If I were a Democrat running for Congress in 2014 who supported the Affordable Care Act, known as "Obamacare," I would be running a campaign explaining why I am proud of my vote. And I would challenge my GOP opponent to answer five questions:
First, without Obamacare, what would you do about people who lose their health insurance because they have lost their jobs and can't get health insurance because they have a pre-existing condition?
Second, without Obamacare, what would you do about people who lose their health insurance because they have suffered a catastrophic illness and their insurance company refuses to renew them?
Third, without Obamacare, what would you do about so-called free riders? These are individuals who have never purchased health insurance yet still benefit because, under federal law, they are guaranteed access to emergency rooms. This means that they get to ride freely on the backs of their friends and neighbors who have paid insurance premiums over the years and don't need to rely on emergency rooms yet subsidize emergency rooms in most hospitals with their tax dollars.
The answer to this obviously unfair "free riding" phenomenon is the individual mandate, which requires everyone to "pay or play" with a fine so that all contribute to the costs of health care since, at some point in their lives, all will need it.
The fourth question could be the real crusher in the 2014 congressional elections: If you support repeal of Obamacare because the individual mandate -- "pay or play" -- violates your conservative libertarian principles, does that mean you support repealing Social Security and Medicare?
This is not far-fetched. Indeed, the analogy is on point.
Recall that the Supreme Court, led by the conservative Chief Justice John Roberts, approved the constitutionality of the individual mandate by calling it a tax -- i.e., it is within the power of Congress under the Constitution to fund and achieve its social and legislative goals.
Recall also that when Social Security passed in the mid-1930s, and Medicare in the mid-1960s, Republican conservatives also opposed it, using similar language protesting the affront to individual liberty and making similar ominous warnings about the approach, if not the arrival, of socialism in America.
Opponents of Social Security also argued, as they do today with Obamacare's individual mandate, that young healthy people should not be forced to pay a tax if they don't obtain health insurance to subsidize the old and infirm. But supporters of Obamacare point out that unless the young and the healthy are in large proportions participating and paying premiums, the cost of insurance, with a disproportionate base of the unhealthy and the infirm left behind, would be prohibitive.
The fifth question goes to a moral issue that I believe will resonate with the American people: Do you agree with conservative health care writer Avik Roy, that "no wealthy nation [such as America] should allow a destitute woman who has been hit by a car to die in the street"?
I was recently reminded of the power of this moral issue, so eloquently and simply articulated by Democratic Rep. Elijah Cummings, who represents the inner-city neighborhoods of Baltimore. He told me a true story about an anti-Obamacare constituent who said he couldn't support the congressman for reelection because of his support for that legislation.
Cummings said, "That's OK -- that's your right. But you have to understand that without ObamaCare, people in my congressional district will die because they can't afford to go to a doctor." He added: "But even if you vote against me, if you lose your health care insurance, I will be there as your congressman ensuring you get affordable health insurance thanks to Obamacare."
I believe that, like Social Security was for FDR and Medicare was for LBJ, the Affordable Care Act could end up as one of President Obama's most enduring historical legacies. But that can never happen unless Democratic congressional candidates and Obama become less defensive and more proactive and positive in getting the facts out -- and proudly, unapologetically, explaining why Obamacare is good for the American people and is the right thing to do for all citizens in red states, blue states and purple states.
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This column appears first and weekly in The Hill and the Hill.com.
Davis served as special counsel to former President Clinton and is principal in the Washington D.C. law firm of Lanny J. Davis & Associates, and is Executive Vice President of the strategic communications firm, Levick. He is the author of a recently published book, Crisis Tales: Five Rules for Coping with Crises in Business, Politics, and Life (Threshold Editions/Simon and Schuster).
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