In a ‘Seinfeld election,’ does Obamacare matter?

The midterm elections of 2014 threaten to be about nothing in particular – like the old TV show “Seinfeld.” Even the Affordable Care Act, the defining issue of the Obama presidency, is fading as a motivating factor for voters.

A poll released Tuesday by the Kaiser Family Foundation found that among the most enthusiastic voters, only 3 percent cited the ACA, or Obamacare, as the reason for their level of enthusiasm. The top reason, at 13 percent, was to elect more Republicans or switch control of the Senate to the GOP. Next was a sense of civic duty. Third was a desire to vote out incumbents.

Down at No. 11 was the health-care law – a ranking based on the views of voters across the political spectrum. Also, the Kaiser poll found that 27 percent of Republicans are more enthusiastic about voting this November than in previous congressional elections, while 20 percent of Democrats and 18 percent of independents feel that way.

So clearly, President Obama’s health-care reform, pro or con, doesn’t have the political pull it used to. Five years after the issue rose to the top of the Washington agenda, Obamacare fatigue has set in with voters, says Charlie Cook, editor of the nonpartisan Cook Political Report.

“More often than not, they don’t like [the law],” says Mr. Cook, speaking at a forum Tuesday at the Kaiser Family Foundation office in Washington. “But they think this has already been litigated, this thing’s not going to get repealed anytime soon, and so let’s move on and start working to fix it.”

Republican strategists are telling their candidates that they’ve “milked the health-care cow for all there is,” and that they need to be about something other than the party attacking health-care reform, Cook says.  

Indeed, a lot of campaigns have gotten away from the issue, “though some still like to beat that drum, part of it out of habit, part of it because the base loves it, part of it just so nobody forgets it – not that anybody is going to forget it,” says Cook.

In Iowa, where the race for the open US Senate seat between state Sen. Joni Ernst (R) and Rep. Bruce Braley (D) is one of the hottest contests in the country, health care is in fact on the agenda. But Republicans have changed their message.  

“Republicans in Iowa have started talking about health care, Obamacare, as an example of the overreach of the president,” said Kathie Obradovich, a political columnist at The Des Moines Register, speaking at the Kaiser forum.

GOP examples of presidential “overreach” on Obamacare include the requirement to include contraceptive coverage in employer-provided health plans and Mr. Obama’s delay of mandates in the ACA. The Republican-led House is getting ready to sue Obama for allegedly failing to carry out his constitutional duty to enforce the ACA – specifically, when he delayed the employer mandate to provide health coverage.

“That’s probably a pretty effective message in Iowa,” Ms. Obradovich says. “It’s a purple state. People are concerned about the balance of power.”

In North Carolina, home to another close race – Sen. Kay Hagan (D) versus North Carolina House Speaker Thom Tillis (R) – Obamacare was all over the airwaves a year ago when the campaign started, “but the ads have pretty much disappeared,” said Jim Morrill, a political writer for The Charlotte Observer, at the Kaiser event.

But health-care reform came up right out of the gate last week in their first debate, during a testy exchange. Mr. Tillis claimed Senator Hagan had said “if you like your plan, you can keep it” 24 times while the bill was under debate. Hagan accused Tillis of trying to take the United States back to a broken health-care system.

Contraceptive coverage also came up. Tillis said he supported the US Supreme Court’s ruling in the Hobby Lobby case – which allows some businesses not to provide contraception in their health plans – but also favors more availability of birth control over the counter.

“I don’t know how much [the birth control issue] has done for Tillis, but it’s animated Kay Hagan’s side and the women’s groups who support her,” Mr. Morrill said.

On the broader issue of Obamacare, public opinion has held remarkably steady during the past four years, the Kaiser tracking poll has shown. In its September poll, 47 percent of Americans view the law unfavorably, versus 35 percent with a favorable view. The favorable number has been greater than the unfavorable only a few times since April 2010, the month after the ACA was signed into law.

The Kaiser poll has also found consistently that attitudes toward the law divide along party lines and track attitudes toward Obama.

In a break from the approach of Republicans in Congress, a strong majority of Americans – 63 percent – want their member of Congress to work to improve the law, compared with 33 percent who want their member to vote to repeal the law and replace it with something else. Among Republicans, 35 percent say they want to fix the law, not repeal it.

But the Republicans in Congress aren’t ready to make that leap from repealing to fixing. “Any Republican that says, ‘We ought to roll up our sleeves and try to fix it’ – they just get beat up by tea party types, saying that trying to modify it is accepting it,” Cook says.

When asked to state the most important issues in their votes for Congress this November, voters ranked health care second at 13 percent. Economy/jobs came in first at 21 percent. But in an election that isn’t primarily about issues, the public isn’t demanding a vigorous debate about Obamacare.

“Clearly, it’s not top of mind for most voters, and it’s not driving their interest in this election,” says Mollyann Brodie, director of survey research at the Kaiser Family Foundation. “But it’s certainly a part of the campaign season, and for that reason alone, it’s important for us to be discussing its role.”