White House Rallies Support For Health Law

With a new report on the number of Americans with pre-existing conditions, the Obama administration is stepping up its efforts to rally support for the president's health care law.

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Today, the Republican-led House of Representatives began debate on repealing Democrats' health care overhaul. A vote is scheduled for tomorrow. The repeal effort is considered largely symbolic: It's unlikely to come up in the Senate or get past the president's veto.

With that said, the debate itself is still important. Republicans feel it gives them a chance to set up what will be a key issue for them in the 2012 elections, and Democrats consider it an opportunity to do a better job defending the law than they did last year.

NPR's national political correspondent Mara Liasson reports.

MARA LIASSON: Last year, the Democrats struggled to overcome their own internal divisions on health care, and that public, messy fight hurt the law's image with voters.

But now, Democrats on both ends of Pennsylvania Avenue are on the same page: focusing on popular individual parts of the law. Here's HHS Secretary Kathleen Sebelius on a conference call today, discussing a new administration report.

Secretary KATHLEEN SEBELIUS (Department of Health and Human Services): As many as 129 million Americans, almost half of our population, age 64 and younger could be discriminated against based on their pre-existing health conditions. But thanks to the protections in the Affordable Care Act, by 2014, those citizens will have the freedom and security that comes with having quality, affordable health coverage.

LIASSON: The operative phrase there is could be discriminated against. Most of them aren't and won't be because they don't get their insurance on the individual market.

But Sebelius was ready with an example on hand, a real person who had once had her insurance dropped, Dawn Josephson.

Ms. DAWN JOSEPHSON: In December of '08, our son was diagnosed with sudden onset strabismus. It's an eye condition, basically affects the muscles in his eyes. We did a lot of different things to try to avoid surgery, but ultimately it came down that he needed to have surgery, and that took place in July of '09.

LIASSON: In November of '09, the Josephsons' insurance company canceled their coverage. But the next year, the health care bill passed, and it became illegal to drop coverage for children with pre-existing conditions. So the Josephsons got insurance again.

Pollsters have told Democrats that individual stories like these are a lot more effective than reciting a list of popular provisions, most of which won't go into effect until 2014 anyway. That delay has been a big problem for Democrats, says Drew Altman of the Kaiser Family Foundation.

Mr. DREW ALTMAN (Kaiser Family Foundation): Once the major benefits of this law are in place, and tens of millions of people have benefits that they value, they are very hard to take away. It would be the first time. And so there's a race going on between those who oppose the law, who would like to prevent the major and very popular benefits from being put into place, and those who want to see those benefits put into place.

LIASSON: This new round of health care debate does give Democratic supporters of the law an opportunity to craft a more compelling message. It also gives Republicans an opportunity to fulfill a campaign promise and to remind people about things in the law they don't like, such as the individual mandate to have insurance.

Still, while the law may not be popular, there is little consensus outside the Republican base for tossing it all and starting over. And that may be why Republicans have yet to come up with a substitute that reduces insurance costs and expands coverage while preventing Medicare cuts or tax hikes. That's hard to do.

Drew Altman says the ultimate fate of the Obama health care law won't be determined for several years.

Mr. ALTMAN: The most important factor there is certainly not a repeal vote in the House or the efforts to slow down implementation, but it's the 2012 election because if the president is re-elected, then the legislation is likely to move forward pretty much as contemplated in the statute, and if he isn't, then all bets are off, and anything could happen with this legislation.

LIASSON: Both sides know it, and that's why they're eager to test their best weapons in this preliminary battle.

Mara Liasson, NPR News, Washington.

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