Defend 'Obamacare' unabashedly, some Democrats say

WASHINGTON (AP) — Some Democrats say it's time to stop hiding from the president's signature health care overhaul — even in this year's toughest Senate elections — now that enrollments are higher than expected and costs lower.

Republicans practically dare Democrats to embrace so-called "Obamacare," the Republican Party's favorite target in most congressional campaigns. Yet pro-Democratic activists in Alaska are doing just that, and a number of strategists elsewhere hope it will spread.

President Barack Obama recently announced that first-year sign-ups for subsidized private health insurance topped 7 million, exceeding expectations. And the Congressional Budget Office — the government's fiscal scorekeeper — said it expects only a minimal increase in customers' costs for 2015. Over the next decade, the CBO said the new law will cost taxpayers $100 billion less than previously estimated.

Republicans already were pushing their luck by vowing to "repeal and replace" the health care law without having a viable replacement in mind, said Thomas Mills, a Democratic consultant and blogger in North Carolina. Now, he said, Democrats have even more reasons to rise from their defensive crouch on this topic.

"Democrats need to start making the case for Obamacare," Mills said. "They all voted for it, they all own it, so they can't get away from it. So they'd better start defending it."

Even some professionals who have criticized the health care law say the political climate has changed.

"I think Democrats have the ability to steal the health care issue back from Republicans," health care industry consultant said Bob Laszewski said. "The Democratic Party can become the party of fixing Obamacare."

In truth, some Democratic lawmakers often talk of "fixing" the 2010 health care law. But it's usually in response to critics or in a manner meant to show their willingness to challenge Obama.

For instance, Democratic Sen. Mary Landrieu who faces a tough re-election bid, used her first TV ad of the campaign to highlight her demand that Obama let people keep insurance policies they like.

But Landrieu and other hard-pressed Democrats have not gone as far as a pro-Democratic group in Alaska that is unabashedly highlighting the health law's strongest points.

The independent group Put Alaska First is airing a TV ad that praises Democratic Sen. Mark Begich for helping people obtain insurance even if they have "pre-existing conditions," such as cancer. The ad doesn't mention Obama or his health care law by name, but it focuses on one of the law's most popular features.

Other Democrats should consider such tactics, political consultant David DiMartino said.

"There is still time to tell the story of Obamacare to voters," he said. Democratic candidates don't want to be defined entirely by the health law, he said, "but now they can point to its successes to fend off the inevitable distortions."

Republican Party strategists don't agree. The recent upbeat reports might help Democrats temporarily, but "the negative opinion of Americans toward Obamacare is baked in," Texas-based Republican consultant Matt Mackowiak said. "If Obamacare was truly trending positively," he said, "Sebelius would have stayed, and Democrats in tough races would be picking a fight on Obamacare, instead of mostly hiding from it."

Kathleen Sebelius, the health and human services secretary closely associated with the health care law, is stepping down. Democrats say it's a sign that the biggest problems are past, but Senate Republicans vow to use her successor's confirmation hearings as another forum for criticizing the law.

Democrats hardest hit by anti-Obamacare ads — including Sens. Kay Hagan of North Carolina and Mark Pryor of Arkansas — continue to defend the health law when asked, but they generally focus on other topics, campaign aides say.

Polls don't suggest public sentiment is shifting toward Democrats, said Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health. But with at least 7.5 million people enrolled despite last fall's disastrous rollout of insurance markets, Blendon said, Democrats have some strong new material to use.

"Each of the Democratic candidates is going to have to make a calculation on whether or not they can motivate Democrats," Blendon said. "For Democrats to get an advantage out of the law, they have to convince people they have something to lose if the Senate changes hands."

Republicans need to gain six seats to control the 100-member Senate.

New political problems might arise for the health care law before the Nov. 4 election. For instance, the individual requirement to carry health insurance remains generally unpopular, and now penalties may apply to millions of people who remain uninsured.

So far, Republicans have had an edge in public opinion, particularly when those with strong sentiments about the law are considered. A recent AP-GfK poll found that strong opponents outnumber strong supporters, 31 percent to 13 percent. And motivated voters often make the difference in low-turnout nonpresidential elections. But the poll also found that most Americans expect the health law to be changed, not repealed.

That puts Republicans in a tricky situation: Party primary voters demand repeal, but general election voters in November are looking for fixes.

"It's not a cheap and easy political target anymore," Laszewski said. "Republicans are going to have to tell us what they would do different."

Democrats deride Republican proposals to "replace" the 2010 health care law, saying they collapse under close scrutiny. Since they generally contemplate a smaller federal government role, many of the Republican ideas are likely to leave more people uninsured. Some approaches do not completely prohibit insurers from turning away people with pre-existing medical conditions.