Democrats’ Mission Impossible: Selling Vague Promises of Future Health Reform

Democrats are preparing a campaign to sell the American people on their health care reform bill after it passes. To put it simply, this is going to be a painfully difficult job.

Lacking allied voices and faced with unflinching GOP opposition, the burden on the White House and congressional Democrats to sell a completed health care package is undoubtedly steep. But a strategy is already materializing. A Senate leadership aide tells the Huffington Post that a five-pronged video series is in the works to be released shortly after the bill is signed into law. The big push is to put people who will immediately benefit from the legislation on center stage. Expect Facebook groups and community-centered events, sources said.

Among the policy provisions that Democrats feel are easiest to pitch are the funds set to go to preventive care, the elimination of the practice of discriminating against pre-existing conditions and the benefits of the overall package for small businesses. Lawmakers, meanwhile, will be provided with tailor-made bullet points to use when they are back home or on TV -- with the benefits of the bill broken down along lines of income, gender, age and other subsections.

The fact that the bill will have pissed off union members and progressives who would normally be defending reform is really just the start of the Democrats’ problems with the sales job. The biggest obstacle is that, basically, there will be nothing to sell. A few small improvements are made relatively quickly, but 98% of the bill does not go into effect until 2014. For example, the ban on excluding pre-existing conditions does not take effect for four years! Selling vague and distant promises is a nightmare.

Let's pretend the bill were progressive enough for me. Let’s pretend it has a robust public option, a national exchange with super tough regulation, true community rating, standardized high-quality low cost sharing plan design, generous affordability tax credits, drug re-importation, etc. Even if the bill did all this, I would still find selling this bill, which I strongly support, to be extremely difficult because it would not help almost anyone for four years. “Just trust me, everything will be great sometime half-way through Obama's second term,” is a terrible sales slogan.

The easiest way to sell people on something is to have them feel and see it working. Selling even a great bill with its benefits delayed for years would be a huge uphill battle, selling this deeply flawed bill without support from the base seems like an impossibility.

Democrats only hope for salvaging some popular support for the bill rests in their ability to rally the base by making improvements and, most importantly, front-loading as much relief as possible. For example, starting the exchange early only for small businesses, and stronger, better-subsidized, longer-lasting COBRA coverage (to bridge the gap until 2014) seem like two relatively cheap but important relief measures. If Democrats can't put more immediate relief in this bill, they should be working diligently to quietly slip as much immediate health care relief as possible in every single bill between now and the 2010 election. If Democrats are going to try to run on passing a big bill labeled “health care reform,” voters damn well need to see a lot of people's health insurance getting better.