Defend Obamacare unabashedly in 2014 midterms, some Democrats say

WASHINGTON -- With enrollments higher than expected, and costs lower, some Democrats say it's time to stop hiding from the president's health care overhaul, even in this year's toughest Senate elections.

Republicans practically dare Democrats to embrace "Obamacare," the GOP's favorite target in most congressional campaigns. Yet pro-Democratic activists in Alaska are doing just that, and a number of strategists elsewhere hope it will spread.

President Barack Obama recently announced that first-year sign-ups for subsidized private health insurance topped 7 million, exceeding expectations. And the Congressional Budget Office - the government's fiscal scorekeeper - said it expects only a minimal increase in customers' costs for 2015. Over the next decade, the CBO said the new law will cost taxpayers $100 billion less than previously estimated.

"Democrats need to start making the case for Obamacare," Mills said. "They all voted for it, they all own it, so they can't get away from it. So they'd better start defending it."

Even some professionals who have criticized the health care law say the political climate has changed.

"I think Democrats have the ability to steal the health care issue back from Republicans," health care industry consultant said Bob Laszewski said. "The Democratic Party can become the party of fixing Obamacare."

In truth, some Democratic lawmakers often talk of "fixing" the 2010 health care law. But it's usually in response to critics or in a manner meant to show their willingness to challenge Obama.

For instance, Sen. Mary Landrieu, D-La., who faces a tough re-election bid, used her first TV ad of the campaign to highlight her demand that Obama let people keep insurance policies they like.

But Landrieu and other hard-pressed Democrats have not gone as far as a pro-Democratic group in Alaska that is unabashedly highlighting the health law's strongest points.

The independent group Put Alaska First is airing a TV ad that praises Democratic Sen. Mark Begich for helping people obtain insurance even if they have "pre-existing conditions," such as cancer. The ad doesn't mention Obama or his health care law by name, but it focuses on one of the law's most popular features.

Other Democrats should consider such tactics, political consultant David DiMartino said.

"There is still time to tell the story of Obamacare to voters," he said. Democratic candidates don't want to be defined entirely by the health law, he said, "but now they can point to its successes to fend off the inevitable distortions."

Republicans are confident that running against the law will be a winning issue for them. "The intensity level of those who have been most affected by this law is greater on the negative side than on the positive side," House Majority Whip Kevin McCarthy, R-Calif., told the Wall Street Journal. "I don't see that being a difficult conversation for us to have."

Democrats hardest hit by anti-Obamacare ads - including Sens. Kay Hagan of North Carolina and Mark Pryor of Arkansas - continue to defend the health law when asked, but they generally focus on other topics, campaign aides say.

Polls don't suggest public sentiment is shifting toward Democrats, said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. But with at least 7.5 million people enrolled despite last fall's disastrous rollout of insurance markets, Blendon said, Democrats have some strong new material to use.

Republicans need to gain six seats to control the 100-member Senate.

New political problems might arise for the health care law before the Nov. 4 election. For instance, the individual requirement to carry health insurance remains generally unpopular, and now penalties may apply to millions of people who remain uninsured.

And Republicans have also tried to poke holes in the narrative that the law is succeeding. They've raised questions about the validity of enrollment figures, saying we still don't know how many of the enrollees were previously uninsured, or how many have actually cemented their coverage by paying their first premium.

So far, Republicans have had an edge in public opinion, particularly when those with strong sentiments about the law are considered. A recent AP-GfK poll found that strong opponents outnumber strong supporters, 31 percent to 13 percent. And motivated voters often make the difference in low-turnout nonpresidential elections. But the poll also found that most Americans expect the health law to be changed, not repealed.

That puts Republicans in a tricky situation: GOP primary voters demand repeal, but general election voters in November are looking for fixes.

"It's not a cheap and easy political target anymore," Laszewski said. "Republicans are going to have to tell us what they would do different."

Democrats deride GOP proposals to "replace" the 2010 health care law, saying they collapse under close scrutiny. Since they generally contemplate a smaller federal government role, many of the GOP ideas are likely to leave more people uninsured. Some approaches do not completely prohibit insurers from turning away people with pre-existing medical conditions.

Economist Douglas Holtz-Eakin, who advises many top Republicans, said the emerging GOP plans aren't tied to the ups and downs of Obama's law but look ahead to the 2016 presidential election, when the party will need alternatives.

Ultimately, he said, "there can't be a Republican 'replace.' ... There needs to be a bipartisan reform." That doesn't seem likely, but Holtz-Eakin said it was the only kind of change that will prove durable.

Democrats can cheer the latest statistics, "but they are not out of the woods yet," he said. "They have waived and deferred a million things they knew were unpopular, and those are still out there."

McCarthy agreed, telling the Journal that the frequent delays and adjustments to Obamacare during the roll-out period will not fool voters into believing the law has succeeded. "What they're trying to celebrate is not a celebration," he said. "They have now lowered the bar so far that it just proves the system is not working."