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Healthcare reform has been signed into law. But the battle to sell it continues.

Republicans, none of whom voted for the bill, are seizing on public dissatisfaction and confusion over healthcare reform to push for repeal as a key argument in the fall elections. Democrats know they have to fight back. And so it falls on party leaders, from President Obama on down, to settle on a single, simple message and then pound it home.

In his East Room signing ceremony Tuesday, Mr. Obama stressed the elements of reform that go into effect this year, almost defying Republicans to try to take the new protections away.

Healthcare 101: What the bill means to you

鈥淚n a few moments, when I sign this bill, all of the overheated rhetoric over reform will finally confront the reality of reform,鈥� Obama said to a crowd of Democratic lawmakers and invited guests.

Obama accentuates the positive

Among the elements the president stressed, all of which begin this year: tax credits for small businesses to help them provide insurance for employees; a ban on dropping the insurance of people who get sick; a ban on refusing insurance for children with preexisting conditions; and allowing parents to put adult children up to age 26 on their policies.

Obama also appealed to American exceptionalism in speaking to what he called 鈥渢he core principle鈥� that everybody should have access to healthcare.

鈥淲e are a nation that faces its challenges and accepts its responsibilities,鈥� he said. 鈥淲e are a nation that does what is hard, what is necessary, what is right.鈥�

Republicans, meanwhile, are marshalling their arguments as they call for repeal.

The top Republican on the House Budget Committee, Rep. Paul Ryan (R) of Wisconsin, knows that just saying 鈥渞epeal鈥� feeds the Democratic argument that the GOP is the 鈥減arty of no,鈥� so he is calling for 鈥渞epeal and replace.鈥�

In his 鈥淩oadmap for America鈥檚 Future,鈥� Congressman Ryan would change the employment-based insurance system with tax credits that allow employees to purchase insurance on their own, which would de-link employment and health insurance.

GOP: 'We've got a better idea'

鈥淥bviously we鈥檙e not for keeping this law,鈥� Ryan told the Politico website in a videotaped interview. 鈥淲e should repeal it and replace it with reform, but not just to go back to the status quo that we knew yesterday.鈥�

For now, though, most Republicans are focused just on repeal. The Democratic challenge, in protecting what they have passed, is to convince the public that it鈥檚 a good thing 鈥� both to halt any momentum toward repeal before it starts and to help the party鈥檚 candidates in the fall midterms.

Part of what made achieving reform so difficult, despite the Democrats鈥� big majorities in Congress, is that Obama and other leaders kept changing the rationale for healthcare reform.

Initially, it was framed as a part of economic reform 鈥� that 鈥渂ending the cost curve鈥� on healthcare inflation would help the nation鈥檚 fiscal health. Then it became a plan to insure the uninsured, of which 32 million Americans are now projected to join the rolls in the next four years. By the end, Obama was arguing for making history and for fending off an insurance industry that would 鈥渞un wild鈥� if unchecked, continuing to deny people coverage and imposing massive rate increases.

Now that the bill has passed, Obama is on a mission to help the public understand what鈥檚 in it 鈥� especially the parts that are widely popular. The challenge will be to keep the unpopular parts 鈥� such as the cost and the prospect of greater government involvement in the healthcare system 鈥� from giving his opponents momentum.

For Obama, the good news is that he is still president at least until January 2013. If any full or partial repeal crosses his desk, he can veto it.

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