Between now and November . . .

I wrote a few days ago that I wanted my Representative Michael Capuano to vote yes on the Mitt Romney health care legislation before Congress, and I am happy to say that he did so. I also said that from a purely policy wonk point of view anyway -- that is, leaving the political consequences of a defeat to the side -- I only support the legislation because I believe it gets us to new ground from which further changes can be made. That means that Democratic prospects in November are important in evaluating whether we will really find ourselves much better off in the end.

Since the major elements of the legislation won't take effect for years, you might think that the political impact will depend mostly on who succeeds in catapulting the propaganda (in the immortal words of a fool) between now and November. But as Karoli points out, there are some changes that will take effect quickly that people will experience positively.

A major success of the Republican campaign of lies was persuading older folks that the legislation would somehow take away Medicare benefits. In fact the opposite will happen immediately, the notorious doughnut hole will close and they will have lower out of pocket costs for medications. I don't suppose that will make any teabaggers reconsider, since the president's complexion isn't going to change, but Democrats can run on it.

The elimination of recissions, unfortunately, won't be noticed because people won't know what would have happened to them without the legislation but it may help informed progressives feel better about the whole thing and get more enthusiastic about November, which God knows we need. There may be a few people out there who don't have employer-provided insurance, who have pre-existing conditions, and who can afford to buy into the high risk pool. These will tend to be small business people and professional free-lancers, that sort of thing, who probably tend to be non-insane Republicans. Conceivably it will make a few people think twice, but it's a very small number. The same goes for people with children under 19 with pre-existing conditions. A few will benefit, but enough to matter politically? We'll see.

The funding for community health centers is an unalloyed good; but it will mostly benefit poor people who won't notice a dramatic difference in their lives, I think. Still, it includes people in rural areas who tend to be conservative for all the wrong reasons and it may soften a few of them up.

So there will be some folks out there who notice quickly that their lives have gotten a little bit better; and nobody will notice anything worse. Of course the price of health care will keep going up, and maybe people will blame the legislation. Still, if the Dems play their cards right and take advantage of the immediate effects of the bill to generate strong messages and stay on them, it can help them. If Obama still has majorities in both houses next year, he can keep going. The audacity of hope.

BTW: Here's a good summary of the bill. Seniors who hit the doughnut hole will get $250 in cash this year. That might buy a few votes, who knows?