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As Health Care 2.0 begins, Democrats look to overturn failure in PR war

WASHINGTON — Wednesday's repeal of the health care overhaul was a show of affection for voters that gave Republicans control of the U.S. House of Representatives.

"It's a promise kept," declared Rep. Mike Pence of Indiana.

But symbolism only goes so far. The repeal legislation will be stymied by the Democrat-led Senate and then the real debate begins — Health Care 2.0.

The do-over marks the renewal of a public relations war that Democrats are determined to win this time, aware their past failure exacted a price in November.

It will be a contest of ideas and ideology, with Democrats like Florida Sen. Bill Nelson and President Barack Obama eager to display a moderate side as they head into the 2012 election.

"We allowed (Republicans) to take control of the debate," said former Rep. Allen Boyd of Monticello, one of four incumbent Florida Democrats to lose, in large part because of their vote for health care reform.

"They just talked in very generic terms about 'socialism' and 'public option' and the bad things they saw," Boyd said. "When you talked specifically about parts of it, most everyone agreed it was a good provision."

Democrats and their allies started the offensive on the eve of Wednesday's vote, unleashing a blitz of news releases, studies, targeted e-mails and a TV ad warning of a return of control to insurance companies.

Voters nationwide received e-mail from Organizing for America, Obama's campaign arm, urging them to call their representative and voice support for the law, a tactic Republicans mastered last year with opposite aim.

Callers overwhelmed the phones of new South Florida Rep. Allen West, who voted for the repeal anyway, as did other Florida Republicans.

On conference calls with reporters and in speeches on the House floor, Democrats highlighted popular provisions of the law: an end to insurers denying coverage for pre-existing conditions; allowing children to remain under their parents insurance until they are 26; and payments to seniors to help with prescriptions.

Rep. Jan Schakowsky, D-Ill., arrived on the floor Wednesday with poster-sized pictures of constituents she said have already been helped by the law. Rep. Debbie Wasserman Schultz of South Florida continued to blanket cable TV shows, warning about undoing the law and accusing Republicans of failing to focus on the economy.

And the White House spent the day blasting e-mails of quotes from experts, elected officials and interest groups like AARP, all in favor of the law.

Taken together, it's a far more aggressive posture than the first time around. The White House faced criticism for an uneven message last year and vulnerable Democrats generally avoided talking about health care on the campaign trail.

"They've got to re-brand this whole thing," said Jonathan Oberlander, a professor of health policy at the University of North Carolina. "People understand it as 'ObamaCare,' a pejorative. They need to make it so when people hear 'ObamaCare,' they don't think of death panels and rationing and other things that aren't true and think instead how this will make for a better health care system."

It's not easy.

Much of the law does not go into effect until 2014, giving critics ample time to shape public opinion about the unknown. A new Associated Press-GfK poll found strong opposition to the law had softened recently. But the public was nearly divided. And nearly six in 10 oppose the requirement, starting in 2014, that people carry health insurance except in cases of financial hardship.

Republicans have been highly effective with simple, sweeping statements, the latest being that the law is a "job killer." Democrats counter that a mandate that businesses offer insurance to employees will slow down overall health care costs and create jobs in the industry.

The dominant term during the last round — "government takeover" — has been widely debunked. PolitiFact, the fact-checking website of the St. Petersburg Times, named it 2010's "Lie of the Year" because the law mostly relies on the private market.

But the GOP talking points came in waves.

"The American people have soundly, soundly rejected the Democrats' government takeover of health care," Rep. Sandy Adams, R-Orlando, said Wednesday before voting.

Republican strategist John Feehery said the Democrats' problem has been a lack of focus. The law has so many angles and affects different groups of people, from children to the elderly. Highlighting them all can be confusing.

"Is it really 129 million people who have pre-existing conditions. Is it about the uninsured? Is it about costs?" Feehery said. "No clear message makes it easy to oppose."

Rep. Steny Hoyer, the minority whip, conceded Tuesday that his party did a poor job pitching the law's benefits but said the public desires some help.

"Only one in five Americans don't believe that we need some sort of policy which leads to access to affordable, quality health care, so there is a pretty large consensus on the need for that," Hoyer told reporters. "There is not a consensus yet on exactly how do we do that."

Democrats agree some parts of the law can be changed. There is growing consensus, for example, on eliminating a requirement that businesses file an IRS form 1099 for transactions valued at more than $600 — a costly and time-consuming requirement, businesses said.

Mostly, though, Democrats are holding firm to the overhaul they forged and have been trying to accomplish for decades.

Strategists say Democrats can win the PR war. As more people benefit from the provisions already in effect, it will provide Obama and the party with a centerpiece for the 2012 election.

Republicans will be drawing contrasts, too, but by gaining control of the House, their stake in the debate has grown and they will have to show they are serious about coming up with alternative plans to fix the health care problems facing the country.

Alex Leary can be reached at

As Health Care 2.0 begins, Democrats look to overturn failure in PR war 01/19/11 [Last modified: Wednesday, January 19, 2011 10:47pm]
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