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Obamacare Is Hurting Democratic Candidates Because Republicans Are Hurting Obamacare

ASSOCIATED PRESS/The Tampa Bay Times, Dirk Shadd

The Democrats last night narrowly lost the special election for the Florida congressional seat held for years by the late Republican Bill Young, and the pundits’ verdict is clear: it's Obamacare that done it. From Politico:

Jolly’s win shows just how politically treacherous the path is for Democrats running in such moderate-to-conservative areas. Rather than moving to the center, Jolly pushed to the right, painting himself as a foe of President Barack Obama and his Affordable Care Act—and presenting Sink as a staunch ally.

“She supports Obamacare. I don’t. I’m David Jolly, and I approve this message because [we] need someone to look out for our interests, not President Obama’s,” he said in one TV ad. In the face of those kinds of attacks, Sink’s can’t-we-all-just-get-along message just didn’t cut it.

Following Sink’s loss, some Democrats said they’re rethinking their approach to combating the GOP’s Obamacare-centered assault. Sink’s nuanced “fix it, don’t repeal it” message was one that the national Democratic Party is urging many candidates to embrace, but it may have been drowned out by the avalanche of loud Republican attacks. One Democratic operative predicted that candidates would now find it safer to flat-out state their opposition to Obamacare, saying that, “It’s gonna be tough to get Democrats to support the Affordable Care Act this cycle now with the standard ‘fix the good, get rid of the bad’ schtick.’”

By this logic, Democratic candidates in 2014 should be running as fast as they can from Obamacare. This strikes me as entirely wrong. What Democrats need this year is more Obamacare, not less.

Let me explain. For starters, Democratic pollsters who surveyed the Florida district, number 13, on the Gulf Coast around St. Petersburg, say that the Affordable Care Act was not a drag on Democratic candidate Alex Sink, that in fact survey respondents said they trusted Sink more than Republican David Jolly to handle Obamacare.* Sink’s candidacy had other problems—her image as an outsider who’d moved to the district just to run to the race, her generally over-cautious and un-dynamic manner, President  Obama’s low approval ratings amid a slow economic recovery and, yes, the quadrennial Democratic problem of getting voters to turn out for non-presidential elections. As NBC’s First Read reports: “Turnout last night was 183,634. However, in the 2012 general election—when Obama narrowly carried the district—turnout was nearly double at 329,347. And even in the 2010 election, turnout in that district was 266,934.”

So how to get more Democratic voters out? Well, this is where the more Obamacare comes in. To the extent that the new law has not created a groundswell of enthusiasm for Democratic candidates among the law’s intended beneficiaries it is surely in part because…so many of the law’s intended beneficiaries are not being helped by the law. Fully one half of the expansion of health coverage under the law was supposed to occur through the expansion of Medicaid, to cover all people under 138 percent of the poverty line. And in Florida and nearly two dozen other states, that expansion is not happening, thanks to the Supreme Court ruling that made the expansion optional and the opposition of Republican governors and state legislators.

In Florida alone, there are more than 1 million people who were supposed to be covered by the Medicaid expansion but are still uninsured. In Pinellas County, the heart of the 13th Congressional District, there are more than 50,000 people in that coverage gap (the district as a whole had more than 134,000 uninsured in 2011, slightly below average for Florida's very high rate of uninsured). Yet this basic reality is constantly overlooked in coverage of the law—pundits note that the law is not polling all that well even among the uninsured, as if this some kind of ironic commentary on the law’s failure. No, it’s a commentary on the fact that millions of the uninsured aren’t benefiting from the law, because of the blockage of the Medicaid expansion. Why should they tell pollsters they support it? It’s not doing anything for them.

Making matters worse for Democrats is many of these people do not know why the law is not helping them—all they know is that when they go to try to sign up, they are told they are not eligible for subsidized private coverage on the new exchanges, which is intended for people making more than 138 percent of the poverty level. It doesn’t help matters that the decimated local press has been devoting precious little ink to the Medicaid expansion blockage.

So what are Democratic candidates to do? Well, for one, argue for the Medicaid expansion. Make sure lower-income voters understand what’s at stake and why they have so far been denied any of the law’s benefits. No, not every voter who gets covered by the Medicaid expansion is going to vote for the Democrats as a result—stories from states that have expanded Medicaid, such as Kentucky and West Virginia, are replete with anecdotes of voters who are grateful for their new coverage without necessarily making the connection to Obamacare and Barack Obama. But enough lower-income voters will make the connection that it could help Democratic candidates like Allison Lundergan Grimes, Mitch McConnell’s Senate challenger, who is making a strong push for downscale, Democratic-leaning voters by stressing her support for raising the minimum wage.

For years, Democrats have grappled with the “What’s the matter with Kansas” problem—the tendency of many middle and working class white voters to vote Republican even though their economic interests would appear more closely aligned with the Democratic platform. I’ve tended to view the problem somewhat differently—that the challenge for Democrats is not so much “their” natural voters voting “wrong” but rather not voting at all, being deeply disconnected from the political grid and therefore making it possible for Republican candidates to prevail.

And this is why the Medicaid expansion fight is not just an urgent policy challenge—covering five million of the neediest Americans—but a political imperative for the Democrats. A whole swath of people whom they set out to help with the Affordable Care Act, some of whom would reward them for that effort, are right now simply not getting the help. Tens of thousands of them live in a single congressional district that the Democrats lost, at great cost, last night. The Republicans get this political dynamic—it's a big reason why they've been fighting so hard to block Medicaid expansion. On this, Charlie Crist is right: it's high time the Democrats get it, too, and start fighting for Obamacare, not shrinking from it.

*Addendum, 4:15 p.m. Here is the key passage from Democratic pollster Geoff Garin's memo on the election, which says his polling showed that Sink had, at the very least, drawn even with Jolly on Obamacare. He writes:

"Our polling, which showed the trial heat virtually even over the course of several weeks, indicated that the debate over the Affordable Care Act helped Sink more than it hurt her, particularly in creating a lead among Independent voters that almost negated the entirety of the Republicans’ superior numbers in the partisan turnout. Two factors helped Sink level the playing field in the Affordable Care Act debate. First, David Jolly’s advocacy of repealing the Affordable Care Act put him deeply at odds with Independent voters, who have clear concerns about Obamacare but who do not want to repeal it. By 57% to 31%, Independents preferred a Democrat who supports fixing and improving Obamacare over a Republican who supports repealing it. Second, Sink was helped by her decision to play offense, and not just defense, in the Affordable Care Act debate. David Jolly and his surrogates at the NRCC and the U.S. Chamber of Commerce spent a huge amount of money attacking Alex Sink for her support of Obamacare. The net impact of these ads was negligible because voters were just as concerned, if not more so, by Jolly’s position on the issue, particularly with regard to the consequences of repealing Obamacare. In our polling, we tested voters’ reactions to the attacks the Republicans were running against Alex Sink, as well as their reaction to a critique of David Jolly’s position on the Affordable Care Act. The results of these tests [click link above for the wording of the tests and the results] showed that the criticism of Jolly’s position was at least as potent, if not more potent, than the attacks Jolly and his allies were leveling against Sink. As a result of the back and forth over Obamacare during the campaign, Alex Sink had a consistent advantage in our polling when voters were asked which candidate they trusted more to deal with Obamacare. In fact, in every poll we conducted, Sink had a larger advantage over Jolly on Obamacare than she had in the core trial heat question—indicating that the issue ultimately provided more of a lift than a drag to her campaign. The issue could not completely overcome the Republican Party registration advantage or the district’s decades-long tradition of sending a Republican to Congress, but it came very close to doing so."