The Politics of Health Care Reform

In the wake of health care reform's successful passage into law by Congress and President Obama, a lot of attention is being focused on how this all plays out in November and beyond.

What I think will become increasingly clear over the next several months (and years) is that the sky is not falling, Armageddon is not just around the corner. This health care reform law is not a government takeover of America's health care. It's not some Bolshevik plot. In fact, it leaves the decentralized, private health care system largely in tact, merely reforming it around the edges. Most Americans will either benefit immensely from this bill or experience no change at all--at least for the first several years.

Jonathan Chait points out that the health care bill that was signed into law by President Obama is a very moderate, even centrist Republican, bill. It closely resembles the reforms Mitt Romney signed into law in Massachusetts in 2006, as well as the Republican alternatives to "Clintoncare" in 1993. At its core, the bill relies on the existing private system that's in place, only marginally increasing the number of people who get their health insurance from a government program.

Already we are beginning to see a shift in public perceptions of the bill. A new Gallup poll shows that more people now support the passage of the reform bill (49%) than oppose it (42%). This is largely due to the following:
(1) Liberals who were reluctant to support the bill previously--due to its aforementioned centrism--have now come on board. These "opponents" of the bill were generically counted in the "oppose" column of public opinion surveys, even though said opposition was because they didn't think the bill went far enough. These folks have now gotten behind the largest expansion of the social safety net since Medicare, despite its perceived inadequacies.
(2) Success breeds support. Through the often rough legislative slog, the public became disillusioned in the process and the rhetoric. That part is now over, and in its place is a pretty good bill.
(3) We now have a definitive bill with definitive reforms. As the public's understanding of what's actually in the bill increases, support has increased. And I expect even more of increased support in the weeks and months and years ahead. People will realize that, contra Republican rhetoric, the sky is not falling. Before the Democrats had a single, actual bill, politicians and pundits and advocates had a difficult time defending the legislation against some of the more outlandish criticisms. That now changes.

And what about the 2012 Presidential election? Many viewed Mitt Romney as a favorite to win the Republican nomination and possibly challenge Obama for the presidency. In many ways, as Matt Yglesias points out, that ship has sailed. This plan so closely mirrors Romney's 2006 Massachusetts plan that it will be nearly impossible for Romney to justify his past embrace of health care reform to the far-right of his party.