The law that dare not speak its name

“MY INSURANCE was cancelled because of Obamacare. Now the out-of-pocket costs are so high, it’s unaffordable,” said Julie Boonstra, a cancer patient, in an ad attacking Gary Peters, a Democrat running for the Senate in Michigan. It turned out, however, that Mrs Boonstra will save over $1,000 this year because of the health law; she just didn’t know it. Mrs Boonstra’s confusion is not unusual. Many Americans are eligible for federal subsidies to help pay for insurance, but don’t know it.

According to Kantar Media, a firm that tracks political advertising, health care is the main subject of campaign ads, especially Republican ones (see chart). Obamacare is unpopular—over half of Americans disapprove of it. Republicans talk about it constantly on the campaign trail, though not as intemperately as they did during their own party’s primaries. Democrats scarcely mention it.

The Republican National Committee’s first paid ads of 2014 reminded voters of Barack Obama’s promise that “if you like the plan you have, you can keep it.” The Urban Institute, a think-tank, estimates that 2.6m Americans had their plans cancelled at the end of 2013 because they did not meet Obamacare’s standards. Politifact, a watchdog, called Mr Obama’s promise the “lie of the year”. Republicans quote it all the time. At an event put on by Americans for Prosperity (AFP), a conservative group, in Raleigh, North Carolina, Donald Bryson, the state director, notes that the president repeated it 22 times. Munching on barbecued pork to the sound of bluegrass music, audience members assail the law as an attack on their liberty.

Since Republicans came within one vote of blocking Obamacare in the Senate, any Democratic senator can be accused of having cast the decisive vote for it. Kay Hagan of North Carolina, for example, has been hit by a flood of ads slamming her support for Obamacare.

At the warehouse of a small lighting company in Greensboro her Republican opponent, Thom Tillis, warns that Obamacare is destroying businesses. The company’s owner, Gordon Hunt, says he has passed up chances to expand in order to avoid the law’s requirement that firms with 50 or more employees must provide health insurance for their workers. In an ad earlier this year, Mr Tillis cited an estimate from the Congressional Budget Office (CBO) that Obamacare would cost America the equivalent of 2m jobs.

The CBO said that Obamacare, by raising labour costs and making it easier for individuals to buy insurance without relying on an employer, would reduce the incentives for people to work, by the equivalent of 2.5m full-time workers by 2024. An analysis by the Centre for Economic and Policy Research, a think-tank, suggests that more people are choosing to work part-time. A previous study found that this uptick was probably the result of the slow recovery, not Obamacare.

Democrats have several counter-arguments they could use. The growth rate of health-care spending has slowed from an average of 7.2% from 1990–2008 to 3.6% last year. The number of uninsured people under the age of 65 fell from 44.3m in 2013 to 40.7m in the first three months of this year, and premiums have not spiked in most places (though they still could, and some people will find out just before they vote).

Mark Pryor of Arkansas is one of the few Democratic senators who mentions Obamacare, albeit only obliquely. In an ad he mentions his vote “for a law” that requires insurers to provide affordable coverage to people with pre-existing conditions, like himself (he has suffered from cancer). Mr Pryor is behind in the polls.

Republicans often use Obamacare as shorthand for Democratic incompetence (eg, the Obamacare computers crashing on day one) and for broader criticism of big government. It is also, of course, a word that reminds voters of an unpopular president, says Elizabeth Wilner of Kantar. Opinions of the law itself have hardly budged since its enactment, dividing along partisan lines.

Yet for all the Republican bluster about repealing Obamacare, there is no chance that this will happen while Mr Obama is president, and little chance thereafter. Less than a third of voters want the law scrapped, according to a poll by the Kaiser Family Foundation, a research outfit, while nearly half would like to see it improved. Even Republicans like parts of it, such as the ban on insurance companies charging people more if they are sick. If the law were less confusing, it might be an easier sell.