Races we’re watching
By: Jennifer Haberkorn
October 29, 2010 04:37 AM EDT
Six months ago, the midterm elections were expected to hinge on the recently-passed health care reform legislation, which had awoken a contingent of anti-big government conservatives. Since then, the economy and job creation has taken its place as the prime issue in races across the country.
Health took a backseat, but it never went away.
Health reform, along with the stimulus, formed the basis for an anti-government backlash among voters that some Democrats were never able to shake. Republicans based their rally cry around repealing the extensive legislation, even though they won’t have the practical tools to do it for at least two years.
If Republicans win a commanding majority of the House on Tuesday, as expected, Democrats are likely to publicly question whether passing the health reform legislation was worth it.
Health reform has played a more prominent role in some races more than others. The results here could send signals for how lawmakers and 2012 candidates implement and talk about the health care law. Here are five races we’re watching:
Wisconsin Senate: Sen. Russ Feingold (D) vs. businessman Ron Johnson (R) – Feingold has been one of the most aggressive supporters of the health care overhaul on the campaign trail, while some of his Democratic colleagues have been hiding their voting record.
A win by Johnson on Tuesday could convince Democrats that there is no viable way to spin the health reform law.
Feingold went up with several television spots in recent weeks arguing he is taking on the insurance industry to protect Wisconsin residents while Johnson – who entered the race because of health reform and is promising to repeal it – would defend insurers in Congress at the cost of consumers. One of the ads features Wisconsin residents demanding “Hands off my health care,” to Johnson.
“Feingold has used the issue in a very interesting way,” Celinda Lake, a Democratic pollster, told reporters at a forum by industry publication Health Affairs this week. “He used his health care ad to show he’s taking on the health insurance industry.”
But Republicans say that Feingold has shot himself in the foot by making his re-election campaign about health reform.
“Feingold is as good as an example as any of where the health care reform bill has been a point of debate,” said Whit Ayres, a Republican pollster and president of Ayres, McHenry & Associates. “I think that’s the reason Senator Feingold is going to be ex-Senator Feingold.”
North Dakota House (at-large): Rep. Earl Pomeroy (D) and Rick Berg (R) – Pomeroy was once held up as the moderate Democrat who could win in November on health reform.
Late last month, he began running ads saying he voted for the law to stand up to the insurance companies and protect North Dakotans, Medicare and rural hospitals.
Former Senate Majority Leader Tom Daschle, who helped craft the legislation said earlier this month – when Pomeroy’s ads defending the law were up – that a Pomeroy victory could prove to Democrats that reform is a positive for them.
“If he wins and he wins over the basis of his campaign over these least couple weeks for his advocacy for health care, it is just going to destroy all the punditry and conventional wisdom about health care and how to position yourself as you go forward,” Daschle said, as reported by the Huffington Post.
But since then, Pomeroy has changed his tune. In recent days he’s gone up with television ads hinting that he acknowledges voters are frustrated. “I know I’ve disappointed you with a vote here and there. But you can always count on the fact that I do what I do for the right reason, or the people of North Dakota.”
Governors: If Republicans pull off a wave of victories in the nation’s statehouses, a blockade against the reform law could follow in the states. Governors will be in a key position to stall or block enactment of pieces of the law.
Doing so would make reform supporters’ job more difficult. They argue that once Americans can see or feel the benefits of the reform legislation, they’re more likely to support it. Governors will be in a position to make that conversation easier or more difficult.
Beginning next year, governors and state legislators are going to have to start setting up pieces of the law, such as the insurance exchanges, where consumers will buy insurance after 2014. Governors can also encourage or stop their state agencies from applying for grants, reviewing insurance rates or participating in the law.
“Governors are going to have a great deal of control on how things come out,” says Kavita Patel, director of the health policy program at the New America Foundation. “You could have states potentially flipping from a Democrat or moderate Republican to a more conservative Republican who doesn’t want to do anything. It would roadblock the expansion of health insurance reform.”
To be sure, the law has fallback plans, in which the federal government would implement many of the reforms if the states choose not to.
Minnesota Gov. Tim Pawlenty, a Republican with an eye on the 2012 presidential campaign, has been the most outspoken governor against the law until now. Other Republican governors likely to take a lead role in opposing the law if they win on Tuesday are Kansas’s Sam Brownback and Ohio’s John Kasich.
Governors also have to contend with the 2014 expansion of the Medicaid program while dealing with stretched state budgets. The expansion is of Medicaid is going to be particularly important in California and Florida, which, combined, account for 30 percent of the Medicaid population.
New York House (24th District): Rep. Michael Arcuri (D) and Richard Hanna (R) – Rep. Michael Arcuri, a freshman moderate, was one of five Democrats to support the House’s health care bill and later flip to oppose the Senate version when it came back for a vote in the House in March.
Since then, he’s been forced to defend not only the first vote but also the image that he’s a flip-flopper – a charge Hanna threw at him before Arcuri actually cast the second vote. He’s now in a down-to-the-wire race with Hanna. Arcuri’s opposition to the law has been viewed as a plus, but it’s still unclear whether it’s done enough to save him.
California Insurance Commissioner: Mike Villines (R) and Dave Jones (D) – The Golden State’s next insurance commissioner will play a key role in health reform implementation, as well as reviewing insurance industry rates in an important state.
“Insurance commissioners throughout the country are going to have a significant impact on how [insurance] rate review is carried out,” says Dylan H. Roby, a research scientist at the UCLA Center for Health Policy Research. The commissioners will also be responsible for overseeing insurers.
Insurance rate changes are likely to continue to play a key role in the health debate. Outcry over a 39 percent rate increase proposal in California last winter gave Democrats a convincing argument that their health reform legislation was needed to crack down on insurance companies. Future rate increases are likely to be held up by reform opponents as a sign that the law is failing. Supporters of the law have already tried to preempt that claim by arguing that insurers are gaming the system and blaming reform without merit.
Kevin S. Wrege, Esq.
PULSE Issues & Advocacy LLC
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