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Seth Masket

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The Price of Reform

Posted: 10/08/10 02:06 PM ET

(Co-authored with Steven Greene, Professor of Political Science at North Carolina State University)

At the time the Affordable Health Care for America Act passed, there was much speculation that a "yes" vote might put Democratic House members from moderate and conservative districts in greater danger of electoral defeat. Political science research on congressional elections tells us that voters are known to punish members of Congress for being too ideologically out of step with their districts, but would one particular roll call vote matter?

It certainly seems that a number of Democratic members thought so. In Colorado, the Democratic members in the most conservative districts -- Betsy Markey and John Salazar -- voted for the legislation despite concerns that it could potentially seriously damage their re-election chances. Indeed, Markey voted against an earlier version of health care reform and reportedly agonized over the final passage vote.

Now, six months after President Barack Obama signed the landmark bill into law, the Republican Party, in its Pledge to America, has vowed to repeal parts of it. But with ongoing economic troubles, the issue of health care seems to have substantially faded from political consciousness. Has the health care vote had any lasting negative effects on Democrats running for re-election in more conservative districts?

To see how House members in these districts were faring, we looked at the current election forecasts created by fivethirtyeight.com and The New York Times. We focused on members from the 50 most conservative congressional districts that are represented by Democrats.

Of these 50 districts, only 41 had members who cast a vote on health care reform and are currently running for re-election. Dividing these members into two groups based on their health care votes, those who voted for health reform are running 2.7 percentage points behind those who voted against it.

Of course, there are a number of other factors, such as the members' own ideology and the liberal or conservative tendency of their districts, which might explain this difference. We therefore estimated a statistical model that controlled for the ideology of the members and the ideology of the district.

Our results from this more sophisticated analysis further bolster the case that voting in favor of health care created lasting damage for Democratic members in conservative districts. With our controls, we found statistically significant evidence that Democratic supporters of health care reform are running just over 3 percentage points behind Democrats who opposed the bill.

Typically, of course, most members of Congress running for re-election win by much greater margins than 3 percent, but this is not a typical midterm election. In 2010, for Democratic incumbents from conservative districts in a distinctly anti-Democratic year, 3 points is serious business. Indeed, of the 41 Democrats we examined, only six are forecast to win by more than 3 points - and none of those voted for health care reform.

In truth, most voters probably do not have a clear idea of how their member of Congress voted on the health care bill and are rather largely focused on the state of the economy. However, the vote has clearly created a dynamic that has disadvantaged reform supporters in conservative districts. A "yes" vote on health reform by a Democrat in a competitive district might have sent a signal to Republicans that this Democrat might be particularly vulnerable. This sign of weakness would have drawn more highly qualified and better-funded Republican challengers, whose stronger campaigns have placed the pro-health reform Democrats at a disadvantage.

Many political forecasters are predicting that the Democrats will lose control of the House in November. This outcome would be driven largely by the state of the economy and by Obama's relative unpopularity. However, the health care vote may determine some of these races at the margins, causing some Democrats who voted for the legislation to go down to narrow defeat.

Of course, if we had robust economic growth, this would all be moot, and even most Democrats in conservative districts would likely be cruising toward re-election, as incumbents typically do. In this atypical year, however, the health care vote may very well provide the crucial difference that costs Markey and Salazar their seats.

 

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pa30
All things bright and beautiful
07:27 AM on 10/11/2010
Politicians should be held accountable. Why are they surprissed that people remember what was done , and the way it was done? Time to pay up.
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06:52 PM on 10/10/2010
I just signed up for the Fed's "high-risk" pool and in two weeks will finally have insurance after being rejected by numerous companies for having a bad back. I've been uninsured for several years now because I'm self-employed. It's not cheap, but it's a lot less than the COBRA plan my last company offered when they laid everyone off. It's a huge relief. Thank you, Mr. President and Democrats for making that happen!!
12:57 PM on 10/10/2010
Why is that? It's because people in those areas don't open their eyes and their minds, relying on lies from the right.
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mackbolan
Libertas inaestimabilis res est
05:40 AM on 10/10/2010
if health care was a right the same way that the original ten amendments are understood going to a doctor would never cost you a dime...
11:37 PM on 10/10/2010
Nothing is free.
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mackbolan
Libertas inaestimabilis res est
02:12 AM on 10/11/2010
actually you are wrong....if i inherit a gun from by grandfather i am not under any type of obligation to the government in order to use that gun....try logic sometime...it works on most everything....
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11:06 PM on 10/09/2010
Harry Reid pleads to remember good deeds he’s done.

This [Health Reform] our gift(?) to American people," said Pelosi.

This is ripping off majority of Americans to provide the minority with “free†health care.
Every statement below can be verified.
Our current health care system is advanced but also inferior.
It is based on a very profitable agenda - surgery and prescription drugs.
Drug corporations practically own the medical schools, lobbyists, FDA and AMA.

The doctors prescribe drugs for the patients and for own profit.
The heart disease, cancer and diabetes are reaching the epidemic proportion.
In one year, 106,000 hospital patients died from prescription drugs side effects in this country.

Our leaders did not have intention changing it.
They punish small businesses and hard working Americans.

They are making drug corporations richer.
Watch TV for an hour. 5 drug ads interrupt the program and 3 lawyers’ ads convince to sue the drug companies for illness caused by the drugs.

The “pre-existing conditions†portion is good part of the Bill, but…
The Bill would cripple economy and increase government control.

The Bill is cutting down Medicare for millions of American seniors.
With Medicare funds reduced, live span of the seniors would be reduced.

With the seniors’ shorter live, the money saved on Social Security retirement benefits, could be used for any causes, like skateboard parks, parking lots for private jets, “save the Planet†bogus projects, electric golf carts, “Pelosi & friends†re-election campaign, etc.
Thank you, Harry Reid.
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p456
Walking Tall.
11:06 AM on 10/09/2010
Please Democrats come together in November and take back America and finish what we started. Vote for the most progressive candidate we can find. It's not to late to get single payer health care, and all of the other good things having a real majority can do. We have already seen what a GOP majority result is like. I know what it's like being a progressive in a conservative district. I live in the Mississippi of the southwest. Arizona is mostly red but we are slowly adding more blue. Soon we will be purple and that's when things will really change for the better out here.
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mountainweb
Conservative Commonsense
07:10 PM on 10/08/2010
"Our results from this more sophisticated analysis further bolster the case that voting in favor of health care created lasting damage for Democratic members in conservative districts", did not take a "sophisticated analysis" to figure out what everyone with commonsense knew at the start.
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capjas1369
06:43 PM on 10/08/2010
I hope they leave it alone and see if the thing works first. It's going to help me next year in a few ways - my cost is going down and my coverage isn't changing at all. And I really wish people would stop calling it ObamaCare... Newsflash: the president doesn't really have the kind of power and he didn't exactly pen the whole thing himself. How about calling it Heath Care Reform for now and leave it at that.
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ProudLiberalDan
Standing up an fighting conservatives since 1987
07:07 PM on 10/08/2010
No.

It wasn't a health care "reform" bill. It was a health insurance "mandate" bill, which the President said he opposed during his campaign.

Let's call it what it actually is, not what they want to sell it is, so we can amend it in the future.
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mountainweb
Conservative Commonsense
07:11 PM on 10/08/2010
Because obama laid claim to it before it turned "sour" and now he is stuck with it....
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ProudLiberalDan
Standing up an fighting conservatives since 1987
06:26 PM on 10/08/2010
But this bill wasn't "reform".

It was a corporate welfare bill mandating people buy private insurance under tax penalty if they don't, something Candidate Obama said he opposed, with no choice of any form of public option.

The only way to stand behind this corporate welfare bill at all, especially with Daschle confirming that the President bargained away any public option in his "negotiations" with the hospital and pharmaceutical industries, and with the President publicly mocking those of us who support a public option, can only be as a flawed "first step".

The public option had vast popularity. Why the Democrats aren't running with a vow to use the filibuster-bypassing budget reconciliation process to pass a Medicare buy-in can only be explained as a desire to protect their share of corporate campaign cash.
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DenverBigDaddy
Conservative does not equal Tea Party....
05:51 PM on 10/08/2010
Should it not be the price of crappy reform? Write good legislation that your constituents want and these problems go away.....
05:37 PM on 10/08/2010
My congressman,John Salazar,represents more than half this state geographically-over 54,000 square miles.You may imagine that this entails significant diversity of opinion and experiences among the electorate inhabiting this vast expanse,and you would be correctomundo! John's office can count on at least 2 or 3 e-mails and maybe a call every month from me as I try to convince him to support one or another of my progressive issues and I'm usually not successful,but since the majority [by far] of my fellow citizens and neighbors think Obama is a socialist/marxist/fascist[I'm thinkin'magic negro here] and that the centrist Salazar [57 on a one to 100 scale 0 most conservative]is a Pelosi clone,I realise he could not be elected if he said what I thought very often.I'm not saying that this electorate is informationally challenged but if it's not a sound bite on Fox,or shouted out 24/7 on hate radio,most of these folks aren't going to know that healthcare reform is a step [an historic one at that] in the right direction that is going to improve their lives,and will unfortunately continue to vote AGAINST their own interests.
03:51 PM on 10/08/2010
Is it their vote that has gotten them into trouble or their feckless support of that vote? There is a lot of disinformation about the health care reform, and there are a lot of people who think the reform didn't go far enough. Members should be honest about the reforms problems and tell their constituents that it is a work in progress.
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JohnHKennedy
04:23 PM on 10/08/2010
Obama supported the Public Option in his campaign but traded it away during the secret health care negotiations.

"Appointed" Senator Michael Bennet, who ran hundreds of internet ads proclaiming himself the PUBLIC OPTION HERO
also sold us out.

And the entire group of House Progressive Caucus members that "pledged" they would not vote for a health care bill WITHOUT a Public Option or Single Payer,
Every One of Them Sold Us Out.

And they are upset that WE Are ANGRY?
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ProudLiberalDan
Standing up an fighting conservatives since 1987
07:09 PM on 10/08/2010
Don't forget that the President also threw away his campaign stance AGAINST a mandate to buy private insurance as well.

http://www.youtube.com/watch?v=TU3s2SMhjuI
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DenverBigDaddy
Conservative does not equal Tea Party....
05:52 PM on 10/08/2010
Exactly.....how were we supposed to know what was in it until it got passed?
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DBtv
03:26 PM on 10/08/2010
If you are arguing that those voters who don't think the bill went far enough are going to vote for the republick party candidates to "send a message", I'm not sure what that message will be when teabagger congresspeople begin dismantling what we were able to get passed.
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JohnHKennedy
04:26 PM on 10/08/2010
Obama can VETO anything the Repugs throw at him as they will most certainly not have a majority big enough to override a veto.

And any ConservaDem stupid enough to vote with the Repugs will get PRIMARIED!
03:46 AM on 10/09/2010
I'm arguing support from dems would be much stronger, AND that the 72% included a lot of indies and "conservatives" who couldn't but notice Dems standing up for them... if they had.
Alas, "compromise" was giving the 28% their way against majority wishes so it's just a theory like evolution;..(
02:59 PM on 10/08/2010
Uh, shouldn't this analysis factor in that the public option was excluded despite 72% support among all Americans.

Presuming the politician is being punished for what they did rather than what they didn't do should have been a factor too, yes?
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JohnHKennedy
04:28 PM on 10/08/2010
"excluded despite 72% support among all Americans."

That is one of the Major Reasons for the REBELLION in the Democratic Party.

This was an incredibly stupid thing for our reps to do, not to include it.
BlueDog1
"Taking the High Road"
02:51 PM on 10/08/2010
Blue Cross did it...............