Amidst ongoing doubts about health care law, Senate Dems' answer is to go on the offense
The GOP bets that voters' displeasure will intensify in 2014 as more provisions take hold. Besides exchanges and Medicaid enlargement, businesses with at least 50 full-time employees will have to provide insurance coverage and state insurance regulators will enforce coverage minimums. Many market analysts predict premium increases for individual policies.
"It's not accidental that President Obama scheduled the most popular provisions to be in effect for his election year," argued Brad Dayspring, a spokesman for the national GOP's Senate campaign arm. "He's left a lot of 2014 Democrats hanging out to dry with the unpopular provisions."
Democrats say Republicans need Obama's health care overhaul only to rally their core supporters, who are particularly important in midterm elections in which the electorate typically is older, whiter and more conservative.
Dayspring said the issue wins independents.
John Anzalone, a Democratic campaign consultant and pollster, retorted: "What happens when the boogeyman that's promised never comes?"
Anzalone, who counts Hagan among his politician clients, said the best counter for vulnerable Democratic incumbents is to use their office actively to help constituents take advantage of the law. House Democratic leader Nancy Pelosi outlined the same approach in a 78-page memo to her caucus members last month.
Democrats also argue that Republicans ignore their own vulnerabilities and individual state dynamics that could complicate a GOP effort to run a national campaign.
The law, Begich notes, established long-term coverage plans for Native Americans. "That's important to Alaska" and lingered in Congress for two decades before finding a place in the act, he said.
Landrieu can point to bonus payments she negotiated for Louisiana's Medicaid program to make up for money lost because of several hurricanes. Conservative commentators mocked the arrangement as the "Louisiana Purchase," but Jindal, who asked for the extra money, gladly used it to balance Louisiana's budget in multiple fiscal years.
Hagan and her North Carolina colleagues paid special attention to pharmaceutical companies that develop drugs called "biologics." They negotiated 12-year monopolies for those drugs, a win for the biomedical sector that dominates the "Research Triangle" around Raleigh.
Veteran North Carolina political observer Gary Pearce, a Democrat, said Hagan also could benefit from the fact that leading GOP candidates expected to challenge her come from the new legislative supermajorities that have pursued a long list of conservative priorities, including rejecting Medicaid expansion that North Carolina hospitals wanted. A Republican primary fight among top statehouse Republicans, Pearce said, could leave Hagan "in a good position to paint Republicans in a right-wing corner."
In Louisiana, the GOP may find its health care expert in Rep. Bill Cassidy, who spent several decades as a hospital physician in Baton Rouge and has served among leading GOP congressional critics of the law. But as a congressman, Cassidy voted with his caucus to repeal the law in full more than three dozen times.
Justin Barasky, Senate Democrats' campaign spokesman, said those votes give Democrats fodder to argue that the GOP candidate sided with big insurance companies. The same scenario could apply in Arkansas if Rep. Tom Cotton, who's expected to run, ends up as GOP nominee.
Landrieu also can use Jindal as a GOP counter on health care. Now chairman of the Republican Governors Association, Jindal has dismantled the state hospital system that Louisiana State University runs, closing some facilities and contracting with private firms to run others. Voters have not embraced the changes.
Arkansas Republican strategist Alice Stewart acknowledged that her party has had only mixed success using health care as a national issue, but she said Pryor's eventual GOP opponent can make it resonate.
"It's not just a generic criticism of Obamacare," she said. "This is part of explaining that Mark Pryor goes to Washington and doesn't represent the values of this conservative state." She recalled then-Rep. John Boozman ousting Sen. Blanche Lincoln in 2010 after her vote for the law.
"Voters here remember that going from Blanche to Sen. Boozman was an important step," Stewart said. "Mark's in the same boat."
Follow Bill Barrow on Twitter at https://twitter.com/BillBarrowAP
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