Speaker Nancy Pelosi (D-Calif.) has drawn the battle lines for a late-summer brawl over the fate of sweeping health care reform legislation.
In one corner, her Democratic Caucus, fighting for a public insurance option to compete with private insurers. In the other corner, the insurers, emptying deep pockets to protect their hold on the market.
Tracking with a similar message shift by the White House, Pelosi last week dramatically ramped up her attacks on the insurance industry, trashing insurers as immoral villains who squeeze “obscene— profits for their executives by denying care to the needy. And she made it clear that she expects a hot war with them in August.
“We know what we’re up against,— the California Democrat said Friday. “This is going to be carpet bombing, slash and burn, shock and awe, anything you want to say to describe what the insurance companies will do to hold onto their special advantage, which exploits the patients and holds the American consumer at the mercy of the insurance company.—
Pelosi’s rhetorical escalation marks a sharp pivot for Democratic messaging in the health care debate. Until last week, Congressional Democrats mostly kept their gloves on as they sought to keep industry groups engaged — and discourage them from bankrolling the kind of multimillion-dollar opposition campaigns that sunk a Democratic-led health care overhaul 16 years ago.
Democratic aides pointed to two reasons for the shift: a desire to strike pre-emptively against an industry that they expect to spend heavily in August to scuttle the public insurance option and a need to seize on a new strategy to sell a package that has been sliding in popularity in polls.
“These guys are about to blow us up, on the one hand,— one senior Democratic aide said. “On the other hand, our messaging has been flailing. We’re having trouble breaking through and telling our story.”
The approach carries risks. A Wall Street Journal/NBC poll released last week found support for the overhaul slipping most quickly among those who have private insurance — with 47 percent of those now covered calling the plan a bad idea, up from 37 percent five weeks ago — an apparent sign that those with coverage fear greater government involvement.
As a result, not all House Democrats are on board for the August offensive against insurers. For example, Majority Leader Steny Hoyer (D-Md.), a moderate, was notably less vocal than Pelosi and others in leadership last week in lashing the industry.
“For folks who have had a generally decent experience, who like their health care, that message doesn’t resonate as well,— a Democratic leadership aide said, adding that lawmakers would make their own decisions about how much to emphasize an anti-insurance line over a “positive message— about new consumer protections in the bill.
[IMGCAP(1)]But Pelosi suggested Democrats will need to spend August in campaign mode against the insurers if they want to salvage a strong public insurance option. “You have to address the opposition,— she said. “You cannot let them define you without telling the public who is doing the defining.—
Pelosi’s new tone followed a similar pivot by President Barack Obama, who in a July 22 prime time news conference started describing the effort as “health insurance reform,— putting a finer point on what had earlier been described as “health care reform.— The next day, at a town hall meeting on health care in Ohio, Obama said the reform plan would “keep the insurance companies out of your health care decisions.— And last week, he told an audience in North Carolina that the current system works “well for the insurance industry, but it doesn’t always work well for you.—
Other House Democratic leaders helped make the case last week. Rep. Chris Van Hollen (Md.), a Pelosi deputy and chairman of the Democratic Congressional Campaign Committee, argued at a press conference last Monday that insurance industry profits have surged this decade at the expense of patients paying higher premiums for reduced care. Van Hollen argued that going on the attack against the industry wasn’t likely to spook those who report that they are pleased with their care because “even people who are covered know well they are at risk of not getting the full benefits that they need when they need them.—
A card that House Democrats are expected to tote with them during the recess makes the party’s emphasis clear: “Health Insurance Reform to Hold Insurance Companies Accountable,— its banner reads. “Putting you and your doctor back in charge — not the insurance companies — to guarantee stability, lower costs, higher quality, and more choices of plans.—
What shape the insurance industry response will take over August is not immediately clear. Karen Ignagni, president of America’s Health Insurance Plans, released a statement last week decrying “divisive political rhetoric— after Pelosi leveled her first broadside against the industry. Ignagni was on Capitol Hill on Friday, meeting with Hoyer and members of the Congressional Black Caucus to tout steps that the industry is already taking to cut costs and improve care. “I think Members have been very responsive and very pleased to hear and see the support of our industry for the insurance market reforms that every American wants,— Ignagni said as her huddle with the CBC broke up. “Every American wants to know that they can get into the system, they can stay in the system and they will pay fairly.—
House Republican leaders, meanwhile, offered the GOP rank and file an optimistic take on the political environment and a packet of August talking points slamming Democrats over health care.
“Last January the political pundits and media experts were writing the obituary of the Republican Party,— reads the opening paragraph of the GOP recess material. “As we enter the August District Work Period, and after seven months of intense legislative activity, the American people are turning to us for solutions and to protect them from the radical agenda of our Democrat Congress.—
In a memo Friday, Minority Leader John Boehner (R-Ohio) urged Members to use recess to promote their alternatives and repeat the message that Democratic policies will worsen the economic situation.
“The 111th Congress to date has been a textbook illustration of what happens when a powerful majority tries to go it alone and write legislation that benefits its special-interest allies but is woefully out of step with the vast majority of Americans.— the memo states. “It’s also an example of what happens when Republicans set out to win the issues, stay unified, and offer better solutions every step of the way. “
House Republicans have more than 300 events planned over the recess, over half of which will have to do with health care.
Jackie Kucinich contributed to this report.