Republicans are banking that anti-health reform ballot initiatives will give them a significant edge in the November midterm elections.
The debate on the measures, which will be voted on in a half-dozen states, comes as Democrats are increasing their efforts to bolster support for their signature domestic achievement during the 111th Congress.
The strategy is similar to the GOP’s effort in 2004, when Republicans fired up their base by seeking ballot initiatives on same-sex marriage.
Michael McDonald, an associate professor of government and politics at George Mason University, said ballot measures can attract up to 1 or 2 percent more voters. In tight races during midterm elections that historically spark lower turnouts than presidential election years, that can make a difference.
“If you look across a large number of initiatives and referendums, what you see is a small, positive turnout effect,” said McDonald. “And it does seem to spill over to the overall turnout rate for other races.”
Republican activist Grover Norquist said the GOP is most likely to benefit from the ballot measures because the health law’s individual mandate is unpopular. He added that Democrats who voted for health reform will have a hard time telling their constituents that they disapprove of a specific provision in the law.
“It plays to independents … and to people who are [only] mildly for” health reform, said Norquist, the president of Americans for Tax Reform.
Norquist noted that in 2004, then-President George W. Bush won nine of the 11 states that banned same-sex marriage. Some interpretations of exit polling data suggest that the measures increased turnout by as many as 1 million people, most of whom voted for Bush.
However, Norquist said the health reform ballot measures this year were not part of a national strategy. He said state Republican activists talk to each other every week to share their ideas.
South Carolina and Missouri have health reform questions on their primary ballot, while three states — Arizona, Florida and Oklahoma — will give voters a chance in November to amend their state constitutions to say residents of those states can’t be forced to pay a penalty if they don’t buy health insurance. The amendment seeks to nullify the individual mandate, which consistently polls as one of the law’s most unpopular provisions.
The question on Missouri’s primary ballot is similar, but is a statutory measure rather than a constitutional amendment. And in South Carolina, participants in the GOP primary will be able to vote on an advisory measure telling state lawmakers that they want them to halt the implementation of federal health reform.
Several other states could yet weigh in on health reform if citizen petitions are successful or if Republican statehouses and governors put the issue on the ballot.
The individual mandate repeal effort was spearheaded by a nonpartisan group of conservative state lawmakers called the American Legislative Exchange Council (ALEC).
ALEC officials say they have a policy — not political — objective and point out that their effort predates national health reform. Rather, it was a reaction to former Massachusetts Gov. Mitt Romney’s (R) 2006 health reform overhaul.
“We don’t care who gets it done,” said ALEC health task force director Christie Herrera, “just as long as they get it done.”
Herrera said she doesn’t think Republicans need the ballot measures to bring out the vote.
“I think you’re going to see huge turnout among conservatives and libertarian voters,” she said, “just because there’s huge residual anger against the health reform law.”
One key race that could be affected by the health ballot initiative is the three-way Senate race among Independent Charlie Crist, Rep. Kendrick Meek (D-Fla.) and Republican Marco RubioMarco RubioWhat Trump's Cabinet picks reveal House passes water bill with Flint aid, drought relief What the 2016 election can tell us about 2018 midterms MORE. Polls and political experts suggest that race will be tight.
Matt Roberts, communications director for the Arizona Republican Party, said the ballot measure could sway enough voters to make the difference in tight races such as those of Democratic Reps. Ann KirkpatrickAnn KirkpatrickWomen make little gains in new Congress McCain wins sixth Senate term In Arizona, history and voter registration data gives GOP edge MORE and Harry Mitchell, both of whom voted for health reform.
“I think the measure that’s going to be on the ballot is certainly going to be a positive issue for Republicans,” Roberts said.
The White House and health reform advocates are holding more than 100 healthcare events nationwide on Tuesday as President Barack ObamaBarack ObamaObama to appear on 'The Daily Show' with Trevor Noah Brian Williams slams fake news Obama: I absolutely faced racism while in office MORE touts the $250 “doughnut hole” Medicare prescription drug rebate checks and other provisions that are popular with seniors during a national tele-town hall meeting in Maryland.
Proponents of the law are launching a five-year, $125 million campaign to defend health reform. The campaign, headed by Democratic operative and Wal-Mart Watch founder Andrew Grossman, is expected to be chaired by former Senate Majority Leader Tom Daschle (D-S.D.) and Victoria Kennedy, wife of the late Sen. Edward Kennedy (D-Mass.).
Health reform “is not going to be as much of a positive as I think it should be,” Daschle told The Hill. “But I am increasingly confident that the tides are turning. The more people understand about health reform, the more they understand the implications of what it can do in the future. It will be far more to our advantage.”
Norquist disagrees. He said the ballot issues shine a spotlight on unpopular provisions that Democrats would rather not talk about, even if many experts agree that mandating that people get coverage is the only way to ensure health plans can cover everyone.
“Anything about the bill that was useful and cheerful has been told to you,” Norquist said. “Because they were trying anything to sell it and the numbers kept sinking.”
South Carolina’s Sawyer said the state GOP believes the health reform question and another advisory measure requesting a cap on state spending growth will boost turnout rates over the figure from 2006, which was 11.5 percent. The party hopes that once identified, those voters can then be persuaded to stay engaged until the general election — and beyond.
“If people get to speak specifically to these two issues,” Sawyer said, “then it gives them a reason to show up to the primaries when they may not have had a reason otherwise.”