Obama Makes Retail Sales Pitch to Defend Health-Care Overhaul


The Obama administration, faced with polls showing the overhaul is unpopular, is to selling the plan to locales and highlighting stories of how the health law helps individuals

(Bloomberg) — Six months after the enactment of President Barack Obama's health-care overhaul, the job of selling the plan has moved from Washington to locales like a church basement one block north of Philadelphia's city hall.

Matt Stetson, an unemployed 51-year-old heart patient, told about 50 people gathered there on a recent weekday about how the law will protect people with illnesses from losing health coverage.

"Talk to your friends, your family, your co-workers about the good things this bill does," he said. "I don't want to go back to the time before this bill."

The Obama administration and its allies are relying on similar endorsements to counter attacks on the health-care overhaul. Today, Republicans are making repeal of the law a centerpiece of an agenda they are unveiling in a bid to take control of Congress in November's midterm elections.

The Obama administration, faced with polls showing the overhaul is unpopular, yesterday installed a new feature on the White House website, www.whitehouse.gov, highlighting stories of how the health law helps individuals. Obama visited Falls Church, Virginia, yesterday to meet with people who had coverage denials and other problems with health plans.

The advocacy group Families USA has been issuing reports in all 50 states to explain the law's benefits, including tax credits in 2014 to help pay for insurance. It also is helping set up a non-profit organization, Enroll America, funded by health providers to encourage people to sign up for the benefits.

Declining Support

When the law was enacted in March, a USA Today/Gallup poll showed people supported it by a 9 percentage point margin. In a similar poll in late August, respondents opposed it by 17 points, a 26 point swing.

Senate Health Committee Chairman Tom Harkin, an Iowa Democrat, said sentiment may shift back in favor of the law once people see the benefits firsthand.

"People don't know all the nuances of this thing," he said on a conference call organized by Families USA. "Bit by bit, we'll get it out there. Ten people will know, then it'll grow to 20, then it'll grow to 80, and it'll have a snowball effect."

Supporters hope the message can resonate in time to avert major Democratic losses in the midterm elections.

Keeping Law Intact

Building public support is critical to ensuring the law survives beyond Obama's four-year term in office, when some of the most significant changes will begin. If Republicans succeed in dismantling parts of the law or repealing it, Democrats may not see their signature domestic initiative join the ranks of landmark social policy programs like Medicare and Social Security.

If Democrats "lose the presidency in 2012, I can't imagine the core members of the Republican party wanting to implement this bill as it is," says Robert Blendon, a professor of health policy and political analysis at Harvard University's public health school in Cambridge, Massachusetts.

The law is intended to provide health insurance coverage to 32 million uninsured people by 2019, reduce Medicare spending by about $455 billion over the next decade and create new programs to change the way medical care is paid for. It also implements new consumer protections and overhauls insurance company business practices.

The lack of public familiarity with the details is driving the administration's retail sales pitch. Polls conducted this month by the National Association of Insurance Commissioners and the Associated Press showed that Americans have little idea of what is in the law or when it takes effect.

Hundreds of Events

The administration and its allies have planned hundreds of events around the country like the one in the church basement in Philadelphia. Families USA is helping coordinate many of those efforts by providing staff, experts, and individuals like Stetson that the group says are being helped by the law.

"I think as more and more people learn about things that have been implemented and have been implemented well, this is really going to move public sentiment," said Ron Pollack, executive director of Families USA.

Supporters are showcasing a provision that takes effect today and lets individuals in company-sponsored plans keep their under-26-year-old children on their insurance. Other mandates taking effect prevent insurers from denying coverage to children with preexisting health conditions and bar insurers from either dropping coverage of sick people or limiting coverage substantially. New insurance plans also won't be able to charge co-payments for preventive health services.

Major Gains

Republicans, anticipating major gains in the November elections, have promised to stall the law's implementation. Republican candidates are running on "repeal and replace," promising to roll back the law if they come into power.

Still, even if they capture both houses of Congress, Obama would be able to veto any repeal.

"The president is the president until at least 2012," said former New York Representative Tom Reynolds, who headed the National Republican Congressional Committee. "The president holds the veto pen and he is not about to get rolled by a new Congress," Reynolds said in a speech to insurance industry executives in Washington.

In the meantime, Democrats have the challenge of promoting benefits of the law that won't take effect until after the 2012 presidential race, a timeline that could allow negative perceptions to become fixed.

Direct Effects

"Most people are not directly affected by the law, positively or negatively at the moment," Blendon said in a phone interview. "They're probably not, in the short term, going to change public opinion one way or the other."

The protections that kick in today also won't provide much relief to the millions of uninsured Americans hoping to buy coverage or those who need help paying for it.

"It's probably not surprising that there are not a lot of people who have been able to firsthand, or through friends or family, have a positive experience with an aspect of the law," said Mark McClellan, director of the Brookings Institution's Engelberg Center for Health Care Reform in Washington.


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