I think the single greatest political disaster in store for Democrats over the issue of health care reform is not about policy, mandates, or taxes; it is about time. Americans for the most part do not know that they will be forced to wait for three years before reform really starts.
A recent Kaiser Family Foundation poll asks:
If Congress and the president did pass a health care reform bill, when would you expect that people without insurance would begin to get financial help in buying coverage?
13% answered this year, 36% answered next year, and only 25% correctly answer three years from now. These are numbers that should completely terrify Congressional Democrats. Basically, half the country expects health care reform to be underway and there to be a noticeable drop in the number of uninsured by the time of the 2010 midterm elections. In reality, most of the reforms (and the decrease in the number of uninsured) will not start until several months after the 2012 election.
Most of the American people will know when “health care reform” has passed, but a majority will probably not realize that it means nothing will really change for next three years. That is a recipe for an angry, confused, and disappointed electorate. I would not want to be a Congressman trying to defend a reform package that has not started. And I would sure as hell not want to while stumping for re-election. Just try to explain to individuals in serious need of health insurance reform that they are out of luck until 2013.
I know delaying the onset of reform caused the bills to have a pretty CBO scores (below the magic $1 trillion). It was a stupid, short-term political calculation. Unless Democrats doing something to rapidly speed the roll out, I believe Democrats will pay a huge political price for this clever accounting trick. Explaining why reform is good is hard enough, explaining why you passed a health care reform bill that has not and will not help any of your constituents for three years is a massive political disaster in the making.