Decibel alert: Partisans dial up health care noise

By RICARDO ALONSO-ZALDIVAR, Associated Press

WASHINGTON (AP) - America's national shouting match over health care will only get louder next week as the Supreme Court weighs the fate of President Barack Obama's overhaul.

With formal arguments off-limits to cameras, supporters and detractors have laid elaborate plans to compete for the public's attention outside the Supreme Court building.

At the White House, which on Friday observed a low-key second anniversary of the Affordable Care Act, Obama's advisers are trying to walk a fine line. They want to avoid any appearance of unseemly pressure on the justices while encouraging supporters to speak up. The Obama re-election campaign is also talking up the law's benefits, and there is a steady stream of cheery press releases from the Department of Health and Human Services.

Will any of it make the slightest bit of difference?

Polls show Americans are as divided as ever over the president's signature domestic policy achievement, hard-won legislation that will eventually expand health insurance to more than 90 percent of citizens and legal residents, providing federal subsidies to make premiums more affordable for millions who now struggle to find and keep coverage.

"It's hard to imagine that the various demonstrations for and against the health care law will have much impact," said Peter A. Brown, assistant director of the Quinnipiac University Polling Institute in Connecticut. "Even if public opinion does change, it doesn't matter. The only thing that matters is the nine votes on the court."

That hasn't stopped the activists.

"We want to make sure we are heard," said Tim Phillips, president of Americans for Prosperity, a conservative group founded with the support of billionaires Charles and David Koch which has spent heavily on anti-Obama campaigns across the country.

The group has been collecting signatures online for a "symbolic amicus brief" calling on the court to strike down the entire law. The signatures will be the centerpiece of a rally near the court on Tuesday, when the justices are scheduled to hear arguments on the constitutionality of the law's individual coverage mandate.

That's the central issue in the case: whether the federal government can require individuals to obtain health insurance, either through an employer, a government program, or by direct purchase. Opponents say Obama and congressional Democrats stretched the Constitution beyond any reasonable interpretation, essentially ordering citizens to buy a product.

Supporters of the law say health insurance is unlike any other product because everyone needs medical care sooner or later, and society bears the cost of treating the uninsured. For insurance to work well, the pool must include the young and healthy. The Constitution gives Congress the power to regulate interstate commerce, and the health insurance mandate stands in a line of requirements that go back decades and have been upheld by the courts.

Americans for Prosperity has arranged to bus in supporters from Connecticut to North Carolina and as far west as Michigan. Tea party stars including Rep. Michele Bachmann, R-Minn., and Sen. Rand Paul, R-Ky., will address the rally.

Liberal groups, unions and other supporters of the law have been taking a somewhat different approach. Although they plan Washington events, including rallies and a prayer vigil Monday at the court, they have been putting their main emphasis on outreach around the country. That dovetails with a sustained effort by the Obama re-election campaign to tout the benefits of the law.

On a recent midweek day, a team of nurses and other volunteers took up their cellphones at an Obama campaign office in the Denver suburbs and began calling voters. That particular day, the volunteers were trying to reach elderly women.

Holding up a sheet of talking points about the health law, campaign field director Tami Parker told the volunteers about the Supreme Court challenge.

"We need to talk about how the Affordable Care Act helps women, especially elderly women," Parker said. The talking points ended with an argument in bold: "Some politicians want to take away these new benefits, and put insurance companies back in charge."

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