As debate began on the House floor Jan. 18 on a GOP move to repeal health reform, backers of the law stepped up their defense of the measure and are turning the debate into a campaign to explain the law to more Americans.
A day before the vote on repeal, only 25 percent of the public, according to an AP poll, remains strongly opposed to the law, close to the lowest level of opposition registered in surveys dating back to September 2009.
Support for repeal has dropped sharply, even among Republicans. Just after the November elections, 61 percent of Republicans said they backed repeal. That figure, in the latest AP poll, has dropped to 49 percent.
The poll also showed that 43 percent believe the law should go further in curbing insurance companies than it currently does.
"We welcome, in a certain sense, their attempt to repeal it because it gives us a second chance to make a first impression," Sen. Chuck Schumer, D-N.Y., said Sunday on NBC's "Meet the Press." He said the debate will allow Democrats to talk about "the good things that didn't get a real airing during the sturm und drang of the debate."
During floor debate, House Democrats are sharing stories of people who have benefited from the legislation and are warning that those people would be hurt if the law is repealed.
The Democratic Steering and Policy Committee held hearings Jan. 18 with consumers. Republicans, in contrast, held no hearings prior to their move to repeal.
Also on Jan.18, the Department of Health and Human Services released a report that showed the potentially devastating impact of repealing the ban on insurers' denying customers over pre-existing conditions. The report found that as many as 129 million, or half of all Americans under 65, have some kind of pre-existing condition.
Republicans, as they push for repeal, find themselves in several binds.
They are going to have to design an alternative health care plan but have not, even as debate began, put one forward. The Los Angeles Times noted that "previous Republican efforts at healthcare reform were projected to leave 52 million Americans uninsured in 2019."
The second problem they have is that the health insurance lobby itself does not seem to be backing repeal. Insurance lobbyists believe that by staying neutral now they can stay friendly with more legislators who they can call upon in the future to make changes in their favor.
A third problem is that President Obama, who the GOP wants to hurt with the repeal vote, is far stronger than he was after the Republican election victory in November. The president's increased political strength results from both the historically productive lame-duck congressional session and his actions after the Tucson shootings.
More than 3 in 4 Americans approved of the president's response, according to an ABC Washington Post survey released Monday, his highest rating on a single issue during his presidency.
The GOP and the health insurance companies realize, of course, that total repeal cannot happen. Even if it got through the Senate it would be vetoed by President Obama.
Their best hope is to chip away at individual pieces of the reform law.
They would, in particular, like to remove a clause that went into effect on Jan. 1, which requires insurers to spend at least 80 percent of the premium dollars they take in on actual health care services, rather than overhead or profits.
Republican Conference Secretary John Carter, R-Tex., thinks he can accomplish this by introducing a challenge under authority that would be granted by the Congressional Review Act.
Rep. Pete Stark, D-Calif., said, "House Republicans would eliminate this important protection and allow insurance companies to continue unlimited spending on CEO bonuses, profits and lobbying - and less on patients' health care."