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Professor reflects on HHS bill reform, election implications

Sam Stryker | Sunday, February 12, 2012

President Barack Obama announced a compromise in the Affordable Care Act Friday, mandating that insurance companies, not religious institutions, will be responsible for providing free preventive care to women.

Such a move comes with significant political implications, former political columnist for the South Bend Tribune and Journalism professor Jack Colwell said.

“[Obama] certainly had politics in mind, just as his critics had politics in mind,” he said. “This is a presidential election year so everything he does is going to be, in some respects, political.”

Under the original plan announced Jan. 20, religious institutions would not be exempt from providing preventive healthcare, including contraceptives, in their minimum insurance package. The Department of Health and Human Services (HSS) granted these institutions a year to comply with the legislation’s specifications.

Colwell said Friday’s move was seen as an accommodation to the religious institutions that were concerned about providing these services.

The move by the president will be successful in controlling any lasting political damage, though the damage could have easily been avoided, Colwell said.

“I think initially the president was hurt somewhat by [this],” he said. “Why on earth they thought it would take a year to reach a compromise nobody seems to understand.

“That sounds like bureaucracy in the Health and Human Services Department. When the pressure was on, they quickly reached a compromise.”

Colwell said Obama’s conciliation was made with a specific group of American voters in mind.

“I think what he was doing was going after Catholic voters who were understandably upset about the first decision that was made … there was a lot of dissatisfaction,” he said.

The Catholic portion of the American population was a group Obama could not risk losing in November’s presidential election, Colwell said.

“There are a lot of Catholic officials and voters who tend to support him,” he said. “If he was going to alienate some of them, that could have a big effect on the election.”

Colwell said Friday’s compromise should be effective enough to satisfy this group of voters.

“I think he did [enough]. It seems to be a reasonable accommodation,” Colwell said. “In fact, it is so reasonable you have to wonder why that wasn’t the plan in the first place.”

At the same time, the new plan still allows for women to receive cost-free preventive healthcare such as contraceptives. Colwell said that without this concession, Obama would have risked alienating another block of voters.

“Also, it has continued to make sure there would be birth control free of charge available to all women,” he said. “If he had gone back on that, that would have cost him a lot of votes from women who think that is very important.”

The original decision to have religiously affiliated institutions provide preventive health services drew the ire of Catholic bishops. Colwell said Obama made the compromise with political allies in mind.

“I don’t think there was so much concern with the bishops as it was about some of the people who have tended to support President Obama and the healthcare legislation,” Colwell said. “Some of them were upset and he was in danger of losing support.”

These supporters include Vice President Joe Biden and Senator Bob Casey (D-Pennsylvania.) However, Colwell said Obama did not risk losing support from Sister Carol Keehan of the Catholic Health Organization.

“She has been a supporter of the president on healthcare matters,” he said.

Despite reaching a compromise Friday, Colwell said Republican presidential candidates would not agree with any accommodation Obama proposes. Taking this approach runs the risk of driving female voters away from the Republican Party, Colwell said.

“They have a real danger. If the Republican nominee is seen as opposed to birth control, then that’s a big, big plus for Obama in the election,” Colwell said. “There already is a gender gap where women tend to vote more Democratic … and if the Republican nominee would seem as opposed to contraceptives, that gap would be even wider and it would be harmful to the Republican nominee.”

Colwell said the party is also making a gamble by shifting the focus away from economic issues. Doing so could change the dynamic of the election.

“Republicans have wanted this election to be a referendum on the economy and how the president was handling that and budget issues,” he said. “They have tended to put some of the social issues on the back burner … now suddenly they are moving into some of those cultural issues. Maybe that will help them, but it does take some of the focus off the economic issues.”

Colwell said that while the mandate seemed to initially hurt Obama politically, Friday’s accommodation could ultimately have beneficial implications.

“Initially it was a negative,” he said. “It could turn out to be a positive if the Republican nominee is seen as opposing contraceptive devices. Also, it might help him focusing on what the healthcare legislation does.”

Colwell said since many American’s don’t know what the Affordable Care Act does, Friday’s compromise may shed light on the positive aspects of one of Obama’s signature legislative accomplishments.

“Now there is a lot of focus on what it would provide for women — free access to contraception,” he said. “It’s focusing on this as a preventive measure, something that can hold down medical costs. If people focus on that and agree with that, then it could be a plus for [Obama.]“

Colwell said discussion of the subject would die down and only resurface if the Republican presidential candidate pursued the matter.

“I think it’s probably one of those issues that erupted and captured all of the headlines for several weeks,” he said. “I think it will simmer down some. It will basically be up to the Republican presidential candidate and Republican leadership in Congress if they want to pursue this.”