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August 17, 2019

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Health care bill putting Dina Titus’ political future on the line

Health Reform Rally

Wendy Rountree voices her support of health care reform during a rally Wednesday in front of Dina Titus’ Henderson office.

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Health care reform supporters Heather Krieger and fiance Tyler Smith hold signs during the rally organized by Wednesday in front of U.S. Rep. Dina Titus' office in Henderson.

Dina Titus

Dina Titus

As Democratic Rep. Dina Titus faces a challenging health care vote, how she eventually sells her position to voters could be as important to her political future as whether she votes yes or no.

House Democrats are nervous about voting for a bill that polls show majorities of Americans do not support. Yet Democrats are equally worried about heading into re-election campaigns without accomplishing health care reform after a year spent debating the issue.

For Titus, the internal debate could be heard last week during a tele-town hall meeting with more than 3,000 voters in her Henderson district.

To one caller, Ken, who supports health care reform, saying he is a small-business owner who recently had to discontinue coverage for his workers because of rising premiums, Titus assured him, “I support reform.”

To another, Frank, who was concerned about the costs of the bill, Titus insisted that she wanted to see Congress “tightening their belts” too and was not about to greenlight the bill until she had fully reviewed it. (The final version has yet to be presented to members of Congress.)

“I just don’t believe it’s responsible to commit until you see the bill in front of you,” Titus told him.

A freshman, Titus has walked a fine line, trying to keep her Democratic supporters close while not alienating the independent voters whose ballots make the difference between winning and losing elections in her district.

As the House closes in on a final vote, possibly this weekend, the congresswoman has declined to state her position.

She voted once for the health care bill in the House, in November. Now she’s considering a different version from the Senate, along with a reconciliation bill that would make further changes.

The choices facing Titus, and other Democrats, are fairly clear:

She can choose to heed polling data out this week from the U.S. Chamber of Commerce and the conservative Independent Women Voice, which says Nevada voters will reward her for switching her vote from yes to no.

In the Independent Women Voice poll, 49 percent said they would be more supportive of their member of Congress if they switched from yes to no. The chamber poll showed a slimmer margin, 40 percent, would support candidates who switch their vote, while 33 percent would support candidates who maintain their support for health care reform. Another 14 percent said it will make no difference.

Democratic strategists say the polls are flawed — tilting more toward conservative voters than the makeup of Titus’ district. Southern Nevada has more registered Democrats than Republicans, but the polls surveyed more Republican-leaning voters than Democrats. In the case of the Independent Women’s poll, experts said the sample of a few dozen voters is too small to assess mood in Titus’ district.

Heeding such poll numbers could be the less appealing option for Democrats, said David Wasserman, who analyzes House races for the Cook Political Report.

“Most Democrats understand what happens if they look incompetent,” he said.

For Titus to change her vote now would open her to attacks as a “flip-flopper,” Wasserman said, and leave voters wondering why Congress spent more than a year debating health care with no law to show for it. “That’s more politically perilous than standing consistently behind a minority view,” he said.

Still, the pressure is intense, as anti-health care reform forces are running radio ads in Titus’ district, and Republicans have vowed to make health care the issue this fall in every race in America.

The National Republican Congressional Committee will begin airing today an ad targeting Titus, asking “Is Dina Titus’ political career on life support?”

The worry among House Democrats is palpable. Experts predict dozens of seats could fall to Republicans in November, threatening their hold on the chamber. Democrats lost control of Congress in 1994, after President Bill Clinton’s failed attempt at health care reform.

Yet Democratic leaders believe the difference this time will be passage of the bill.

Polls also show voters are displeased with the current health care system and want changes.

Nationwide, voters overwhelmingly support several individual provisions in the bill. For example, voters tell pollsters they support stopping insurance companies from dropping their coverage and banning those who have pre-existing medical conditions from buying policies.

Democrats believe their political fortunes will fare better this fall if they pass the bill rather than return empty-handed.

The challenge for Titus and other Democrats, if they choose to vote yes, will be articulating their reasons for supporting the legislation in a 30-second sound bite that can withstand the attacks expected from the opposition: ObamaCare. Government takeover. Rationing.

Last week, former Rep. Marjorie Margolies Mezvinsky, who as a freshman from Pennsylvania cast a deciding vote in 1994 on Clinton’s budget package, offered a cautionary tale. She told The New York Times that she had distilled an explanation of her support into a four-minute sound bite. But her opponents could explain their criticisms in 30 seconds. She lost.

White House Communications Director Dan Pfeiffer said the reason Democrats “didn’t have a 30-second answer in ’94 is they failed to pass health care.” He said he could imagine a candidate making “a very compelling case in 30 seconds or less of all the benefits they delivered and the fact that they took on the insurers to do it.”

Titus knows the difference between having to explain oneself and lobbing attacks. She has been on both sides of that equation — as a veteran state senator who had to answer for past votes and as a challenger in 2008 to the incumbent Republican lawmaker she eventually ousted.

A vote for health care would allow her, while on the campaign trail, to take a page from Obama’s book, reaching for the human faces that can tell the story of health care reform — Nevadans who have been dropped by their insurance companies or had their insurance premiums raised to unaffordable levels.

Wasserman believes that if the bill is passed, Democrats will enjoy a brief victory lap then immediately “pivot to the economy” — the top issue on voters’ minds.

Titus’ spokesman Andrew Stoddard would not discuss campaign strategy for the congresswoman, saying she will articulate her decision to voters after she makes it.

“This is about doing what’s best for the district,” he said, “not who is screaming the loudest.”

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