Why Health Care Is a Losing Issue for Republicans

Win or lose at the Supreme Court, the GOP is likely to suffer at the ballot box as long as health is a central issue in future campaigns.

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Over at his relatively new Daily Beast digs, David Frum argues that Republicans are in trouble if they lose the Supreme Court challenges to the Affordable Care Act. He says that if the law is ruled constitutional, then "healthcare comes roaring back as a campaign issue," and a potent one, for "because of the prolonged economic downturn, more Americans than ever have lost -- or are at risk of losing -- their health coverage." What are Republican candidates going to tell those people?

Says Frum:

If Republicans lose in the Supreme Court, they'll need an answer. "Repeal" may excite a Republican primary electorate that doesn't need to worry about health insurance because it's overwhelmingly over 65 and happily enjoying its government-mandated and taxpayer-subsidized single-payer Medicare system. But the general-election electorate doesn't have the benefit of government medicine. It relies on the collapsing system of employer-directed care. It's frightened, and it wants answers.

"Unconstitutional" was an answer of a kind. But if the ACA is not rejected as "unconstitutional," the question will resurface: if you guys don't want this, want do you want instead? In that case, Republicans will need a Plan B. Unfortunately, they wasted the past three years that might have developed one. If the Supreme Court doesn't rescue them from themselves, they'll be heading into this election season arguing, in effect, Our plan is to take away the government-mandated insurance of millions of people under age 65, and replace it with nothing. And we're doing this so as to better protect the government-mandated insurance of people over 65 -- until we begin to phase out that insurance, too, for everybody now under 55.

Meanwhile, at The New York Times, Ross Douthat argues that conservatives may be in political trouble in the presidential race if they win at the Supreme Court and the individual mandate is struck down:

The unpopularity of the president's health care bill is a settled reality of American politics. But as liberals have long hastened to point out, not every provision of the bill is unpopular. If you isolate the legislation's various components, many of them poll reasonably well.

The individual mandate, though, tends to be far less popular than the legislation as a whole .... If the Supreme Court invalidates the mandate, the justices' traditional "presumption in favor of severability" will probably ensure that the rest of the legislation remains intact -- which might reassure moderate voters that the health care bill wouldn't actually trample their liberties, because the courts are on the case. Stripping away the law's most unpopular component might make the rest of it marginally more popular. And setting a clear limit on liberalism's ability to micromanage Americans' private decisions might make voters feel more comfortable voting to re-elect their micromanager-in-chief.

There's a third possibility: the Supreme Court strikes down the Affordable Care Act in full. And if that happens? It sure seems possible that health care would emerge as one of the biggest issues in campaign 2012, and President Obama would be able to best Mitt Romney, who is so twisted around in pretzels on the subject that nearly anything he says can be attacked as hypocritical. And there would remain the general failure of the GOP to articulate a health-care agenda that voters like (besides the prescription drug benefit and promising not to cut Medicare).

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Conor Friedersdorf is a staff writer at The Atlantic, where he focuses on politics and national affairs. He lives in Venice, California, and is the founding editor of The Best of Journalism, a newsletter devoted to exceptional nonfiction.

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