net winners in a reconfigured medical marketplace.

“I’ve always believed that once it was enacted and once it was moving, and people saw it implemented or parts of it implemented, there’d be a lot more support for it,” said Sen. Bob Casey, D-Pa., who acknowledged concern about the public mood. “But we not only have to talk about it, we have to make it work.”

Casey said he may hold town hall meetings over the Senate’s three-week holiday break to talk about the bill and how it would benefit his constituents. The $871 billion legislation would expand health insurance coverage for more than 31 million Americans who would otherwise lack it, according to the Congressional Budget Office, and would also decrease the budget deficit over time.

Democratic leaders say opposition to the bill is overstated. A Dec. 21 memo from pollster Mark Mellman to Democratic senators noted that polls by media organizations tend to ask a generic question—whether voters support or oppose health care proposals under discussion in Congress, for example—without providing context or the specifics of the proposal.

“Focus group research makes clear that voters know little about the substance of the plan—all they know is that some on both the left and the right don’t like it and that it is the subject of intense controversy,” Mellman wrote. “In essence then, these questions ask people whether they favor or oppose—a controversial plan that is in constant flux. Understood that way, it is surprising we find any support.”

Mellman, whose memo was commissioned by Senate Democratic leaders, also argued that the polls count among bill opponents people who would like Congress to “go further,” for example by creating a single-payer health system.

“The individual elements of health reform are popular, and so is the bill when described in detail,” he wrote.

A spokesman for Majority Leader Harry Reid, D-Nev., said that based on the memo, Democratic leaders are urging their caucus to talk about the “specific provisions” and “immediate benefits” of the bill with their constituents.

“Starting next year, there are going to be at least a dozen immediate benefits that people will see, and that’s what we’re going to focus on,” said the spokesman, Rodell Mollineau. It will be an “ongoing campaign,” he added.

Republicans have a different take, and are looking forward to amplifying their opposition when the Senate leaves for the holidays.

“What we’re trying to do is do everything we can to let the American people know what’s in the bill, what it costs and how it affects them,” said Sen. Lamar Alexander, R-Tenn. “They’ve still got time to stop it.”

The Republican story line portrays the bill as the product of a secretive effort carried out behind closed doors by Democratic leaders, who could only secure the needed votes by granting valuable perks to holdout members of their caucus. When it came time to pass the bill, Republicans note, Democrats scheduled votes during a snowstorm and in the middle of the night.

Of course, Republicans exercised their rights under Senate rules and refused to allow votes to be scheduled at more convenient times of the day. But the rest of the narrative—while not so different from the way most major legislation is written—is largely true.

Republicans also are trying to influence public opinion by focusing on how Democrats propose paying for the bill: through a combination of nearly a half-trillion dollars in Medicare spending reductions over the next decade and tax increases on health insurers, drug companies, medical device manufacturers, wealthy Americans and people with high-cost health insurance policies.

In such an environment, Democrats will try to inoculate themselves by tapping public frustration over health coverage denials and other problems in the existing system.

“The most important thing for Democrats is, once the thing passes, insurance reform will be the cornerstone of it. That’s got to go into effect very quickly,” said Bill Schneider, a political analyst with the centrist think tank Third Way. “Democrats have got to keep selling it, even harder, after it passes, because this law — once it becomes law — is going to need an awful lot of protection.”

Some Democrats concede that the results might not be apparent before voters go to the polls, but add that they have to look beyond immediate political repercussions.

“When [the bill] goes into effect, when people have health coverage, when they can get health coverage they can afford and when their kids don’t have to die in their arms of cancer because they can actually bring them to a doctor, the polls will start to change,” said centrist Mary L. Landrieu, D-La, who withheld her support for the bill until relatively late in the debate.

“It may not happen in time for 2010, but we can’t worry about elections right now. We have to worry about leading the country in the right direction.”

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