Tuesday, September 13, 2011

Obama's Strategy of Silence

The president is trying to hide from his "signature achievement."

The White House is quietly implementing a shrewd new strategy of silence on Obamacare. Its goal: making sure the revolt against the unpopular health care overhaul that swept Republicans into power across the country in November 2010 isn't repeated in 2012.

After two years of nonstop focus on health care, the president has stopped talking about the law's far-reaching effects. Now he is concentrating on a few micro changes. Meanwhile the administration is working hard to dampen controversy by handing out buckets of waivers and attacking Republicans over Medicare.

Bringing Obama around to this new course wasn't easy for his advisors. The day after last November's elections, the president belligerently refused to acknowledge that the results were a referendum on his unpopular policies or that Obamacare had hurt Democratic candidates. His health policy agenda was correct and possibly only needed a bit of "tweaking," he insisted.

But his advisers pored over the election results and reached an inescapable conclusion. "The economy, as important as it was, was not the decisive factor this election. Health care was," Democratic pollster Pat Caddell said just after the election. "It is…health care [that] killed them," Caddell said of the 63 defeated House Democrats. "The American people found this a crime against democracy…they want it repealed, and this issue is gonna go on and on." Now the White House's strategy has the president talking as little as possible about Obamacare.

We haven't intercepted their memo to the Oval Office, but we can extrapolate from recent White House tactics what his advisers have recommended Obama must do:

1. Stop talking about it. Every time you talk about the sweeping overhaul of health care, your poll numbers go down. People know you can't spend $1 trillion and pretend to reduce the deficit. Or take more than $575 billion out of Medicare and make it stronger. Anyway, it is now the law of the land and the wheels of bureaucracy are grinding to make sure it takes effect in 2014. Your only job right now is to get reelected to veto any reform bills passed by the next Congress.

2. Focus on the small stuff. People don't know what is in this law, as Republicans so annoyingly continue to remind us with Nancy Pelosi's unfortunate quote -- "We have to pass the bill so you can find out what's in it." We can calm the opposition if the public is convinced that it's only about putting 26-year-olds on their parents' health insurance, free preventive care, risk pools for preexisting conditions, and some new insurance regulations. We should call attention to those who have already benefited from the law's early provisions. If people believe it is only about small changes, they will wonder what all the fuss was about.

3. Attack Republicans. Health care is a Democratic issue and always will be. So go after Republicans for their ridiculous ideas about "private competition" and "putting consumers in charge of decisions." Paul Ryan has given you a golden opportunity to target Republicans for trying to destroy Medicare and forcing seniors to pay thousands of dollars more for health care. Hammer away at him.

4. Calm the opposition. The most important thing is to keep opponents quiet. Health Secretary Kathleen Sebelius is a key ally here since the health law gives her so much power over how it is implemented. Focus on the governors. Sebelius should find ways to give them temporary relief from Medicaid costs. She also should issue waivers to states, companies, and anyone else who complains the new law is hurting them.

THE NEW OBAMACARE strategy is working smoothly except for tactic number 4. The waiver tactic backfired, as it became clear that waivers from the law's early provisions were needed and were being granted disproportionately to politically favored groups (restaurants and spas in San Francisco and hundreds of labor unions, for example). To calm the negative press, the administration now says waivers will be good through 2013, and it will stop granting new ones as of September 22, 2011.

But the rest of the strategy clearly is in place. Since the elections, the president has not given a single speech on the major changes coming from his health law. His main focus has been on tactic number 3--attacking Republicans at every opportunity and claiming that he is the protector of Medicare because he won't "ask our seniors to pay more for health care."

So far, it seems to be working. Obamacare has evaporated as a major issue. The House of Representatives voted overwhelmingly to repeal the law in January and, according to a CBS News poll, about half of those asked think it has been repealed or aren't sure. The confusion suits the White House just fine. Republicans are working to defund the law, delay its implementation, investigate the avalanche of regulations that have already been issued, and examine the impact the law is having on health costs and the ballooning deficit, but their efforts didn't make the front page.

It is difficult to overestimate the sweeping impact that Obamacare will have on our health sector, our economy, and our freedom. (My co-authors and I have highlighted in our book Why ObamaCare Is Wrong for America [Broadside/HarperCollins, 2011] the devastating impact it will have on seniors, families, young people, taxpayers, employers and employees, doctors and patients).

WILL THE SUPREMES rescue us? While many hope Congress will repeal the law, others believe there is a good chance its key provision--that all citizens purchase federally approved health insurance--will be declared unconstitutional by the Supreme Court. That is a big gamble.

The Sixth Circuit was the first of several appeals courts to rule on the validity of Obamacare's mandate; conservatives were disappointed about its decision in late June to uphold it. At least two other appeals courts will issue decisions over the next several months, with a likely U.S. Supreme Court hearing next year and a decision by June 2012.

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