The Democrats’ poor midterm election showing only reinvigorated the conversation about why the party is having such a difficult time explaining its signature accomplishments to the public. During the health care reform debate, for instance, President Obama did not hit his rhetorical stride until the very final days of the effort, after he abandoned his economic case — we need it because it will slow unsustainable health care spending and reduce the deficit — and talked about the bill in terms of how it would protect voters from the worst insurer practices and abuses.
But in his first post-election interview with 60 Minutes, Obama returned to the economic argument, explaining what health care reform would do to the federal budget rather than how it would help every day Americans:
OBAMA: But part of the reason, for example, that I thought it was so important for us to take on health care reform was the single, biggest expansion of government — one that is inevitable if we don’t make some serious changes — is on the health care front. Medicare, the cost of Medicare, Medicaid and, you know medical care for veterans. Medical care in the Defense Department. Medical care across the board. That is the single thing that is gonna be driving the expansion of the federal government over the next several years. And so one of the things that we’ve said is — we’ve got to start getting a better bang for our buck on that front. If we don’t, it is gonna be very difficult for future generations to deal with it.
Compare that to how Obama sold reform on the stump on March 8, 2010:
OBAMA: And the insurance companies continue to ration health care based on who’s sick and who’s healthy; on who can pay and who can’t pay. That’s the status quo in America, and it is a status quo that is unsustainable for this country. We can’t have a system that works better for the insurance companies than it does for the American people. We need to give families and businesses more control over their own health insurance. [...]
Every year, the problem gets worse. Every year, insurance companies deny more people coverage because they’ve got preexisting conditions. Every year, they drop more people’s coverage when they get sick right when they need it most. Every year, they raise premiums higher and higher and higher. [...]
This year, insurance companies will be banned forever from denying coverage to children with preexisting conditions. (Applause.) This year, they will be banned from dropping your coverage when you get sick. (Applause.) And they will no longer be able to arbitrarily and massively hike your premiums .
The turnaround is truly confounding: Obama is reverting back to economic explanation just as some of the most popular consumer protections are being implemented. If anything, the White House should be using this as an opportunity to remind Americans that under the law’s Patients’ Bill of Rights, insurance companies can no longer discriminate against children with pre-existing conditions, drop coverage because of a simple mistake on an application, institute lifetime caps, limit choice of doctors, charge more for emergency services obtained out of network, or levy deductibles, co-payments or co-insurance for certain preventive benefits. Children will also be able to stay on their parents’ plans until their 26th birthday and everyone will have the right to appeal insurer decisions to an independent third party.
The economic argument about why health care reform will bend the cost curve, eliminate unnecessary spending and lower the percentage of GDP dedicated to health care may have wooed moderate Democrats like Kent Conrad or Ben Nelson, but the argument didn’t explain how Americans would personally benefit from reform and it won’t convince them that it’s worth keeping. Now that health reform is law, Democrats must defend it on its immediate merits — provisions Americans can easily understand and are already benefiting from.