We are now going to have the campaign over Obamacare that we would have had during the 2012 election if anyone but Mitt Romney had been the Republican nominee. Because Obamacare was modeled on health care reform that Romney passed as governor of Massachusetts — individual mandate and all — the presidential campaign wasn't focused on the most controversial legislation of President Obama's first term. In the months before major parts of the law finally kick in, we're going to have that fight. With campaign ads in swing states and everything.
First, the ads we usually see in an election year: The Koch brothers-funded group Americans for Prosperity is spending $1 million on TV ads in states like Ohio and Virginia saying Obamacare will mean people will have fewer choices in their own health care, The New York Times reports. Organizing for Action — the advocacy group Obama's 2012 campaign was converted into — will counter with TV ads saying Obamacare is great. (Both ad campaigns feature moms.) Oregon will air ads for its state health exchanges featuring twee guitar-playing youth and stay-at-home dads in scenes that "could have been pulled straight out of Portlandia," The Washington Post reports. (Healthy young people are the group the government most needs to convince to sign up for insurance, which might explain the tone of the ads.) Oregon is spending $2.9 million on Obamacare outreach.
Then, the typical election-year testimonials from various groups: The American Medical Association will do "whatever we can in our power" to promote the law, president Ardis Hoven said in a C-SPAN interview. Republican senators warned the NFL and the NBA not to do that, after Health and Human Services Secretary Kathleen Sebelius said she was talking to the sports organizations to publicize the law. The NFL told the senators it had no plans to market Obamacare.
Then there's the typical election-year tinkering with the law to make voters happy: The Obama administration is trying to make Obamacare more popular in other ways. It decided to allow people seeking subsidies to buy insurance to just state their income — meaning people could lie and say they make less money in order to get a bigger subsidy. And the Treasury Department announced last week that one of the least popular Obamacare measures would be delayed for a year — the mandate that businesses employing more than 50 full-time workers offer health care coverage. This will increase the cost of Obamacare, but also mean less complaining from employers like Denny's. That also makes it easier to implement the law, former Office of Management and Budget head Peter Orszag told The Washington Post. Not that it will be easy!
The White House has known for months that it will struggle to implement some parts of Obamacare, National Journal's Margot Sanger-Katz reports. The administration is struggling to get the online health insurance exchanges ready in time for people to enroll in October. The exchange sites are supposed to be easy to use, but they're very hard to build, because the sites "need to be able to talk to several federal agencies—IRS to verify an applicant's income and employment status, the Department of Homeland Security to determine her citizenship, and the state government to see if she qualifies for Medicaid, to name a few—all in real time, so a person could fill out a form and purchase insurance in one sitting." The White House has hired former Clinton aide Chris Jennings to make implementing the law go more smoothly. As George Washington University professor Sara Rosenbaum told The Hill, the administration needs someone to "bring the technical and political together."