Republicans and Democrats on Wednesday engaged in a fierce brawl to define what the Affordable Care Act means to consumers – making it clear that Americans' qualms about the law will remain a volatile issue throughout the election year.
Top officials from the two parties clashed in the House Budget Committee, on social media and in states with hot political races. They relentlessly attempted to put their own spin on a Tuesday report from the nonpartisan Congressional Budget Office, which estimated that the law will cause people to voluntarily work less.
The CBO figured the law will mean losing the equivalent of as many as 2.5 million jobs over the next decade.
While total employment and compensation should go up over the next decade, the increase is likely to be smaller than it would have been if the health care law was not in effect. That's because people may choose not to work, or to work less, in order to get the most government-offered benefits they can.
The analysis, though, also found that the law would help reduce federal deficits and spur economic growth, good news for supporters.
To the political world, the report was largely a gift for Republicans. In the House of Representatives, party leaders have tried more than 40 times to repeal parts of the law, only to see their efforts die in the Democratic-run Senate. Last week, President Barack Obama mocked the repeal bills in his State of the Union address.
Democrats thought they had finally gained some momentum on the health care issue, particularly since the woes plaguing the signup website have eased.
The one big argument Republicans had left was that the law would force employers to slash hours and jobs.
Wednesday, they gleefully contended that the CBO agreed.
"The middle class is getting squeezed in this economy, and this CBO report confirms that Obamacare is making it worse," said House Speaker John Boehner of Ohio.
"This is one of the perverse incentives in this terrible law," said Sen. John Barrasso of Wyoming, chairman of the Senate Republican Policy Committee. "It actually encourages able-bodied people to not work."
Democrats battled back, and it became clear the CBO report could be interpreted in different ways.
White House Press Secretary Jay Carney called the law's benefits "dramatic." At the committee hearing, Rep. Chris Van Hollen of Maryland, the panel's top Democrat, grilled CBO Director Douglas Elmendorf, who said the law will "boost the demand for goods and services" and in turn increase the demand for labor.
Republicans are buoyed, though, by ongoing skepticism about the law, particularly in more conservative states. Republicans need a net gain of six seats to win control of the Senate, and they are given decent chances to win Democratic seats in conservative states like Arkansas, Louisiana, Alaska, North Carolina, South Dakota, West Virginia and Montana.
Southern Media and Opinion Research, a Baton Rouge, La.-based polling firm, has consistently found roughly 70 percent to 80 percent of Louisiana voters dislike the law.
"Most people were not unhappy with their health care coverage, and they see the government messing that up," said Bernie Pinsonat, an analyst with the group. "It's an example of government making people uncomfortable and uneasy."
Adding to the Democrats' woes are their votes. All Senate Democrats voted for the law in 2009, including Mary Landrieu of Louisiana, Mark Pryor of Arkansas, Mark Begich of Alaska and Kay Hagan of North Carolina. They all face re-election this year.
Republicans won't let them forget it, but Democrats are fighting back.
Landrieu, who has led efforts to fix parts of the health care law, is pushing the Keeping the Affordable Care Act Promise Act. It allows people to keep their coverage if they like it and provides consumers with an explanation from their insurer about how the policy may not meet the new law's minimum coverage standards.
The White House last fall issued guidelines permitting state insurance officials to allow insurers to renew canceled plans for one year. The CBO expects this fix will lead to 1.5 million people renewing canceled plans
Begich has been sharply critical of the health care signup's problems. In November, he signed up for coverage on the new Alaska exchange and agreed to forego the federal contribution he could have received.
Republicans still risk overplaying this hand. Boehner has conceded the party has to do more than simply say no, and House Republicans have drafted a statement of "health care standards." The one-page document offered no details, only vague pledges to "give health care security and peace of mind to all Americans."
Polling suggests people's attitudes towards the law are not changing. Gallup's national survey Jan. 31-Feb. 1 had 51 percent disapproving, roughly the same number since the fall.
The survey also found 37 percent thought the law would make their family's health care situation worse, one-fourth said it would improve it and about one-third thought it would make no difference.
Those numbers suggest "this issue is here to stay," said Kyle Kondik, managing editor of Sabato's Crystal Ball at the University of Virginia Center for Politics. "It says it's going to be one of the big issues in this election."
Lesley Clark of the Washington Bureau contributed.
By David Lightman
McClatchy Washington Bureau