Democratic leaders are girding for a political war over the health care overhaul heading in to this year's midterm elections, preparing strategies and raising funds to fend off attacks by Republicans eager to capitalize on voter discontent.
Analysts from both parties predict the sweeping impact of the proposed health care changes, which will affect every American, to be the overriding issue, with the strongest and most personal impact in 2010.
Democratic leaders acknowledged this week in last-minute party fundraising appeals that they expect Republicans to come out with both guns blazing in pursuit of major gains in the House and Senate.
"They will spend the next 11 months spinning our health care victory into a weapon and hitting us with it. We might have the momentum now, but we must show the GOP and the pundits that we can sustain it until the 2010 elections," said Sen. Robert Menendez of New Jersey, chairman of the Democratic Senatorial Campaign Committee.
"Now that they lost this battle, they will be focusing their fight -- and their millions and millions of dollars -- on defeating us," he said.
National polls show strong opposition to the bills that have passed the House and Senate and now must be reconciled in a conference committee before facing a final vote. Polling data compiled by the Senate Republicans' campaign committee shows that Democrats are trailing their Republican challengers in every battleground state where opposition is strongest.
In the House, between a dozen and two dozen Democrats who voted for the bill are on their party's vulnerable list.
A Rasmussen poll conducted recently shows that Americans were opposed to the Democratic reforms by 55 percent to 40 percent, and think by a 54 percent to 24 percent margin that its enactment would make the quality of medical care worse. "Those figures have remained fairly consistent for months," Rasmussen said this week.
Democratic pollster Mark Mellman, in a strategy memo provided to Democratic senators last week, said the reason for the health care plan's unpopularity resulted from "voters knowing little about the substance of the plan" and the belief that those on the left remain unhappy with the Senate's decision to drop a government-run health insurance option.
Whatever is in the ultimate bill that Congress sends to President Obama next month for his certain signature, voters from all political persuasions will show their dissatisfaction at the ballot box, said health care policy analyst Grace-Marie Turner of the Galen Institute, a free-market think tank opposed to the reform.
"If they have to wait until November, so be it. They haven't changed their minds about ObamaCare over the last six months, and their opposition will get even stronger the more they learn about the details of the bills the House and Senate have passed," Ms. Turner said.
But some independent political pollsters and elections analysts question whether the health care issue will have staying power throughout next year since the health care legislation's provisions will not take effect until 2014 and since the economy likely will be the overriding concern for most voters.
"I think in the short term it will provide the Republicans with advantages in the sense that it will help Republicans to continue to consolidate their base," pollster John Zogby said.
"But in the mid- to long term, it will provide a Democratic advantage because it will be done, and therefore the debate will have lost its edge. Secondly, it will be seen as a step forward among those who are looking for some sort of health care relief, even though the act does not go into effect for several years, and, third, it allows Democrats to change the subject. The focus is likely to be on the economy and Afghanistan," Mr. Zogby said.
"I think the issue will burn out and be a net advantage to the Democrats who will say at least they did something," he said.
However, Jennifer Duffy, senior Senate elections analyst at the Cook Political Report, thinks it is still unclear how the issue will play out next year and which party will benefit, and points to vulnerable Democrats such as Sen. Blanche Lincoln of Arkansas, where opposition to the health care bills is strong. Mrs. Lincoln voted for it anyway after getting $100 million for her state to offset Medicaid costs. Polls showed that Mrs. Lincoln was trailing all four of her prospective challengers by three to six percentage points.
"I expect both parties to use health care. Republicans will take aim at Democrats sitting in swing or Republican-leaning seats like Lincoln. It seems that Democrats want Republicans on the record saying that health care should be repealed," Ms. Duffy said.
"The truth is that it is very hard to know how voters will react to the issue next fall. A vast majority of voters are still waiting to see what the legislation does and how it affects them. When that becomes clear, then they will make a final assessment about whether they are happy with it," she said.
A National Republican Senatorial Committee (NRSC) polling matchup of Democratic senators who face the voters next year and who backed the health care bill that passed the Senate on Christmas Eve showed last week that a number of these Democrats were in trouble.
In Colorado, for example, Sen. Michael Bennet was trailing his Republican rival by 37 percent to 46 percent. In Connecticut, Sen. Christopher J. Dodd was running well behind the Republican front-runner, 44 percent to 38 percent. In Nevada, Majority Leader Harry Reid, who crafted the bill that passed the Senate, was running behind his likely challenger by 49 percent to 43 percent.
"Not coincidentally, in these states, including a few blue states, where more voters disapprove than approve of the Democrats' health care bill, it's the GOP candidate who is leading in the head-to-head polls," NRSC spokesman Brian Walsh said.