The Hippo


Jul 15, 2019








Health care reform upheld
Court decision shapes campaign landscape


It had been lurking in the background for a while now. It’s on the forefront once again.

The federal health care reform bill, dubbed Obamacare, became the central campaign issue for Republicans in the 2010 election. It represented government overreach by Democrats. It represented fiscal irresponsibility. It represented growth of government. That’s what Republicans saw anyway. And they saw themselves right to a historically successful election. 

For Democrats, it represents a stab at solving a problem that has plagued the country, and particularly the Democratic party, for decades. The late Massachusetts Sen. Ted Kennedy called health care reform the cause of his lifetime. 

In the end, it took a veto-proof majority in the Senate to stuff the massive legislation through. No one says the legislation is perfect. But, even with a split decision by the U.S. Supreme Court in support of the law’s key provisions, it’s more difficult for claims of its unconstitutionality to stick. 

Still, it’s unclear in what ways the Supreme Court’s decision will impact the election. It has to be a central issue for Republicans. At the very least, it can still represent massive growth of government. But that the key provisions of the bill have been affirmed by the Supreme Court gives Democrats some fairly firm ground to stand on as well. 

Democrats, particularly the top Democrat, President Barack Obama, will no doubt be touting the benefits of the plan. That’s going to help them. It’s possible that after all the negativity and vitriol during the last two years, touting accomplishments might carry more weight than pushing cutbacks — the “less is more” line of thinking. 

In New Hampshire, the issue’s impact is a little less clear. Sure, former Rep. Carol Shea-Porter, who is running against Rep. Frank Guinta, and Sen. Jeanne Shaheen voted for the reform legislation, but it wasn’t as though New Hampshire lawmakers played key roles in piecing it together. 

Regardless, everyone wanted to weigh in following the Supreme Court’s monumental decision. 
Differing messages
Democrats can paint themselves as problem-solvers. Republicans can still be outraged over government’s overreach. The problem for Republicans is that it will probably be impossible for them to duplicate the amount of outrage the bill’s passage initially resulted in two years ago. Also, the Democrats set it up so that the most popular components of the bill would be enacted now. That helps them. 
“Today’s Supreme Court decision puts behind us the hysterical claims of the far-right and allows us to get to work making sure that the Affordable Care Act works for everyone in New Hampshire,” said gubernatorial candidate Jackie Cilley in a statement. “As governor, I’m confident that I’ll be able to work with the legislature and our representatives in D.C. to make sure that all the [Affordable Care Act] reforms, including Medicaid expansion, serve the citizens of New Hampshire.” 
That’s the hope for Democrats. They want to paint the right as extreme on this, that Democrats are the grown-ups. Who knows if that approach will work, but Democrats have got to keep trudging ahead on this while also trying to trivialize Republican attempts to disrupt the bill’s enactment. 
For Republicans, the hope is that the Supreme Court’s decision is once again a call to action. 
“Today’s ruling means that Republicans, conservatives, and anybody who wants their freedom protected will become active in this year’s elections,” said House Majority Leader Pete Silva, R-Nashua, in a statement. “We have a clear contrast in views about whether we want a one-size-fits-all, government run health care system that hurts Medicare, limits patients’ choices and requires constant direction from Washington bureaucrats or if we want states like New Hampshire to set health care policy. Now is the time for people who care about our future, our seniors and our liberty to get involved and elect candidates who will end this disastrous law and bring balanced, patient-focused health care to the citizens of New Hampshire.” 
Or, move forward
Guinta took a different tack. The bill is still massive. It’s still costly. He’s going to try to make sure people remember that. But his statement on the bill’s passage was more focused on what to do now. 
“While questions about its constitutionality are now resolved, there are still problems with this law,” Guinta said in a statement. “For example, it will cut $580 billion from Medicare over the next 10 years. And its ability to effectively deliver genuine health care reform remains unanswered.”
Guinta is trying to position himself as the problem-solver. It will be interesting to see whether other Republicans follow suit. 
The health care reform issue has been problematic for Republicans because it’s been difficult for them to get past the perception, frankly, that they are not as concerned about the issue as Democrats are. Republicans have very different proposals than Democrats on how to solve health care reform issues, but for whatever reason, those ideas don’t typically make it to the forefront. Perhaps Democrats have simply won the messaging battle on the issue. Guinta, for one, said he was ready to sit down with his colleagues from both sides of the aisle to amend the law as needed. 
In 2010, there was outrage over this bill. But there was also hope for Republicans. Presidential candidates talked about repeal. Many said it was their No. 1 priority. But perhaps the Supreme Court has finally dashed those hopes. Maybe that means it’s time for Republicans to find new ways to talk about Obamacare. 


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