Republicans have threatened to make the controversial health care overhaul a central issue in every congressional race next fall. So Democrats want to have something to show for their efforts — before the November elections. And President Obama has begun telling voters not just what the overhaul will do for them, but what it will do for them right away.
In Ohio this week, Obama offered a laundry list of benefits that would take effect in six months to a year, including a guarantee that children can get health insurance — even if they have a pre-existing illness — and a measure that would let young adults stay on their parents' policies until they turn 26.
Democrats in Congress are being encouraged to use these talking points with their constituents. The White House is trying to shift the conversation away from the messy legislative process — which Republicans are keying on — and instead focus on what the health care overhaul would do for families and businesses.
Focus On What's Coming Soon
Many of the plan's most important benefits wouldn't kick in till 2014. Those include the guarantee that anyone can buy insurance; the exchanges where individuals and small businesses can shop for policies; and the government subsidies to help pay for them. Because it's hard to campaign on changes that are more than three years away, Democrats are also stressing the overhaul's smaller, but more immediate impacts.
In the short run, the plan would provide tax credits to small businesses that offer health insurance to their workers. It would give $250 to seniors to help pay for prescription drugs, if they fall into the coverage gap known as the "doughnut hole." And it would impose a variety of popular, fast-acting restrictions on the insurance industry: No more lifetime limits on coverage. And no more canceling a policy just because someone gets sick.
Then There Are The Downsides ...
But the overhaul wouldn't directly limit the cost of insurance policies. In fact, in the short run, costs could go up. Insurance companies would have to cover more right away, but the requirement that people buy insurance wouldn't take effect until 2014. Between now and then, more people may drop their insurance, leaving a smaller pool of policyholders to pay for expanded coverage.
"The policy goal is correct, and that is to give people more health security," said Karen Ignagni, president of America's Health Insurance Plans, an industry trade group. "It's very difficult to accomplish without having everyone participate — if you don't expect that the costs are going to go up."
Anti-tax activists warn there are other immediate effects that the president didn't talk about in his Ohio speech. The overhaul would quickly impose multibillion-dollar levies on drugmakers, medical device makers and the insurance industry itself.
"There's taxes that kick in right away. There's even more taxes that kick in after a very few years," said Ryan Ellis, policy director for the group Americans for Tax Reform. "Look, there's short-term benefits the president is talking about that he has every right to talk about from this bill. But if he's going to be honest, he needs to also talk about the short-term costs."
The health care overhaul would raise taxes on individuals making more than $200,000 in 2013, and on so-called Cadillac health insurance plans in 2018.
Democrats say they're confident they can win the political argument, if voters consider both the costs and the benefits of the health care bill. They'll have an easier time, though, if some of the benefits are in effect when voters go to the polls.