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Democrats wonder what to say about PPACA

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(Bloomberg) — For the third election cycle, Democrats are still debating their options for handling the political fall-out from passage of the Patient Protection and Affordable Care Act (PPACA): fight, flight or finesse.

Former President Bill Clinton advised fellow Democrats to embrace the law on the campaign trail. Democratic polling expert Celinda Lake, who released a new survey last week, told candidates to avoid it.

“The reality is it’s a negative. The reality is you can’t walk away from it. The reality is you’ve got to fight it,” said Chris Kofinis, a Democratic strategist at the consulting firm Purple Strategies.

In key races, as the now-delayed March 31 deadline for new enrollment on the health insurance exchanges arrives today, Democrats face this reality: The law’s a political loser, and there’s no easy fix.

Handling the issue deftly is key to Democrats who are at risk of losing control of the U.S. Senate in the November election. Republicans need a net gain of six seats to take over.

It’s the third election in a row that PPACA has played a role. In 2010, the year Obama signed it into law, Democrats lost their House majority. In 2012, Obama won re- election when up against Republican Mitt Romney, whose Massachusetts law was a model for PPACA.

Bungled website

The bungled start to the law’s insurance exchanges has put Democrats on the defensive again.

Ronald Reagan favored the political maxim “if you’re explaining, you’re losing.”

That hasn’t stopped Clinton and others from advocating that the party’s House and Senate candidates answer Republican fire with a nuanced message.

When Obama asked him to speak at the Democratic National Convention in Charlotte, N.C., in 2012, Clinton responded that “I could only do it and be effective if he let me explain and defend the health care deal,” the former president told’s Joe Conason in an interview published March 29.

His experience, Clinton said, taught him that it was a “terrible mistake” for Democrats to talk only about their popular positions. Instead, candidates should “turn in toward all controversies and embrace them –- even if you said you were wrong or a mistake was made,” he said.

While not every Democrat has Clinton’s gift for turning complex policy into simple talking points, Democratic strategist Anna Greenberg said candidates are too easily spooked by Republican attacks on the law.

‘Nervousness’ unwarranted

“There is a nervousness that is not warranted. I do believe we could go on offense on this and make some pretty strong arguments about what they’re for and what we’re for,” Greenberg said. “It’s basically a wash. What I see in my surveys is that it doesn’t do much either way.”

Republicans say they have the edge and are backing that up with early advertising for the midterm elections.

Since the beginning of last year, 41,439 ads opposing Obama’s health insurance law have been run on local broadcast television, according to New York-based Kantar Media’s CMAG advertising data reports. By comparison, proponents of PPACA have aired 3,748 spots, or a little more than 8 percent of the total.

Republican strategist Carl Forti, founder of the Alexandria, Va.-based communications firm Black Rock Group, said Democrats can expect more of the same.

“Obamacare isn’t just a motivator for Republicans, it’s hurting Democrats with independents and soft Democrats,” Forti said.

Sixty-five percent of independents and 21 percent of Democrats opposed the law in a CNN/ORC poll of 801 adults released earlier this month that had a margin of error of plus or minus 3.5 percentage points.

Republican candidates

PPACA’s unpopularity has helped persuade better Republicans to enter House and Senate races against established Democratic candidates, Forti said. “Obamacare is one of the main reasons the field is as large as it is for Republicans,” Forti said.

Lake, who polled for Clinton’s 1992 presidential campaign, said Democratic candidates must shift the political discussion away from the issue before they face voters in November.

In a George Washington University Battleground poll released March 25, Lake and Republican partner Ed Goeas found that Republican voters are more energized to vote than Democrats. That tracks with a historical enthusiasm advantage for the out-of-power party when a president is in the middle of his second term.

Voter enthusiasm

Sixty-four percent of Republicans said they are “extremely likely” to vote in November, compared with 57 percent of Democrats, the polling experts said at a Christian Science Monitor breakfast last week in Washington.

In a memo accompanying the poll, which found that 53 percent of voters oppose the law, Lake said that Democrats are best off talking about other issues.

“The Democrats must pivot from rebutting attacks on the Affordable Care Act to an agenda of bold economic action,” Lake wrote along with colleagues Daniel Gotoff and Alex Dunn.

Democrats should pick and choose which pieces of the law to highlight, said Margie Omero, another Democratic strategist.

“There’s no not talking about it,” she said. “It’s appropriate for a candidate, wherever they’re running from, to say ‘Here are some of the things that I agree with about it and here are some of the things I disagree with about it.’”

More 6 million Americans have reportedly selected commercial “qualified health plan” (QHP) coverage through the new PPACA public exchanges now that the enrollment period is coming to a close.

Popular aspects

Omero and Greenberg agree that Democrats should match the parts of PPACA that are popular against repeated votes by House Republicans to repeal it altogether.

Furthermore, many of the individual policies within the law have proved more popular than the whole, including provisions that prevent insurers from denying coverage based on pre- existing medical conditions and which allow adult children to stay on their parents’ plans until they are 26 years old.

“You don’t have a majority of people who want to repeal it,” Greenberg said. “The number of people who want to repeal it has gone down. And you have a majority who say we should fix it or expand it.”

While some Democrats are focused on driving up turnout among the party’s base, Kofinis said the challenge for his party is to “figure out how to appeal to a midterm voter” who already plans to go to the polls.

Until Obama begins to sway them, he said, Democratic strategists and candidates will continue to search in vain for a sound strategy: “That begins and ends with the White House.”

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