Just How Unpopular Is The Health Care Bill?

In the later phase of the health care debate, the argument most often heard from Republicans has been this: The American people have rejected this bill; we are only their messengers.

The verb "rejected" is often amplified with words such as "overwhelmingly" or "resoundingly" or "again and again."

How can President Obama and his Democratic Congress possibly move a piece of social change legislation comparable to Social Security or Medicare without the support of the American people?

You can almost hear the deafening roar of response, even as you ask the rhetorical question.

As the GOP has featured this line over recent weeks, Democrats have been thrown back on defensive arguments. They say the bill's components are popular, even if the bill itself is not. They say the popular judgment is mostly negative because the news has been dominated by the process in recent months, not by the substance of the bill — which remains largely mysterious to the average voter.

This recalls the judgment of some historians and political scientists that the Clinton administration's push to change health care in 1993-1994 ended badly not so much on substance as on image. The "optics," as political operatives would say, were awful. So the bill failed.

Lately, the optics have been pretty awful again. The moves made in December to nail down 60 votes in the Senate (and forestall a Republican filibuster) looked sleazy and cheapened the underlying bill. And when Democrats talked for a time about using a "deem and pass" procedure in the House that would enact health care "without a vote," the optics got even worse.

But with all that bad publicity and all the doubt generated by a year of debate and opponents' vituperation, the latest Gallup Poll showed 48 percent against the bill and 45 percent in favor.

That does not look like overwhelming rejection. In fact, it's within the margin of polling error.

Moreover, the 45 percent level of approval was achieved despite the same poll's finding that the respondents believed the bill would only improve health insurance and health care for two groups: those currently uninsured and those with low incomes. Clear majorities of respondents thought everyone else, including doctors and other health professionals and the middle class, would suffer.

Yet even given that impression, more than 4 out of 10 were willing to approve the idea of an overhaul along the lines President Obama has proposed.

What would happen if the bill's image were to improve, even slightly, in the days and weeks ahead? What if the passage, and the proliferation of positive details about the actual bill, were to lift its approval in the Gallup above 50 percent? What would be the primary Republican argument in that case?

Would they say the bill was only popular at 60 percent or 70 percent or more?

One thing is clear. Without the Democrats' narrow win in the House this past weekend, the Republicans would have won the health care argument in two ways. First, they would have blocked legislation they opposed. But beyond that, the snuffing out of the bill would mean all their arguments against it would be deemed true — or successful, and therefore unchallenged.

Was the bill a governmental takeover of health care? We would never really know, but the argument would be remembered in these terms.

Would the bill have been a body blow to the economy? Would it have killed jobs, destroyed small businesses and undermined Medicare? Would it have bankrupted America?

Without a bill in place, all these arguments would remain unproven and impossible to disprove. We would know only that these arguments prevailed, and that the bill, in defeat, would stand guilty as charged.

Perhaps the bill in implementation will grow even less popular, as problems arise and receive extensive airing. But what would happen if, as consumers learn they will benefit, in many cases, from provisions of the bill, they start to feel better about it?

Is it possible the bill has been a more potent political weapon in prospect than it will turn out to be in reality?

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