Dems Caught In Populist Crossfire
Most white Americans think health reform benefits the poor and uninsured, not people like them.
On the long climb to health care reform that ended with this week's momentous signing ceremony, President Obama aimed many of his arguments at a different audience from the one targeted by predecessors who faltered on the same steep hill.
Compared with earlier presidents, Obama focused his case less on helping the uninsured and more on providing those with coverage greater leverage against their insurers. That shift was especially evident in his final drive toward passage.
And yet, polling just before the bill's approval showed that most white Americans believed that the legislation would primarily benefit the uninsured and the poor, not people like them. In a mid-March Gallup survey, 57 percent of white respondents said that the bill would make things better for the uninsured, and 52 percent said that it would improve conditions for low-income families. But only one-third of whites said that it would benefit the country overall -- and just one-fifth said that it would help their own family.
"The goal is to make this a middle-class health care bill." --Rahm Emanuel
In both that Gallup Poll and the latest monthly survey by the nonpartisan Kaiser Family Foundation, nonwhite respondents were much more likely than whites to say that the bill would help the country and their own families. Those responses reflect not only experience (African-Americans and Hispanics are more likely than whites to lack insurance) but also minorities' greater receptivity to government activism. By meeting a tangible need in these communities, health reform is likely to solidify the Democratic hold on the one-quarter (and growing) minority share of the electorate, especially if Republicans define themselves around demanding repeal.
But whites still cast about three-quarters of votes. And if most remain convinced that health reform primarily benefits the poor and uninsured, Democrats could find themselves caught in an unusual populist crossfire during this fall's elections.
Obama has already been hurt by the perception, fanned by Republicans, that the principal beneficiaries of his efforts to repair the economy are the same interests that broke it: Wall Street, big banks, and the wealthy. The belief that Washington has transferred benefits up the income ladder is pervasive across society but especially pronounced among white voters with less than a college education, the group that most resisted Obama in 2008. Now health care could threaten Democrats from the opposite direction by stoking old fears, particularly among the white working class, that liberals are transferring income down the income ladder to the "less deserving."
In the Kaiser poll, even fewer noncollege than college-educated whites said that the plan would benefit the country. In one sense, that's ironic: Census figures show that noncollege whites are more than twice as likely to lack health insurance as whites with a degree. But these working-class whites have grown more skeptical than better-educated whites that government cares about their needs. And the searing recession has only hardened those doubts. In a recent memo, Democratic pollster Stanley Greenberg warned that these anxious and alienated voters are approaching a "tipping point" that would send them hurtling toward Republicans in November. House Democrats seem aware of that risk: Of the 34 Democrats who opposed the final health care bill, 28 represent districts with an above-average share of whites without college educations.
These trends frame perhaps the Democrats' greatest political challenge today: convincing economically squeezed white voters that Washington understands their distress. On health care, that means emphasizing the bill's provisions that will most quickly benefit those with coverage, led by insurance reform (such as allowing adult children to remain longer on their parents' policies) and more prescription drug help for seniors. "The goal is to make this a middle-class health care bill," White House Chief of Staff Rahm Emanuel says.
Simultaneously, Democrats hope that the approaching Senate debate on financial reform will portray them as advocates for average families -- and Republicans as defenders of banking and investment interests that are resisting tougher regulation. Greenberg says his recent polling shows that Obama's collision with insurers on health reform has already softened the belief that Democrats favor Wall Street over Main Street. He predicts the financial fight "will shift it further."
That could be. But despite a Gallup Poll showing a post-passage bump in support for the health care bill, skepticism that government will ever deliver for them is bred in the bone for many white voters, especially those in the working class. Health care reform won't win sustained acceptance -- or politically benefit the Democrats who finally shouldered it into law -- unless it begins to excise those deeply embedded doubts.
