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Rx for Midterm Elections

Will health-care reform help or hinder candidates in November?

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When Idaho Gov. C. L. "Butch" Otter signed on to a multi-state lawsuit to overturn the Obama administration's brand new health-care reform law, he made an electoral bet. Sen. Mike Crapo, who voted against the Patient Protection and Affordable Care Act in December 2009, made the same wager when he co-sponsored an effort to repeal the bill.

But a virtually unknown Democrat from Teton Valley is making the opposite bet, running for Senate on a pro-health-care reform platform.

"This is not health-care reform, this is health insurance reform ... the government is refereeing health care," said Tom Sullivan, a small-business owner and first-time candidate from Tetonia. "This is an opportunity for us to make the American people more productive."

Sullivan has an opponent in the May 25 primary--Brooklyn, N.Y., attorney and single-payer advocate William Bryk--but he hopes to challenge Crapo in November, in part on Crapo's opposition to the Democrats' health reforms.

"It's not about whether it's a right or a privilege," Sullivan said during a recent Boise visit. "It's about the overall net effect of having a healthy population."

Recent polls indicate that either wager is risky. A late-April poll from the Quinnipiac University Polling Institute found that voters disapproved 55-40 of the way President Barack Obama handled health-care reform. The Kaiser Family Foundation asked, also in late-April, how Americans felt about the law itself. They found the reforms favorable by a margin of 46-40, but respondents were confused about what the law actually does. More recent Gallup and Rasmussen polls were equally contradictory, showing respectively, support for the bill and support for repeal of the bill.

Part of Sullivan's bet is that by fall, more Americans will understand what the law does for them and therefore accept it.

By September, insurance companies won't be allowed to deny coverage to children with pre-existing conditions, must end lifetime limits on coverage and rescissions (when people are dropped after they get sick) and must provide no-cost preventive care visits. Seniors will get a $250 rebate for prescription drugs if they've been denied drug coverage under the so-called Medicare donut hole.

"As components of this roll out leading up to full implementation in 2014, people are going to be seeing a lot of the benefits of this," said David Irwin, a spokesman for the AARP of Idaho.

Across the nation, the AARP is beginning to educate its members about the reforms that are coming down the pike, even before election season swings into full gear. But as reform backers prepare their campaigns, Crapo and many other conservative candidates are insisting on repeal, echoing the Republican message in the lead up to passage of the bill.

Crapo favored health-care co-ops and Medicare/Medicaid reform during the Congressional debate and last week he cited a recent Congressional Budget Office report that estimates that discretionary spending on health-care reforms will cost $115 billion--taking the potential cost of reform over the $1 trillion mark.

"We were making these arguments when we were debating the bill, but the proof of it was not out," he said.

Jonathan Parker, executive director of the Idaho Republican Party, said health care probably won't be the main issue in November, but that it will be a strong issue for Republican candidates in Idaho.

"I just think overall a majority of Idahoans oppose the actual health-care bill that went through Congress," Parker said.

Idaho Republicans will continue to call for opening insurance policy sales across state lines and bringing costs under control. So might Idaho's Democratic Rep. Walt Minnick, though he's not arguing for repeal. Minnick was one of a handful of Democrats who voted against the bill.

"Walt thought through this very carefully," said Idaho Democratic Party Executive Director Jim Hansen. "He doesn't support repealing it, and he doesn't support this crazy lawsuit."

The National Republican Congressional Committee funded a pre-primary television spot criticizing Minnick's votes against abortion-related amendments to the health-care reform bill, and Parker cited Minnick's original support for Nancy Pelosi to become speaker of the House--the same Pelosi who also supported health-care reform--as reason to oppose Minnick.

The subtle arguments in favor of health-care reform might be hard to make in Idaho as well.

"From a policy perspective, I think most people would approve of it," said College of Idaho political economist Jasper LiCalzi. "But it's the big picture stuff that people don't like."

Boise doctor Ted Epperly, chairman of the board of the American Academy of Family Physicians, agreed that people are starting to settle into the idea of the massive reforms.

"It will be interesting to see what the voters have to say, however I think the politicians will absolutely make it an issue," said Epperly, who supported Obama's reforms and was at the White House this month discussing ways to increase the number of primary care doctors using incentives that were written into the bill.

Sullivan and Crapo have about five months to read the bill--Sullivan says it's really only 230 pages if you take out all the triple spacing--and hone their arguments, as the powerful forces of public opinion are shaped by the early roll-out of health-care reform.

"Whether it's enough time or not, what really matters is principles," Sullivan said. "I'm not going to straddle the fence."