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Ahead of Elections, Lawsuits Revive Debate on Health Reform

September 14, 2010 at 2:14 PM EST
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A judge in Florida listened to arguments filed by 20 attorneys general who are challenging the validity of a new health reform law. Gwen Ifill talks to reporters for more.
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GWEN IFILL: Now to the continuing fallout over the health reform law.

The battle continues to play out even as the law begins to take effect. In Florida today, a federal judge heard arguments filed by 20 attorneys general who are challenging the validity of the law. And the debate remains alive in the political arena as well.

As the seven-week sprint to the midterms began today with a final round of big primaries, the six-month-old health care law, once sold by Democrats as a political plus, is so far anything but.

(CHEERING AND APPLAUSE)

GWEN IFILL: The latest evidence: a new poll released today by “National Journal” and the Pew Research Center. It shows 45 percent view the law unfavorably, 38 percent favorably. For some Republicans, campaigning against the law has become part of their anti-Washington, anti-big-government pitch.

MAN: I will work to cut spending, lower taxes, repeal Obamacare.

GWEN IFILL: Just last spring, Democrats hoped voters would embrace the issue.

SEN. CHARLES SCHUMER (D-NY): I predict, David, by November, those who voted for health care will find it an asset.

GWEN IFILL: But the president acknowledged last Friday the measure may have turned into a political problem for Democrats.

U.S. PRESIDENT BARACK OBAMA: We’re in a political season where every candidate out there has their own district, their own makeup, their own plan, their own message. In an environment where we’ve still got 9.5 percent unemployment, people are going to make the best argument they can right now.

GWEN IFILL: Opposition to the law is also playing out in the courts and on the floor of the Senate. Today, Nebraska Republican Mike Johanns proposed changing tax-filing requirements for small businesses and allowing some employees to opt out of insurance coverage.

SEN. MIKE JOHANNS (R-Neb.): So, today, are we going to turn our deaf ear to the job creators in America? Are we going to stand with the president, who doesn’t want anybody fiddling with his health care reform, or are we going to stand with small businesses?

GWEN IFILL: Florida Democrat Bill Nelson said Johanns’ approach would undercut the law’s intent.

SEN. BILL NELSON (D-Fla.): Now, what the senator from Nebraska is doing is, he is driving a stake into the heart of the health insurance reform bill by taking two million people out of that pool that are uninsured that otherwise would be getting health insurance.

GWEN IFILL: Both Johanns’s amendment and Nelson’s alternative failed.

Part of the problem: Several of the law’s key provisions do not take effect until next week, among them, children with preexisting health conditions will no longer be denied coverage, and young adults under the age of 26 will be able to stay on their parents’ health plan. Insurance plans won’t be able to drop coverage when people get sick. And lifetime limits on coverage will be lifted. The biggest changes, which would require coverage for tens of millions of Americans, won’t take effect until 2014.

For more on all this, we turn to Karen Tumulty, a political reporter for The Washington Post who’s been spending time on the campaign trail, and NewsHour regular Susan Dentzer, who is editor in chief for the journal “Health Affairs.” She’s been spending time tracking the rollout of the new law.

Karen Tumulty, we just saw Chuck Schumer back in March say: I’m — I am convinced — I am certain that we’re going to be able to run on this. He said it better than I did.

What happened?

KAREN TUMULTY, national political correspondent, “TIME”: The exact opposite of what the Democrats were hoping for.

Back in June, the Gallup poll was suggesting that Americans were pretty evenly divided over the health care law. In fact, there was a 3 percent margin more people supporting it than opposed it. Now, in late August, the most recent Gallup poll suggests that the opposition is now 17 percentage points greater than the support for this bill.

And I think one of the reasons is that this bill fits into the larger narrative of this election year. It’s exhibit A, essentially, in the Republicans’ case that the Obama administration and that the Democrats who have been in charge of Capitol Hill have been guilty of expanding government too much and of overreach. And, again, that is — it — it — this becomes the — the single key piece that is driving that narrative.

GWEN IFILL: So, who is running against it? And who is running away from it, I guess?

KAREN TUMULTY: Well, interestingly enough, you do hear a lot of the — it feels like some of the Democrats who are talking about it the most are in fact the Democrats who voted against it.

And you’re also — a couple of weeks ago, I was in Wisconsin, where, suddenly, Russ Feingold, the senator, finds himself under challenge from an opponent who had never even been in politics before May, who now has a decent shot at beating him. And he argues that the reason is…

GWEN IFILL: His name is?

KAREN TUMULTY: Ron Johnson, a businessman from Wisconsin, claims that the reason he decided to run was because of this bill, which he calls: the single greatest assault on our personal freedom in my lifetime. It is — really, again, plays into the whole narrative that the Republicans have built.

GWEN IFILL: Susan, what has changed and what hasn’t changed about people? Is it people’s understanding of what is in the measure? Or is it just being used for, I guess, political — the details of the bill being used for political advantage?

SUSAN DENTZER, editor in chief, “Health Affairs”: I think Karen is right. I think the overall change here, if it is a change — and it’s really just a worsening of the problem — is that the economy is so dominant now in the various races, if you look at voter sentiment, how voters feel about issues, health reform is a distant third, after the economy and jobs and dissatisfaction with government in general.

So, it’s — there’s just not enough in health reform at the moment to break through any of that for the people who are opposed to it. Another point I would make is, this is still very partisan — 68 percent of Democrats still very supportive of health reform, 77 percent of Republicans violently opposed to health reform.

GWEN IFILL: So, let’s talk about truth-squadding. What has actually happened since this bill passed — was enacted six months ago that people can point to and say, my life is better because of this health care law?

SUSAN DENTZER: Well, as the piece noted, as of six months after enactment, which happens to be September 23, a number of provisions relating to insurance market reform go into effect. And those will help people. Now, mind you, they will help people who already have coverage, because they amend the terms of existing coverage. And, also, for many people, they won’t really feel the effects until January 1, when new plans go into effect.

So, for example, if you are relieved that your plan is now no longer going to have annual limits or will have restricted annual limits, and no lifetime limits anymore, you won’t really necessarily feel that relief until January, when all of that actually goes into effect, because your new plan year takes effect.

Those kinds of things are important, but they tend to benefit people who already have coverage. As the piece noted, the big bang when you start to roll out subsidies to help people who don’t have coverage, all of that doesn’t take effect until 2014. In the end, if you look at the Kaiser tracking poll, the most persuasive number, I think, is that 51 percent of Americans are disappointed now in health reform, because not that much has happened.

GWEN IFILL: And, yet, Karen, and, yet, last August about this time, incredible uproar, lots of town hall meetings taking down this bill, saying it was socialism. We didn’t hear that this year.

KAREN TUMULTY: No, we didn’t. And it was really interesting, at least in the places where I was going to these town halls, the kinds of questions that people were asking. You’re right. People were not screaming socialism and death panels. They were asking questions like, you know, I have a small business. And, suddenly, you know, I’m going to have to provide — what is this going to do to me?

And I don’t think that, until people feel this law fully implemented, not just the expansion of coverage that comes in a few years, but whether it lives up to its promise of transforming the health care system, of reining in some of these forces that have been driving everyone’s costs through the roof, not until people see whether that is working — and that could be decades away — are they really going to, I think, know whether this is a bill, a law that has helped more people or hurt more people.

GWEN IFILL: I think the supporters of this law would have said, of course we knew it was going to take time to roll out. But in the time that it’s taking to roll out and be felt, what real possibility is it that efforts to repeal all or part of it are serious?

SUSAN DENTZER: Well, the efforts are very serious. Whether they result in serious ends remains to be seen. It’s very clear that the Republican strategy is to pick away at various sources of revenue that finance the legislation. That was part of the dance this week. If the House — if the Republicans take back the House or increase their margins in the Senate, you will see more of the same.

Of course, as long as President Obama is in the White House, he would presumably veto all of that legislation. So, we don’t expect much. But, of course, all of this is sort of gearing up a general aura of dissatisfaction with the legislation that could build on itself and perhaps help the Republicans in 2012.

GWEN IFILL: Let’s take that general aura of dissatisfaction and kind of flip it on its head.

How do you take away something from people that they already have? Is the White House perhaps counting on the fact that, now that this is law, they can talk all they want about rolling it back, but that’s harder to do than getting it in the first place even?

KAREN TUMULTY: I agree. I think that if this becomes a debate over repealing this law, it becomes a completely different kind of debate.

But a lot of the issue, I think, is going to be shaped and framed around how well this law is implemented over the next few years. If, as the government, both the state governments and the federal government, come — come up with unanticipated consequences, glitches in the law that they didn’t expect, if they are able to sort of fine-tune it, and make the implementation more smooth than a lot of people expect it to be, I think that that, too, will also gradually make people feel more comfortable with the law.

GWEN IFILL: And how much is this not really playing out so much in Washington as it is on the state level or even in these individual congressional races, which sometimes actually feel like local races?

SUSAN DENTZER: Well, there is a lot of tension at the state level, where, as in many states, as we see, you have attorneys general suing to undermine the law and essentially have provisions of it declared unconstitutional cheek by jowl with people who are in charge with planning for the implementation, setting up the health insurance exchanges, figuring out what rules they now need to enforce some of the new provisions on insurance companies.

So, they’re all kind of looking over their shoulders, saying, well, what the heck is happening, and worrying about what the tendency is going to be over time. I think, on balance, what the Democrats are hoping is that, as more and more of these provisions roll out, and because they are so interdependent, it will just frankly get harder to start to take this all apart, and people will start to see, bit by bit, some additional benefits.

The preexisting condition restrictions program — or preexisting conditions program, rather, which enables people now who couldn’t get coverage at all because of chronic illness or other things, people — you know, a few more thousand people get coverage under that, it’s a lot harder to take that away.

GWEN IFILL: It sounds like we have a long-term challenge and a short-term, the short-term between now and November.

Thank you both very much.

SUSAN DENTZER: Thanks, Gwen.

KAREN TUMULTY: Thank you.