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How the White House Bungled the Politics of Health Care

Backlash blindness.

12:00 AM, Oct 28, 2010 • By GARY ANDRES
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President Obama and Democratic leaders in Congress seriously misdiagnosed the politics of health care reform. Yet their malpractice is even more extensive than generally known.Polling consistently shows that opposition to the new law outstrips support. Rasmussen’s tracking surveys regularly demonstrate significant majorities want it repealed.  And not a week goes by without more dire projections of health insurance premium increasing and employers dropping or changing coverage.

How the White House Bungled the Politics of Health Care

Hopeful Obama rhetoric like “if you like what you have you can keep it” or “my plan will reduce insurance premiums by $2500 per family,” now sound more like traditional “bait and switch” than the politics of hope.

These examples of over promising and under delivering are among the most commonly referenced reasons driving public dissatisfaction.

But a more unexpected reaction – one that has so far received far less attention -- also deserves mention, particularly less than a week before the November elections.

Call it backlash blindness. The White House failed to grasp the full public reaction to the legislation – a blunder with massive political consequences.  They thought Democrats would swoon in appreciation and Republicans might just quietly concede defeat.  Both presumptions were wrong. 

Instead of responding enthusiastically to the passage of the new law, the Democratic rank-in-file exhibited a mix of disappointment and complacency. Some are angry -- it didn’t go far enough, they say. Others view it as a “check the box” exercise and have moved on to other challenges.

Either way, passage of the new law has not produced a political windfall of gratitude or enthusiasm for the Democrats.

This outcome is a bit ironic because the White House and Democratic leaders said it would do both, using a historical parallel to build support for the legislation. 

Their party lost the majority in Congress in 1994 – the story goes -- because of failure to enact President Clinton’s health care reform measure.

Don’t make that mistake again, they implored. Pass the bill, make history and maintain political control.

And so they did.

An even bigger blunder occurred, however, in misjudging the reaction among Republicans and conservatives.

In a survey I helped conduct for Resurgent Republic around Labor Day, their backlash came into full view. Voters that placed themselves the farthest distance from Obama on a scale of 0-10 on health policy were more likely to say they were certain to vote than those agreed with Obama. Other recent surveys I’ve conducted demonstrate a similar trend – voters that oppose health care reform are more energized about voting than supporters.

Ironically this outcome occurred, not because of legislative failure, but due to its success.

Some might have predicted this result. Presidential scholars Jeffrey E. Cohen and Ken Collier identified the possibility of an outcome like this over a decade ago.  In a chapter they wrote in Presidential Policymaking: An End-of-Century Assessment, Cohen and Collier explain that president’s must exercise extreme caution in their strategies of “going public” and pursuing their agendas, lest they generate an even more powerful uprising against them. “Each action that a president takes to alter the agenda poses the risk of successful challenge," Cohen and Collier write. “Presidential mobilization may ironically stir counter mobilization.”

Those cautionary words were written in 1999.  In today’s polarized and fragmented media world, the motivation and tools to counter mobilize have grown exponentially.

Health care reform affected both parties, but in different ways.  Obama and his allies in Congress misjudged how each group would react.

They overestimated the amount of support passage would produce among their own allies, and further assumed opposition might wane as more Americans learned about the details of the legislation.  As the Christian Science Monitor’s Gail Russell Chaddock wrote after the bill passed, “Democrats say Americans will soon forget the go-it-alone process they used to move this historic legislation as they come to know its benefits.”

But the bigger misstep was underestimating the backlash.

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