Health Care and the 2012 Election

I have a piece up at Al Jazeera on how health care is likely to affect the 2012 election. I focus in particular on the Affordable Care Act and its implications.  Here I’ll note a few points by way of summary.  Interested readers can click through to see the whole discussion.

An emerging finding in the political science literature is that health care reform hurt Democratic congressional incumbents in 2010.  Eric McGhee reported that finding on this blog immediately after the election (here and here), and the finding has stood up pretty well.  A forthcoming article (gated; ungated) by Brendan Nyhan, Eric McGhee, Seth Masket, Steven Greene, and me does some statistical heavy-lifting to see if this effect is in fact real and robust.  We estimate that support for health care reform cost Democratic incumbents about 6 percent of the vote, relative to Democratic incumbents who opposed health care reform.  We also suggest how this happened: independent and Republican voters came to see the Democratic supporters of HCR as more ideologically distant (i.e., liberal) than those who opposed HCR.  See Seth’s post for more, plus a Neil Young reference.

But it’s an open question whether HCR will matter as much in 2012.  Because opinions about HCR are already so polarized by party, HCR isn’t necessarily likely to affect the votes of Democrats and Republicans, who are very loyal to their party’s presidential candidate anyway.

Independent voters’ opinions of health care reform could be more influential, but at least three hurdles must be surmounted.  First, there remains a lot of uncertainty about the Affordable Care Act’s provisions, which provides an opportunity for arguments by the presidential candidates to actually move opinions.  If this happens, then independents will likely revise their view of HCR around what their preferred candidate says, rather using their view of HCR to evaluate the candidates.  Views of HCR become the effect, not the cause.

Second, if we assume that Romney will be the nominee, many Americans do not profess to see any difference between Obama’s and Romney’s positions on HCR.  If the difference is never clarified—presuming it can be, given “Obamneycare” and all that—then HCR won’t be useful for distinguishing between the candidates.

Finally, the economy is such a dominant issue now that it may crowd out other things.

The piece has more detail and links to illustrate these points.  However, given its focus on the presidential election, it leaves aside the question of whether HCR will matter in the 2012 congressional elections.  My sense is that there are probably few HCR supporters in the House who are vulnerable. The Republican wave in 2010 should have taken care of most of them.  That said, I haven’t tried to game out every relevant House race.  On the Senate side, I do wonder whether a few Democratic incumbents might take some heat.  I also wonder whether someone like Ben Nelson decided not to run in part because he believed his support of HCR would hurt him.

Again, the piece is here.  I welcome any feedback.

[Cross-posted at The Monkey Cage]

John Sides

John Sides is an associate professor of political science at George Washington University.