With the Obama administration poised for a huge public education campaign on healthcare reform, Republicans and their allies are mobilizing a counter-offensive including town hall meetings, protests and media promotions to dissuade uninsured Americans from obtaining health coverage.
Party officials, political analysts and lobbyists say the coming showdown will mark a new phase in the years-old battle over healthcare reform by shifting the focus from political ideology to specific examples of how "Obamacare" allegedly falls short, just as the administration presses the public on its benefits.
President Barack Obama's signature domestic policy is the first major social program to face a highly organized and well-financed opposition years after enactment. The forces arrayed against it could undermine the aim of extending health coverage to millions of uninsured people at affordable rates, if not enough younger adults sign up to make it economically viable.
Political analysts say Republicans hope to use the healthcare issue to win a bigger majority in the U.S. House of Representatives and gain control of the Senate in the 2014 mid-term elections, by leveraging the law's unpopularity to send voters to the polls in key swing states.
"The best way to get the juices of that right-wing electorate and activist group going is to attack Obamacare - make everything that happens look awful and voters will rebel against it," said Norman Ornstein, an expert on congressional politics at the conservative American Enterprise Institute.
"It's a belief that if they highlight this, and sabotage it as much as they can, and if it's disruptive, that that will work for them in the mid-terms."
The White House and Department of Health and Human Services are well aware of their opponents' political maneuvers.
"There are folks out there who are actively working to make this law fail," Obama said in a speech on Wednesday, condemning the opponents' effort as "a politically motivated misinformation campaign."
The administration, reform advocates and companies including health insurers are expected to spend hundreds of millions of dollars on an education campaign to reach an estimated 7 million people, including 2.7 million young adults aged 18 to 35 who are expected to sign up for subsidized coverage next year.
A new political playbook for Republicans in the House encourages lawmakers who have voted nearly 40 times to repeal or defund the law to showcase their concerns at town hall meetings and special forums with like-minded young adults, healthcare providers and employers.
"Make sure the participants will be 100 percent on message," the House Republican Conference's August planning kit advises for events with businesses. "While they do not have to be Republicans, they need to be able to discuss the negative effects of Obamacare on their employees."
Obama's 2010 Patient Protection and Affordable Care Act is also due for public attack at town halls featuring Democratic lawmakers, where Tea Party activists plan to air their opposition under an initiative by FreedomWorks, the Washington-based grassroots lobby that helped found the movement.
The planned campaign against the law promises to accelerate an already ugly partisan battle, analysts say. Until now, the opponents' message has amounted to unanswered Republican advertising painting the healthcare law as bad for the country.
"You'll start to see that change, because Democrats won't be able to overlook it anymore," said Elizabeth Wilner, who monitors political advertising at Kantar Media's Campaign Media Analysis Group.
Political analysts say the Republican onslaught could prove short-lived. Beginning on Oct. 1, Obama's health reform will help millions of uninsured people buy subsidized health insurance for the first time. Should enough people sign up by the time enrollment ends in March, the law's value as an election issue may run dry.
"The fear is that the law will start to work and people will like it. They'll like having insurance, a safety net if you lose your job. Then Republicans are stuck with it," Ornstein said.
One Republican ploy is to target the law's individual mandate, which requires most Americans to have insurance in 2014, or pay a penalty. It is the only lever the government has to require the participation, but it is also unpopular with voters. Republicans have sought to stoke discontent since the administration delayed a separate requirement that larger employers provide insurance coverage for workers.
"They'll start to feel impacts that are completely in contrast to what they were told when the bill was passed. That's what we're seeing in internal polling from districts that will determine control of the House - Obamacare becoming more unpopular," said Daniel Scarpinato, press secretary for the National Republican Congressional Committee.
Republicans need a net pickup of six seats to win control of the Senate next year, and their most likely path is to focus on Democratic-held seats in Alaska, Arkansas, Louisiana, Montana, South Dakota and West Virginia, according to the Cook Political Report. All are Republican-led states that went to Republican presidential nominee Mitt Romney in 2012 and most have done little or nothing to help implement the healthcare law.
"The Republican strategy is to focus on messages that this is not working in states where the law is still unpopular with voters and where there are really going to be competitive races," said Robert Blendon of the Harvard School of Public Health.
FreedomWorks and Americans for Prosperity, a conservative issue group financed by billionaire brothers David and Charles Koch, known for funding conservative causes, are planning separate media and grassroots campaigns aimed at adults in their 20s and 30s - the very people Obama needs to have sign up for healthcare coverage in new online insurance exchanges if his reforms are to succeed.
"We're trying to make it socially acceptable to skip the exchange," said Dean Clancy, vice president for public policy at FreedomWorks, which boasts 6 million supporters. The group is designing a symbolic "Obamacare card" that college students can burn during campus protests.
Americans for Prosperity launched a $1 million TV ad campaign against the healthcare law this summer to test its message in swing states of Virginia and Ohio. The 30-second ad presents a young pregnant mother who asks questions that suggest the law will raise premiums, reduce paychecks, prevent people from picking their own doctors and leave her family's healthcare to "the folks in Washington."
The group plans a bigger push on TV and social media to persuade young people, especially men under 30, to see the healthcare law as a high-cost liability directed at them.
"This is a good time to be out there explaining what the law means to people," said the group's president, Tim Phillips.
Crossroads GPS, the political group co-founded by former George W. Bush adviser Karl Rove, is designing a fall push aimed at elderly voters angered by Republican allegations that the Medicare program for senior citizens is being used to pay for the healthcare law.
"As people who previously didn't believe they would be affected by it are finding out that they will be affected by it, there may be some traction to repeal the worst parts of the law and eventually repeal the law entirely," said Crossroads spokesman Jonathan Collegio.
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