Some Democrats and their advocates in the press believe Obamacare, a year into implementation, is no longer much of a factor in the midterm elections. But no one has told Republican candidates, who are still pounding away at the Affordable Care Act on the stump. And no one has told voters, especially those in states with closely contested Senate races, who regularly place it among the top issues of the campaign.
In Arkansas, Republican challenger Tom Cotton is pulling ahead of incumbent Democratic Sen. Mark Pryor partly on the strength of a relentless focus on Obamacare. Cotton's newest ad attacks Pryor over the law, as did two of Cotton's four previous ads.
"In our polling, (Obamacare) continues to be just as hot as it's been all year long," says a source in the Cotton campaign. "If you look at a word cloud of voters' biggest hesitation in voting for Mark Pryor, the two biggest words are 'Obama' and 'Obamacare.' Everything after that is almost an afterthought."
Republican Rep. Bill Cassidy, challenging incumbent Democratic Sen. Mary Landrieu in Louisiana, is pushing just as hard. "Sen. Landrieu, I voted for you before, but when you voted for Obamacare, I knew I'd made a mistake," says a woman in a Cassidy ad featuring Landrieu voters who say her support of the health care law turned them away from Democrats.
Joni Ernst, leading the Senate race in Iowa, is pushing hard on Obamacare, too. And in North Carolina, where Republican Thom Tillis is trying to catch up to incumbent Democratic Sen. Kay Hagan, Obamacare is not just a bad law leading to higher premiums, high deductibles and narrower choices of doctors -- it's also a window into Hagan's character.
"Its importance is not only in the policy itself, but more so in the fact that Sen. Hagan said at least 24 times that 'if you like your health care, you can keep it,'" says a Tillis campaign source.
So Republican candidates bash Obamacare and move up in the polls. Given that public opinion remains firmly against the health care law -- as it has been for years -- that's not a shock. Democratic beliefs to the contrary are probably wishful thinking.
Polls suggest that more and more, opposition to Obamacare is based on voters' personal experience, and not just on what they have heard or read about the law.
Since Obamacare was enacted in 2010, the Gallup polling organization has asked people whether the law has helped or hurt them personally, or whether they haven't been affected at all. In the latest survey, most people -- 54 percent -- said they have not been affected. But 27 percent said they have been affected and hurt, while a smaller group, 16 percent, said they have been helped.
"Since the start of this year, the percentage saying the law has helped them has increased from 10 percent to 16 percent," Gallup noted, "while the percentage saying it has hurt them has also gone up, and by a similar amount, from 19 percent to 27 percent."
The trend is pretty clear: more people hurt then helped.
Gallup found an intriguing partisan gap in its results. Looking just at those who said they have been affected by Obamacare, 27 percent of Democrats said they had been helped, while 15 percent said they had been hurt. Among independents, the numbers were almost the opposite: 16 percent said they had been helped, while 27 percent said they had been hurt. And among Republicans, just 4 percent said they had been helped, while 40 percent said they had been hurt.
It's unclear whether poll respondents were inserting their political biases into what they said were their personal experiences, or whether Obamacare has helped more Democrats than anyone else. The latter could make sense; after all, the law was designed by Democrats, passed on strict party-line votes, and directed in significant part toward Democratic constituencies.
But helping Democrats isn't enough to win an election. So Democratic candidates respond to voter unhappiness by pledging to "fix" Obamacare. But their hearts don't seem to be in it. At a recent debate in New Hampshire, incumbent Democratic Sen. Jeanne Shaheen was asked to list her proposed fixes, and all she could come up with was a suggestion to name a committee to study problems with the Obamacare website.
That does almost nothing to address voters' concerns, which remain a potent factor in the campaign.
The bottom line is, there's a reason Republicans keep pushing so hard against Obamacare: So far, it's working.