Before Obamacare, there was Hillarycare. If former secretary of state Hillary Clinton decides to run for president in 2016, Republicans are certain to dredge up her failed attempt to pass health care reform as first lady in the early 1990s.
So it's no surprise that Clinton addressed the issue judiciously and cautiously this week in Florida. She praised the law, which is similar to the universal health care scheme she proposed in her 2008 presidential run. She also said she would be happy to improve it.
"I think we are on the right track in many respects," Clinton told the Health Care Information and Management Systems Society, according to CNN. “But I would be the first to say if things aren’t working then we need people of good faith to come together and make evidence-based changes."
Clinton's comments come as every Democratic politician struggles to neutralize the issue ahead of November's midterm elections. The law was always unpopular, but the botched rollout made matters far worse and Republicans are on the offense in the belief that attacking the law is a vote winner.
Strategists say that rather than entering the debate about what to do with such an electoral liability, Clinton's comments were a smart way to duck a tough issue.
"She is absolutely playing it very safe," said Democratic strategist Hank Sheinkopf. "If she gets caught in a health care shootout she could be wounded very badly. Best move: avoid the shootout -- with Republicans or the administration."
"Hillary Clinton cannot run from the principle of Obamacare. But she does want to portray herself as a no-nonsense problem solver," said Republican Ford O'Connell, who advised Senator John McCain's presidential run in 2008. "She's aiming for the middle ground."
Though Clinton didn't vote for the Affordable Care Act, she is closely tied to it. Not only did she support the law but its signature feature, the individual mandate, was a key feature of her own health care plan during her 2008 run against Obama. (It was Obama who ultimately came around to Clinton's point of view when he included the mandate in his own health care proposal.)
But Clinton did distance herself slightly from the administration by embracing the popular notion that the law could use some fixing -- hence the "middle ground."
Clinton specifically singled out the employer mandate -- delayed twice now by Obama's Department of Health and Human Services -- as a part of the law that needs to be reworked. The problem, as Clinton pointed out, is small businesses with 50 or more employees “moving people from full-time work to part-time work to try to avoid contributing to their health care.”
Meanwhile, Obama has defended the delays as part of an effort to create an overall smooth transition into the new health care regime. “This was an example of, administratively, us making sure that we're smoothing out this transition, giving people the opportunities to get right with the law but recognizing that there are going to be circumstances in which people are trying to do the right thing, and it may take a little bit of time,” Obama said in early February.
"This is a classic cat-and-mouse game," said O'Connell, noting that besides the small business comment, Clinton demurred when asked to name other fixes. "She's staked out her position. The Republicans have to flesh it out before she really gains some serious momentum."
Like Clinton, Democrats find themselves in a tricky place: they must neither embrace nor abandon the law the Democratic Party fully owns. And like Clinton, the strategy seems to be to defend the popular parts of the law and pledge to fix the parts that aren't working.
At the end of the day, however, if the Affordable Care Act still isn't working smoothly by 2016, the forecast for Clinton and Democrats will be dim. "[If] she's the nominee, she can't distance herself from the party," said Scheinkopf. "The problem is that whatever the president does, she's going to be blamed for it."
The idea that Clinton might fix Obamacare does fit well with her overall appeal as a candidate. The premise of her 2008 campaign against Obama was that she could do a better job at basically the same tasks.
It's unlikely Obama will get Republicans to sit down and reform any of the law's problems in his last three years in office. If Clinton ultimately pulls it off, it would validate the executive skills she will no doubt run on.
If she runs, of course.