Opinion: Questions on Health Care Reform

(March 29) -- It's finally over.

But while the battle for universal health care may be coming to an end, the challenges -- for both Democrats and Republicans -- are only beginning.

Only with time -- as the medical, economic and political repercussions of the legislation gradually take effect -- will we begin to understand the true impact of what Congress has done.

When legislation of this magnitude passes, it often benefits those who designed it -- and it tends to generate added support after it's passed, like the football team that becomes everyone's favorite after they win the Super Bowl. That's already happening in this situation, with public support for the legislation marginally increasing overnight.

But that masks what polls have told us over the broader course of 2010: We are not a country split right down the middle regarding health care reform.

We are, in fact, split into thirds: One-third of Americans (the loudest segment) opposes health care reform regardless of the details, one-third supports it regardless of the details, and one-third wants some kind of reform, but they're not sure if this is the right kind.

After months languishing in the jargon of the legislative process, President Barack Obama has recently been back on his game as communicator in chief. The American public, however, still has serious doubts.

In our polling and dial sessions, Americans continue to ask three questions, the answers to which will determine whether this is the beginning of an Obama resurgence or the final straw for exasperated voters:

1) How much will the legislation truly cost? No one outside the most partisan Democrats believes you can add 30 million Americans to the health care rolls without deepening the deficit. What we won't know until 2012 is whether it will prove deficit-neutral, or whether it will follow the all-too-familiar course of government programs and run drastically over-budget.

2) Where will the funding come from? Once again, virtually no one believes Medicare spending cuts can actually finance this trillion-dollar legislation. Congress doesn't have the guts to cut Medicare. So that means tax increases for everyone else, but we don't yet know how many or how much.

3) And most importantly, how will it affect people who already have health care coverage? With the dramatic expansion in coverage, will patients see longer waits at hospitals and less individualized care? And what will the consequences be if Congress follows through on its promise to cut Medicare reimbursements? Americans are afraid not only about whether they'll be able to keep their doctors, but whether their doctors will be able to keep them.

The Democrats aren't the only ones with questions to answer when health care reform becomes law. Republicans will face significant policy and political challenges as well. After all, 30 million Americans will be newly insured, and many millions more will no longer be turned away due to pre-existing conditions. That's a lot of voters who will have the Democrats to thank and Republicans to resent. If current trends continue and universal reform becomes more popular after passage, Republicans could earn the obstructionist label that the Democrats have tried to pin on them.

If there is one thing that Republican and Democratic voters are frustrated about, it's the lack of perceived accountability in our largest, most powerful institutions from Washington to Wall Street. And other than the big banks and mortgage institutions, nothing draws the ire of the public like the insurance companies. While 85 percent of Americans say they are satisfied with their health care provider, they feel big insurance companies deserve the most blame for increased costs and decreased coverage. Should this legislation actually lead to the lower premiums Obama has promised, it would be hard to see him losing in 2012.

But that election and the impact the health care legislation will have on individual American voters' lives remain to be seen. In a surprisingly candid interview with Fox News' Bret Baier, Obama all but admitted to not knowing what exactly was in the final legislation -- this after over a year of deliberation and debate. House Speaker Nancy Pelosi did not help the cause with her ill-advised and ill-tempered remark that, "We have to pass the bill so that you can find out what is in it."

For more than a year, pundits on both sides have pummeled Americans with predictions as to how the health care bill will impact the nation. Politically, I believe passage will generate more votes for the GOP than the Democrats, but a lot can change between now and Election Day.

More importantly, we are one step closer to finding out what the true implications of universal health care reform are -- in practice, not just in theory.

Now that the legislation is law, Democrats must do what they have long promised to do and failed to deliver on: make all of its specifics -- readily and honestly -- available to the American people. Doing so exposes the majority to a risk; the public can't criticize specifics if they don't know them. But the greater risk lies in continuing to conceal this bill from American citizens.

Republicans and Democrats alike must begin to truly listen to the people who sent them to Washington -- or they may be sent home for good in November.

Frank Luntz is the author of "What Americans Really Want ... Really." He is a frequent Fox News contributor.


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