Health care ruling stokes elected leaders in Nevada

The U.S. Supreme Court ruling Thursday to uphold President Barack Obama's health care law isn't an election year game changer, but it does change the debate.

When Chief Justice John Roberts determined the penalty for not buying insurance as mandated in the law is a constitutional tax, Republicans found a new point of attack against Obama's signature accomplishment.

Republicans hate the T-word, and battling tax hikes is a popular issue to fire up the base.

GOP presidential candidate Mitt Romney raised $3.2 million during the day after the high court decision, a testament to the fundraising power of the issue and enduring Republican hatred for the law.

"This law has now been affirmed as a colossal tax increase on the middle class," said U.S. Sen. Dean Heller, R-Nev., in one of the first GOP reactions as Republicans renewed calls to repeal and replace the law.

His Senate opponent, U.S. Rep. Shelley Berkley, D-Nev., delivered a more muted response hours later. She defended the unpopular law that she voted for in 2010 as historic protection for the uninsured.

"Although this law isn't perfect, it does take important steps to rein in insurance company abuses," Berkley said. "No longer will a kid be denied coverage based on pre-existing conditions. No longer will there be caps on lifetime coverage. And seniors will now have access to affordable prescription drugs by closing Medicare's doughnut hole."

The back and forth between Heller and Berkley will typify the health care debate through Nov. 6 now that the divided high court ruled 5-4 that the law is constitutional, delivering Obama an election-year victory.

Republicans will slam the law as one of the largest U.S. tax increases in history, coming at a time when the economy and voters are still recovering from a deep recession. And Democrats will talk up the consumer-friendly aspects of the law, which is meant to share health care costs among more people to help cover 50 million uninsured Americans.

"Yes, the ruling is certainly a win for the president, but I am not sure that it fundamentally changes anything," said Jennifer Duffy of The Cook Political Report. "Public attitudes about health care reform are already baked into the election cake. The ruling isn't likely to change many, if any, minds."

As expected, Romney vowed anew to move to repeal the law on his first day in office if he wins the White House, although he didn't offer details of any private-sector solution. Undercutting him, Democrats put out reminders that the former governor of Massachusetts imposed a similar insurance mandate law in his state.

"Our mission is clear: If we want to get rid of Obamacare, we have to replace President Obama," Romney said.

Obama, in his remarks from the White House, said the debate over the law should end.

"The highest court in the land has now spoken," Obama said. "We will continue to implement this law. And we'll work together to improve on it where we can."

Sen. Harry Reid, D-Nev., echoed the president, saying he was pleased with the outcome. For the Senate majority leader, the ruling amounted to somewhat of a vindication for his efforts to get the landmark bill passed in 2010.

"The United States Supreme Court has spoken," Reid said. "This matter is settled."

Reid urged Republicans to put health care behind them and "stop refighting yesterday's battles. Now that this matter is settled, let's move on to other things, like jobs."

But refighting the battle and keeping the debate going is exactly what Republicans intend to do given voters' lingering doubts about whether the law went too far and is too expensive despite the health care benefits.

Ahead of the high court ruling, 50 percent of Nevada voters said they wanted to see the U.S. Supreme Court overturn the law, according to a Rasmussen survey in April, while 38 percent wanted it to be upheld.

Nationally, more than two-thirds of Americans said they hoped the high court would overturn some or all of the health care law, according to a New York Times poll taken this month. Just 24 percent wanted the law upheld.

U.S. Rep. Joe Heck, R-Nev., a doctor who has offered an alternative health care bill, said reaction to the ruling could drive the debate through the 2012 election just as it did two years ago.

"I think it is going to come back to be an issue across the nation," Heck said. "We know the vast majority of Americans and the majority of Nevadans don't like the law."

Two years ago, Heck ousted former U.S. Rep. Dina Titus, D-Nev., a backer of the Affordable Care Act, in a close election in the battleground 3rd Congressional District. Then, Obama's health care law was a hot issue and the GOP made big gains, taking over the U.S. House. Heck's current Democratic opponent, outgoing Nevada Assembly Speaker John Oceguera, is hoping to ride the president's coattails in Nevada.

Oceguera said Republicans must stop fighting the health care law and focus on creating jobs instead.

"Now that the Supreme Court has ruled, it's time that those in Washington moved on from trying to score political points instead of finding solutions," Oceguera said. "This decision doesn't change the reality that too many Nevada families and small businesses are struggling to pay for the rising costs of health care."

Nevada Senate Majority Leader Steven Horsford, who's running for the state's new 4th Congressional District, read from the same Democratic playbook. Horsford said he hoped "the Republican Congress will stop playing political games and start working on getting our economy moving and creating jobs for Nevadans."

Horsford's Republican opponent Danny Tarkanian attacked what he called a new tax and urged repeal.

"When they should be focusing on promoting economic growth and creating jobs, Democrats insist instead on ramming through job-killing policies that increase taxes on Americans, like Obamacare," Tarkanian said.

Eric Herzik, a political science professor at the University of Nevada, Reno, said it's hard to say whether the Republicans' tax attack will work among swing voters, who might be willing to pay for better health care protection.

No matter what, Herzik and other political observers said the election will be won or lost on whichever candidate makes the best argument for who can fix the economy - Obama and the Democrats working to get him another four years, or Romney and the Republicans who say the president has failed to revive the economy quick enough.

The unemployment rate in Nevada remains at 11.6 percent, the highest in the nation. More people may get insurance under Obama's health care law, but if they don't have jobs that might not help him at the polls.

"This will be one of those litmus tests for voters," Herzik said. "Republicans have to be careful. If their only argument is this is a tax and all taxes are bad, I don't know if that's enough. They have to offer something, too."

Stephens Media Washington Bureau Chief Steve Tetreault contributed to this story. Contact Laura Myers at lmyers@reviewjournal.com or 702-387-2919.
Follow @lmyerslvrj on Twitter.