Opinion

King: Obamacare is faltering as GOP election issue Bill King says if Republicans want to win at the polls by campaigning against the new health care law, they need to offer up a specific alternative.

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Many Republicans have tied their 2014 election fortunes to assailing the Affordable Care Act. U.S. Sen. Ted Cruz's often-repeated promise to repeal every word of Obamacare has become emblematic of the strategy.

And in the first months of this year, it appeared it might be successful. The botched rollout of the healthcare.gov website contributed to a swoon in public support for the law. According to Gallup, the percentage of Americans approving of the law dropped from 48 percent in December, 2012 to 38 percent in January. During the same time, the percentage of those disapproving of the law rose from 45 percent to 54 percent. But that appears to have been the high-water mark for Republican hopes that the Affordable Care Act would be their winning ticket. Since January, support for the law has been slowly, but steadily, recovering. In a poll conducted by Gallup last week, it found that 43 percent now approve of the law.

One thing that Republicans have consistently overlooked is that about one-quarter of those who oppose the Affordable Care Act are opposed to it because it did not go far enough. These are folks who wanted to go entirely to a single-payer system. When you add those who support a single-payer system to those who support the health care law, there is a clear majority that does not support Republicans' proposed health care policies, to the extent there is such a thing. As a result, most polls show that only a minority of Americans support Cruz's call for an outright repeal of the law.

Another point that suggests the Affordable Care Act may not be as big a factor in the 2014 elections as Republicans had hoped is that most Americans have not seen any detrimental effect from the law so far. In the same Gallup poll, more than two-thirds of Americans said that they had seen no effect from the law, while 15 percent to 20 percent each had seen positive or negative effects.

For the most part, support or opposition for the Affordable Care Act falls along existing partisan fault lines. Those who say that they are likely to vote for or against a candidate based on the candidate's position on the health care law are those most committed to voting a party line. Obviously much can change between now and November, but assuming there are no more faux pas on the part of the Obama administration in continuing to roll out the law, it seems likely that it will be an issue to drive base turnout for both sides, but unlikely to sway independent voters. But independent voters might be swayed if the Republicans overplay their hand. One of the interesting ironies about the Affordable Care Act has also been that notwithstanding its general unpopularity, some of its provisions enjoy overwhelming support of the American people. In particular, the provision that allows children to stay on their parents' health insurance until age 26 and the prohibition against denying coverage because of a pre-existing condition both score approval of 70 percent to 80 percent. If Cruz and other Republicans keep saying that they are going to repeal "every word" of the ACA, you are likely to see Democratic political ads in the fall highlighting that Republicans want to take away your children's health insurance and let the insurance companies abandon you when you get cancer.

The Republicans' other problem is that they have no alternative. When they start talking about selling insurance across state lines or curtailing medical malpractice abuse, it just does not resonate with the average Americans worried about losing their jobs and their health insurance. If Republicans want to win in 2014, and even more important, stem their slide into demographic oblivion over the next couple of decades, they'd better start articulating what they are for, not just what they are against.

Obama and the Democrats overreached in 2009 by adopting a massive overhaul of the health care system that clearly had not been thought out. The fact that there have been so many unintended consequences of the law is ready demonstration that was the case. And the American people punished them for doing so in the 2010 election.

But since then, the Republicans have mostly fumbled the opportunity by coming across as strident naysayers with no alternative. That may still be enough to score some wins in 2014. Republicans have an edge because they are defending few seats in Congress and, historically, the president's party does not do well in off-year elections. But if the Republicans do not start offering alternatives to which younger Americans, women and minorities can relate, any successes in 2014 will be short-lived.

King's column appears Thursday and Sunday. Email King at weking@weking.net and follow him at twitter.com/weking.