"Obamacare": A History of the Most Effective Scareword in Politics

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Robert Brent Toplin, Professor of History (retired), University of North Carolina, Wilmington, has published several books on history, politics, and film, and he operates a website, www.politicsoftheusa.com. His film-related books include "Reel History: In Defense of Hollywood," "History By Hollywood," and "Oliver Stone’s USA: Film, History, and Controversy."

When Republican candidates for president confronted each other in several televised debates in late 2011 and early 2012, they frequently criticized “Obamacare.” Those candidates did not say much in detail about the Affordable Care Act passed by the U.S. Congress in 2010. Brief mention of Obamacare served adequately to communicate their disgust withthe Democrats’ plan for health reform.

Sometimes those GOP candidates attacked one of their own, speaking contemptuously about “Romneycare.” That single term implied sharp criticism of the mandated health insurance program that Mitt Romney established when he was governor of Massachusetts.

Why do Republicans favor this personalized, shorthand approach to attacking health care reform? Why do they often connect Obama’s name in their references to health care legislation?

Look back to the Bill Clinton’s first presidential term for the origins of this political strategy. Republicans used the technique then to block the Clinton administration’s plans for health insurance reform.

One of the most effective Republican branding strategies was to attach the name of the president or his wife in references to the administration’s proposals. Republicans spoke often about “Hillarycare” and “Clintoncare.”

A poll conducted by the Wall Street Journal revealed that more than 70 percent of respondents supported the Clintons’ reform bill when they read a description of its principal contents, but when they studied those same details under the heading “Clinton Health Plan,” support dropped between 30% and 40%. Attaching Bill or Hillary Clinton’s name led respondents to think about their feelings toward the president and his wife rather than to specific benefits offered through the plan. For instance, some Americans didn’t like President Clinton’s efforts to protect gays in the military. Others disapproved of Hillary Clinton; they considered her a strong-minded feminist.

This strategy of personalizing references to the legislation as well as other techniques of opposition worked. Democratic legislators sensed defeat was coming by the summer of 1994, and a few months later, major Republican gains in the congressional elections delivered a coup de grace for health insurance reform. There were many causes of the administration’s defeat, but one of the most important factors involved the clever use of language. Talk of Hillarycare and Clintoncare damaged the program’s appeal.

GOP leaders learned from that experience. After Democrats succeeded in passing moderate reforms in 2010, Republicans continued to stir voter resistance to that legislation with frequent references to Obamacare. By featuring Obama’s name prominently, Republicans hint that a power-hungry president is overreaching his authority by forcing an unpopular program on the American people.

The hint is misdirected. President Obama tried to avoid Bill Clinton’s difficulties when he promoted health care reform (Clinton’s major initiatives came out of the White House, creating a sense among Democratic congressmen that they had been left out of the decision-making process). President Obama tried a different tact. He identified some broad reform goals in speeches but left specific details in the bill to legislators in Congress. While it is true that Obama claimed some ownership in an address to Congress that aimed to rescue the reform from the jaws of defeat, the Affordable Care Act was essentially an achievement of legislators in Washington. It was a form of “Congresscare” or, more specifically, “Democratic Congresscare.”

No matter. The public hears little about these distinctions. Instead, Americans hear Republican politicians and media pundits speak critically of Obamacare. The term is one of the most effective scare-words in contemporary politics.

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