The passage and botched implementation of the Affordable Care Act played a significant role in the November election outcome, say several experts contacted by Health Care News. Republicans gained control of the U.S. Senate, retained control of the U.S. House, held onto most of the governorships they started with while picking up surprise wins in the traditional Democratic bastions of Maryland, Massachusetts, and Illinois, also picking up several state legislative chambers.
Grace-Marie Turner, head of the Galen Institute, a health care think-tank, cited pre-election polling showing the health care law would be a deciding factor for a majority of voters in swing Congressional districts.
“President Obama pledged to Democratic members of Congress in 2010 that if they voted for the law, voters would thank them,” Turner said. “The opposite happened, and Democratic losses in 2010 and 2014 can be directly tied to Obamacare.”
Health care policy scholar Michael Cannon of the Cato Institute shared Turner’s view. “Though Democrats tried to deny it, Republicans made a big issue of their opposition to Obamacare during the election, and they won,” Cannon said.
Corbett lost his reelection bid after expanding the state’s Medicaid program under the Affordable Care Act, also known as Obamacare.
Campaigns Focused on Obamacare
Some campaign watchers had predicted Obamacare would fade as a campaign issue. An August 19 story at Bloomberg.com by Heidi Przybyla cited a reduction in anti-Obamacare ads in the North Carolina U.S. Senate race, concluding it was “a sign that the party’s favorite attack against Democrats is losing its punch.”
But an analysis by Kantar Media’s Campaign Media Analysis Group found between October 6 and October 26 Obamacare was the top issue in ads run by Republican candidates for U.S. Senate. Over that period Republicans aired nearly 37,000 spots criticizing the law and their opponent’s support for it, more than any other issue.
In addition, a November 3 article by Sarah Ferris in The Hill cited National Republican Congressional Committee (NRCC) spokesman Daniel Scarpinato saying Obamacare was one of the most important issues of 2014 and noting nearly one-third of all NRCC ads in the cycle had been about Obamacare, more than any other issue.
Sally Pipes, president of the Pacific Research Institute, told Health Care News, “House Minority Leader Nancy Pelosi (D-CA) predicted in March that Obamacare would be a ‘winning issue’ for Democrats in the midterm election” despite polls consistently showing a majority of Americans did not support the law. “The election results of November 4 reveal that the polls were correct, Ms. Pelosi was wrong, and the voters tossed out many of those candidates who were supporters of Obamacare,” Pipes concluded.
‘If You Like Your Plan…’
Republican candidates were able to use the statements of many incumbent Democratic U.S. Senators about Obamacare against them in ads that began early in the election cycle.
As far back as January, the pro-free market group Americans for Prosperity unveiled ads against Jeanne Shaheen of New Hampshire, Kay Hagan of North Carolina, and Mary Landrieu of Louisiana. The ads specifically cited each for their statements echoing President Obama’s claim, “If you like your plan, you can keep your plan.” The issue was a staple of ads throughout the campaign.
Hagan lost, and Landrieu faces a difficult December runoff. Shaheen barely managed to hang on to her seat against Republican Scott Brown, a former U.S. Senator from Massachusetts. Other Democratic senators hurt by similar statements included Colorado’s Mark Udall, Arkansas’ Mark Pryor, and Alaska’s Mark Begich, all of whom lost.
Democratic Senators who potentially have tough re-election campaigns in 2016 may face criticism for similar statements, including Harry Reid of Nevada and Michael Bennett in Colorado.
Exchange Failures Hurt Democrats
The botched implementation of Obamacare at the state level may also have contributed to two surprise Republican wins in the Democrat-friendly states of Maryland and Massachusetts.
In Maryland, Democrat nominee Lt. Governor Anthony Brown was given the responsibility of overseeing the rollout of the exchange. The site crashed immediately after opening for business, and Brown drew heavy criticism for the failures of the site.
Later reports revealed Brown and others in Maryland ignored several warnings the project was not meeting its goals and would not function as needed in the year leading up to the launch.
Brown’s Republican challenger, Larry Hogan, made the failed launch of Maryland’s Obamacare exchange a central point of his campaign in questioning whether the Lt. Governor was ready for a promotion to the Governor’s office.
In an ad titled “Weak Leadership,” Hogan blamed Brown for “$169 million wasted” and “families unable to get health insurance,” concluding with, “Anthony Brown: Just not ready to be governor.” Hogan also brought up the botched rollout in debates, calling it a “complete disaster” and pointing out Brown’s responsibility for the failure.
In Massachusetts, Attorney General and Democratic nominee for governor Martha Coakley appointed three members to the ten-person board of the Health Connector, as the exchange is known as in the state. Coakley strongly defended her appointees in the aftermath of the site’s failure, even after it was shown her appointees knew about the exchange’s troubles but ignored them and allowed the site to be launched.
Her Republican opponent, health care executive Charlie Baker, made her defense of the appointees a campaign issue, charging in a release, “Beacon Hill needs real leaders willing to ask tough questions, especially when it comes to spending hundreds of millions of taxpayer dollars, and the Attorney General proved she is not up to the task.”
Sean Parnell ([email protected]) is managing editor of Health Care News.