A new Associated Press-GfK poll finds that voters are coming around in favor of the new health care law, with support for the measure at its highest point. Forty five percent of Americans support the measure and just 42% oppose it:

The poll found support increased since May among men (from 36 percent to 46 percent), people in their prime working years (from 35 percent to 49 percent among 30-49 year-olds) and Republicans (from 8 percent to 17 percent.) The uptick among Republicans comes even as party leaders are calling for the law’s repeal.

The changes coincide with a concerted effort by the Obama administration, congressional Democrats and their allies to sell the immediate benefits of the law. Those include coverage for young adults on their parents’ plan until they turn 26, a $250 rebate check for seniors with high prescription costs, tax credits for some small businesses that cover their employees and federal funding to train more primary care doctors and nurses.

It’s not clear — since voters always liked those separate elements of the health care law — that the administration’s campaign has helped turn around public opinion or if voters have just moved on to different issues and stopped listening to the Republican misinformation on the issue. The administration’s focus on all of the separate pieces could have re-framed the bill in voters’ minds as a patchwork of all the things they really liked in the first place: the new market regulations, closing the doughnut hole, kids on parents’ coverage.

But what’s clear, I think, is that polls like this will take the wind out of the GOP’s “repeal and replace” now sails. They’ve been arguing that we should set public policy in accordance with opinion polls and as these polls change, we should hold them to it.

A broad coalition of health advocacy groups like the American Association of People with Disabilities, the National Breast Cancer Coalition, the Ovarian Cancer National Alliance and United Cerebral Palsy have all filed an amicus brief in support of the government’s motion to dismiss Virginia’s lawsuit challenging the constitutionality of the individual health insurance mandate. [Read it HERE]

The main contention here is that without an individual requirement, individuals will join health care plans only when they become sick and the government will lose all its ability to require that insurers provide coverage without regard to pre-existing conditions. Consequently, many of the individuals with chronic conditions won’t be able to find affordable coverage or afford the available coverage.

The brief goes through the extensive history of states trying to exclude pre-existing condition exclusions without also instituting a minimum benefit requirement and chronicles some of the real world implications of eliminating the mandate:

- KENTUCKY: “The departure of nearly all insurers from Kentucky’s individual market is probably the most widely known aspect of its reforms…Kentucky’s reforms were eventually repealed in 1998.”

- MAINE: “A 2001 report found that 13 of 18 major carriers ceased issuing new policies to individuals during the eight years since the provision bceame law,” in 1993….”Many insurance providers doubled their premiums in just three years or less, and all but one of the state’s HMOs experienced ‘at least one rate increase of 25% or more in 1998 or 1999.”

- NEW HAMPSHIRE: “New Hampshire was nearly left with no carriers in the market when Blue Cross Blue Shield of New Hampshire announced it was withdrawing from the individual market.”

- NEW JERSEY: “After New Jersey’s preexisting conditions provision took effect in 1993, the state’s individula insurance market became plagued by skyrocketing premiums. Between 1996 and 2001, the cost of the most generous individula insurance plans rose by more than 350 percent.”

- NEW YORK: “New York enacted preexisting condition provisions for the individual market in 1993. Consequently, the portion of non-elderly New Yorkers without insurance worsened from 16.5 percent in 1992 to 20 percent in 1997.”

- VERMONT: “Saw substantial increases in premiums after its similar insurance reform measures took effect in 1993.”

- WASHINGTON: “Within just a few years, non-managed care options disappeared entirely from the individual market…the ‘trend since 1994 has been toward higher deductible and /or more managed products as insurers have progressively closed lower deductible, less tightly managed products.”

The legal conclusion is this: “Comprehensive health reform which includes a preexisting conditions provision must have an accompanying minimum coverage provision to be successful. Because a minimum coverage provision is essential to enacting the ACA’s preexisting conditions provision, it falls squarely within Congress’ authority under the Commerce and Necessary and Proper Clauses.” But I think the larger point is, as Yglesias put it, “these kind of facts are going to be hurdles to the ongoing conservative repeal campaign. Faced with a large and complicated piece of legislation, it’s easy to seize on some aspect or another as the reason to vote no. But it’s much harder to say yes to a repeal movement that would leave a hole in your state’s budget” or, I might add, when some of the nation’s most influential and trusted health groups are lobbying against it.

POLITICO’s The Pulse reports that Sen. Orrin Hatch (R-UT) — who had proudly co-sponsored a 1993 bill that required everyone to purchase health insurance coverage — will introduce two separate measures to repeal “the unconstitutional individual mandate and the job-killing employer mandate, the most egregious elements of this devastating health law.” Republicans tried and failed to pass a similar measure in the House on Tuesday and it’s highly unlikely that Senate Majority Leader Harry Reid (D-NV) will allow Hatch’s bill to come to a vote.

In that respect, the maneuver is pure politics and Hatch — who does have some bipartisan chops when it comes to health care — has had a hard time explaining why he supported a mandate in the past. Here is how he answered that question when pressed by MSNBC’s Andrea Mitchell in March:

HATCH: We were fighting Hillarycare at that time. And I don’t think anyone centered on it, I certainly didn’t. That was 17 years ago. But since then, and with the advent of this particular bill, really seeing how much they’re depending on an unconstitutional approach to it, yea, naturally I got into it, got into it on this issue.

When I spoke to Antonia Ferrier from Hatch’s office she reiterated this point, telling me that “in the intervening years he actually went back and looked at that legislation, looked at the constitutionality of that question, talked to a variety of different constitutional scholars and looking at that legislation that he co-sponsored back in 1993, he realized that this part of the bill, that it was unconstitutional.” But surprisingly, he doesn’t regret cosponsoring what he sees as an unconstitutional measure, since it was a means to “defeat HillaryCare.” “In 1993, he was not examining the individual mandate through a constitutional prism,” Ferrier told me.

Today, he is not examining the mandate through a cost-benefit prism. The individual mandate creates incentives for otherwise healthy Americans to purchase insurance and lowers premiums. Were Hatch’s plan adopted, healthy Americans would avoid buying coverage and insurance plans would be dominated by sicker people. Premiums would increase, severely disadvantaging the millions of Americans with chronic conditions (who actually use care). But when I asked Ferrier if the Senator was concerned about increasing costs, she kept saying that Republicans have offered their own proposals and that the Senator would not accept this law and continue to fight for conservative solutions to the health care crisis:

“That might be the concerns of some,” she said in response to my increasing costs argument, “our concern is about the constitutional questions about it.” “You keep going back to premiums,” she told me. “What I’m talking to you about is a very fundamental American concept of liberty here. We believe we can lower premiums in an entirely different way.”

Hatch will certainly continue to press for his own conservative solutions, but the optics of this are rather damaging: in 1993, he supported the mandate to stop HillaryCare, now he’s opposing it to unravel the health care law. Forget “retrospection,” it’s opportunism at its finest.