Obama’s health-care bill continues to polarise US voters

Can the “new civility” survive in the world of political reality?

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It's a largely symbolic gesture – and one that's been delayed by a week in the aftermath of the Tucson shooting tragedy. But tonight House Republicans are set to vote to repeal the Obama administration-backed health-care reform law. Symbolic, because the GOP doesn't have the votes in the Senate to follow through – and even if they did, President Obama has pledged to use his veto. But the decision to widen subsidised health care to millions of Americans has angered the Republicans like nothing else: it fuelled the growth of the Tea Party movement and polarised voters across the country.

In a new poll in the Washington Post, more than half of those surveyed think the reforms will harm the US economy – while almost two-thirds think it'll add to the deficit. Some 45 per cent believe it will cut the number of jobs. Hence the title of today's motion: a "bill to repeal the job-killing health-care law". It's a title that has stayed unchanged, although Republican leaders have been reluctant to use the K-word after the Tucson massacre; on his website, John Boehner suddenly describes it as the "job-crushing" and "job-destroying" bill, and other members of Congress have been markedly less provocative in tone.

Perhaps this is a sign that the talk of a new political civility has had some impact, at least. As Dana Milbank remarks in the Washington Post: "There were no outbursts of 'Kill the bill!'. No outbursts of 'Baby killer!'. No sinister claims about 'death panels'." Even Tea Party diehards were positively restrained, although there were still some dire warnings – not least from the House majority leader, Eric Cantor, who called the Affordable Care Act an "unsustainable, open-ended entitlement that could very well bankrupt this country and the states".

The Democrats are siezing their chance for a second go at winning over hearts and minds about health care, with the Senate majority leader, Harry Reid, arguing this morning that the Republican plan would "raise prescription drug prices for seniors and let insurance companies go back to denying coverage to sick children".

Meanwhile, on the Huffington Post, the health secretary, Kathleen Sibelius, claimed that the old insurance system forced ordinary families to make impossible decisions: "Do I pay my insurance premium or my mortgage? Do I sacrifice my health benefits or my retirement savings? The Affordable Care Act is designed to free Americans from those terrible trade-offs by providing them with the security of coverage they can afford."

As for job-killing, crushing or destroying, the White House might be cheered by a report in the Washington Monthly which points out that since the act was signed, some 200,000 jobs have in fact been created in the health-care sector. And a new paper by the Harvard economist David Cutler, which argues that repealing it could result in up to 400,000 job losses per year over the next decade.

On the face of it, then, there doesn't look like much room for compromise – the centre ground, if there is any, looks pretty thin. Except that the public mood, though divided over the act itself, is by no means behind the idea of repeal. The poll cited above also shows that most people would rather wait and see how the reforms work out in practice before rejecting them altogether. And with his approval ratings now comfortably around the 54 per cent mark, Barack Obama is on something of a roll. "I'm willing and eager to work with both Democrats and Republicans to improve the Affordable Care Act," he said. "But we can't go backward."

With the former – in these bipartisan times, he doesn't have much choice. As for going backwards, there are multiple legal actions in states around the country trying to declare the entire piece of legislation unconstitutional. And the coming budget fight over the debt ceiling will put health-care funding at its heart. This will be only the start of the sound and fury. It remains to be seen whether the "new civility" can survive in the harsh world of political reality.

Felicity Spector is a senior producer at Channel 4 News.

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