First term Rep. Gerry Connolly, D-Va., says the health care debate has changed dramatically since the combative town hall meetings of last August when some protesters across the country said passage of sweeping overhaul legislation would amount to a government takeover of the health care system. Connolly did not see that same fierce uproar in his district, but when he held a meeting a year ago with residents of the Greenspring Retirement Community in Springfield, several residents confronted him about the health care changes. And several opponents of the overhaul complained that they were not allowed in.
Connolly, who is seeking reelection in a district that once was a Republican stronghold, voted for the law, although he was among the House members to announce their intentions only shortly before the vote. Kaiser Health News Senior Correspondent Mary Agnes Carey talked recently with Connolly about how his constituents are adapting to the new health overhaul. This is an edited version of that interview.
Q: What are people in your district saying about the health care law?
A: What has struck me decisively is how the public mood has switched from sort of the 30,000 foot policy debate of last August and has pivoted to very practical implementation-related questions today. The anger has been replaced with both curiosity and the need-to-know information. So instead of people talking about socialized medicine and how we're going to be just like Great Britain, at town hall meetings this August it's, "I'm 62 and I run a small business and I've got a pre-existing condition and is there going to be some kind of gap coverage for us between now and when we qualify for Medicare? Does the [insurance] plan my kid had to go off of because they were 21 and now they're 24, [will the new law allow me to] get her back on the plan until she's 26?" The policy debate is over for the public. We're now in the implementation phase. How will that work? When will that work? How much? Do I qualify? Very practical kinds of questions.
Q: What happens when you have to explain that constituents need to wait four years for provisions such as the health insurance exchanges or the Medicaid expansion to begin?
A: I would say frankly there's a range of reactions. If we can’t answer the question directly when asked, I usually say let us try to research that for you. [Sometimes] there isn't an answer at all if we didn't address that. I'll give you an example.
There are a lot of military and military retirees in my district. They are on Tricare [the health care program for service members, retirees and their families]. A year ago the [message from Tricare recipients] was, "Keep your hands off my Tricare. I don't want the federal government mucking around in my health care and I've got Tricare for life. I don't want to even see the word Tricare in your health care reform bill."
This year it is, "I'm on Tricare. You know that thing about keeping your kid on until age 26? Does that apply to us?" And of course it allows me to say no, it doesn't. So now if you want us to extend these reforms that you now think are positive, we are going to have to amend the law that governs Tricare. I'm a co-sponsor [of that bill]. I use the occasion to make that point. You wanted that reassurance. You insisted that we leave [Tricare] alone, so we did. So now you can't be upset with us if the stuff you now like in health care reform the more you're hearing about it you want transferred to Tricare too.
Q: What else would you like to fix in the health care bill and what on your wish list is most likely to happen?
A: I think we really need to let it marinate a bit. I think one of the problems the opposition to health care reform has is that they so overstated the case. They were so into histrionics and intemperate charges in some cases – you know death panels and euthanasia – and that the world as we knew it was going to come to an end if we passed this legislation. Well when it didn't, it forced people to take a second look at health care reform and I think that's going on all across the country and you're seeing that reflected in national polling.
Q: But what about seniors? Despite a government mailing explaining the new law, $250 checks being sent out to cover the prescription drug "doughnut hole" and a new television ad starring Andy Griffith seniors don't seem to understand what's in the law for them. Why?
A: A deliberate fear-mongering campaign was launched last year. And I think [opponents of the health care law] really preyed on the susceptible and on the fears of a vulnerable demographic, vulnerable in terms of health status and reliance on this program. Slowly you're seeing an improvement in the polling numbers among seniors. That has improved by a substantial number. It's not as good as the public at large, that's true. But this group in particular was targeted by the other side with a fear and smear campaign.
Q: Have you convened town hall meetings specifically on the health care reform bill?
A: I had two the week we went out [on August recess]. One I had as part of my regular telephone town hall meetings and then I did one jointly with AARP. I probably took 30 questions and I didn't get a single question that even remotely resembled the anger or the passion or the critical policy questioning of last summer. I've been in public life for 16 years. I can read my public. This has turned. Some of the discussion, the more we get into it is, "It's going to help me? Not hurt me?" It has caused a reassessment and slowly but surely you've seen the [approval] numbers creep back up.
Q: Are your colleagues who supported the health care bill worried it will be a major factor in their races?
A: Most of my colleagues are experiencing what I am describing to you. They are pleasantly surprised that health care isn't going to get you. Health care alone is not going to get you. It's on a palette of other things that you have to either positively assert or you have to defend. And everyone has their own narrative going into this election cycle in terms of what they're going to say or defend or whatever. Health care is on that palette but it's not going to be the dispositive issue the other side was hoping for just a few months ago and the press was saying it would be.