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Bullish Blue Dogs Oppose Health Care Repeal

It’s no surprise that Republicans, who voted unanimously against approving the Patient Protection and Affordable Care Act last year, also voted unanimously today to repeal it.

But of the 13 Democrats who voted against the health care bill last year and who remain in the House of Representatives, just three — Dan Boren of Oklahoma, Mike McIntyre of North Carolina, and Mike Ross of Arkansas — joined the Republicans in supporting its repeal.

Conservative websites are already gloating over the electoral consequences for the other 10. Many of the 10 — like Jim Matheson of Utah and Heath Shuler of North Carolina — are from conservative-leaning areas. Others, like Ben Chandler of Kentucky, won re-election by the slimmest of margins last year. There’s fairly strong evidence, meanwhile, that the health care bill hurt Democrats who voted for it last year. And there’s not much sign, yet, that the bill has become any more popular. So what were these Democrats thinking?

One factor that might matter at the margins is that not everyone who opposes the health care bill would prefer to repeal it. According to a New York Times/CBS News poll conducted in September, 14 percent of those who oppose the bill would nevertheless rather let it stand than repeal it in its entirety. While this group is small — something like 7 percent of the total electorate — it’s large enough to create some ambiguity as to whether a majority or a plurality of the public in fact favors repeal: although, in a CNN poll released this week, 50 percent favored repeal against 42 percent opposed, a contemporaneous NBC News/Wall Street Journal poll released tonight had those opposed to appeal with the nominal plurality, 46 percent to 45 percent.

Other pollsters have put more choices before their respondents than simply repealing the bill or letting it stand. Significant numbers want to repeal only parts of the bill, an alternative the Republicans are apparently not contemplating. Others would like to see it expanded rather than contracted. Depending on differences in question wording, it is not clear which of these four options — repeal the bill entirely, repeal it partially, expand the bill, or leave it as is — constitutes the plurality, but it is clear that no one choice dominates over the others.

I somewhat doubt, however, that the 10 Democrats who voted both against the bill and against repeal are parsing the polls quite that much. Yes, the polling on repeal is more complicated the more one looks underneath its surface. But that was also true of polling on the health care bill itself — surveys, for instance, found that many of the core provisions of the bill were popular, and that some of the opposition to it came from liberals who thought it did not go far enough. That didn’t prevent Democrats from losing 63 seats in the House in November; politics often takes place at a surface level.

My guess is that these Democrats are instead engaging in a different sort of calculation: that opinion about the health care bill is really more of a Rorschach test for how one feels about the performance of the Congress, the President and the economy.

Polls had long shown that the public supported the idea of universal health care, something which had been a priority of Democrats for decades. And when their health care bill was first proposed in 2009, it was initially more popular than not. A significant fraction of the public was undecided on it, however, and virtually all of those undecideds eventually came to oppose the bill, rendering it somewhat unpopular overall.

Why did the bill become unpopular? You could write a dissertation on the subject, but as I’ve argued before, the economic crisis probably had something to do with it — and in particular, the fatigue brought on by passing fantastically large stimulus and bailout bills in an effort to halt the slump, and then trying to pass an equally large health care bill right after it. Critically, perhaps — as you can see in the chart above — much of the increase in the opposition to the bill occurred quite early in 2009, at a time when unemployment reports were still showing the country losing hundreds of thousands of jobs each month. By the time the health care bill started to receive a sustained period of media coverage in mid-July, opposition had already risen into the mid-40s, which is not far from where it wound up.

This is not to say that the way that Democrats rolled out the bill and managed its debate didn’t contribute to their problems. They seemed to forget two things: first, that the Congress to which President Obama was outsourcing the marketing of the bill was much less popular than Mr. Obama himself, and second, that infighting over the details of the bill would not make it an easier sell to a skeptical public.

Between now and 2012, however, those dynamics will be somewhat different. The public is gradually becoming more optimistic about the condition of the economy and the direction of the country — in the NBC/Wall Street Journal poll, respondents by a 53-to-21 margin said they expected the country to better off five years from now, up from a 37-to-31 split in August.

Meanwhile, it is no longer Democrats who are in charge of Congress — which remains exceptionally unpopular — but Republicans, at least in the House.

The bet that these Democrats are making, then, is that even if they are modestly on the wrong side of public opinion right now, that may not be the case by 2012. Whereas with the Democrats in charge, one could pivot against the Congress by opposing the health care bill, now one does so by opposing its repeal.

The Democrats, also, may be taking a page from the Republicans’ 2009 playbook and have realized that the best way to ensure that the Congress remains unpopular is to oppose whatever it is trying to do, rather than endorse it with the stamp of bipartisan support.

It is also possible that support for the health care bill will increase if the public’s increasingly high hopes for the economy are made good upon: this might mollify some, if not all, of the concern about profligate spending and cast everything associated with President Obama in a healthier glow. President Obama’s approval ratings are already increasing, in fact, which surely gives these Democrats more confidence in their gambit.

It is by no means a riskless bet they are making, however. The Occam’s Razor case — you just flip-flopped to support an unpopular bill! — is a credible one, and both the economic recovery and the one in Mr. Obama’s approval ratings could prove to be temporary. I am surprised, frankly, that so few Democrats supported repeal.

Still, these 10 Democrats are among those who survived what was probably the most difficult election cycle for their party since the Second World War: their political instincts are not unimpeachable, but perhaps we should give them the benefit of the doubt. If we do, the conclusions ought to be a bit unnerving for Republicans, for they imply a very bullish view about how perceptions of Democrats and their health care bill will evolve between now and 2012.

Nate Silver founded and was the editor in chief of FiveThirtyEight.