Stephanie Grace: Landrieu playing defense on health care law

“It’s disingenuous, but what else can she do? She now realizes her vote for ACA is going to hurt her, and if she cannot change the dialogue, she will not be reelected.” BERNIE PINSONAT, pollster

U.S. Sen. Mary Landrieu’s first campaign ad is vaguely interesting for what it says ­— that the senator is pushing the president to keep his word and allow those who like their current health insurance policies to keep them.

It’s a lot more interesting for what it doesn’t say.

The ad doesn’t acknowledge that Landrieu, D-La., supported the controversial health care overhaul, or that she’s on record having echoed President Barack Obama’s false assurance that customers happy with their policies can stay on them, when the reality is that some preexisting plans didn’t meet the law’s new minimum coverage requirements.

Nor does it explain why Landrieu decided to take on the issue, and to do it now.

The real story behind the senator’s early television buy, nearly a year before voters will go to the polls and decide whether to send her back to Washington for a fourth term, is not that she’s pushing a particular piece of legislation. It’s that she gets that she has no choice but to talk about the health care overhaul, as much as she’d surely love to change the subject, and that she can’t afford to sit by while Affordable Care Act opponents cast her vote in the worst possible light.

That, as TV viewers across the state know, is already happening. Americans for Prosperity, the conservative advocacy group linked to the billionaire Koch brothers, has been pounding away at Landrieu’s support for the law, allowing main GOP opponents Bill Cassidy and Rob Maness to enjoy the show from the sidelines without investing a dime.

This is perilous ground for Landrieu. Pollster Bernie Pinsonat argues that many voters might not have known before the ad campaign that she was a supporter of the law, which got off to a disastrous start and polls poorly in Louisiana, but are getting the message now. He said she has no choice but to come up with a more positive narrative.

“It’s disingenuous, but what else can she do?” he asked, “She now realizes her vote for ACA is going to hurt her, and if she cannot change the dialogue, she will not be reelected.”

If there’s a silver lining to this for the senator, it’s that she if she does a skillful job of changing the dialogue, as Pinsonat put it, there are potential upsides.

Landrieu’s initial ad paints her as an independent voice willing to stand up to the president, not the rubber stamp her opponents say she is — a key message if she hopes to win despite the state’s increasingly Republican leanings.

In talking about the health care law, Landrieu can remind voters what she got for her vote — a big chunk of Medicaid money that Republican Gov. Bobby Jindal wanted — which reinforces her image as someone who can leverage her seniority and status as a swing vote on divisive issues.

She can stress the good parts of the law — yes, there really are some — by emphasizing its guarantee that most people can get previously cost-prohibitive health coverage, with federal subsidies in some cases and despite preexisting conditions in all. That’s no small matter to those affected. She can also talk about the how many more of her neediest constituents would have been eligible had Jindal not rejected the law’s expansion of Medicaid, which the feds would have fully covered for the first three years and largely financed thereafter.

By tackling health care head-on, she can even neutralize her opponents’ insistence that she cast the deciding vote for the ACA. For the record , a fact-checking column in the Washington Post that analyzed the law’s convoluted legislative history determined that, while Landrieu was one of the last holdouts, Nebraska senator Ben Nelson was actually the decisive 60th vote. Frankly, anyone who cares to quibble probably won’t be backing her, anyway.

The one thing Landrieu seems like she won’t be able to do, though, is change the subject entirely. If nothing else, her early ad is an acknowledgement that her opponents just won’t let her.

Stephanie Grace’s email address is