My home state of Indiana, situated in the heartland, is a good place to take the pulse of America. If an issue is on Hoosiers’ minds, it’s probably important to the rest of the country too.

That’s why I recently asked a candidate for Congress running in the southeastern part of the state to tell me what he’s hearing from the people he meets at county fairs, parades and town hall meetings. The first two issues he listed were predictable: energy and jobs.

The third one he mentioned was a bit more surprising: health care.

Sometimes when you ask a candidate about voter priorities, they’ll give you a litany that highlights their own themes. But this candidate is a Republican. His party isn’t known for emphasizing health care reform. In addition, the sprawling, mostly rural but diverse district in which he’s running provides a good barometer for voter concerns. In this case, many are worried about affordability and access of health care.

That seemed to underscore a point made by a group that has launched a $40 million campaign to elevate health care to the top of the agenda this fall. Health Care for America Now calls itself an “unprecedented coalition” of 100 labor, business, community, provider, policy and advocacy organizations.

In its debut at the National Press Club in Washington on Tuesday, July 8, the coalition unveiled the first of a series of television ads that will air between now and Election Day. The group is mobilizing a huge grass-roots effort to promote a broad set of principles that it wants all members of Congress, and presumably their challengers, to embrace.

The coalition is calling for “a bold new solution” that guarantees choice, quality and affordability in health care. The options are to “keep your current private insurance plan, pick a new private insurance plan, or join a public health insurance plan.”

But leaders of the coalition see the health insurance industry as the enemy. Throughout the press conference, they excoriated insurance companies for putting profits ahead of coverage and emphasized that they can’t be trusted as a partner in reform.

They intend to frame this choice for candidates: “Now is the time to pick a side. Which side are you on?”

On the other side is the insurance industry. In a statement released the day of the coalition kickoff, Karen Ignagni, president and CEO of America’s Health Insurance Plans, said that health care costs must be addressed. She said they’re being fueled by variations in care; overuse, underuse and misuse of services; and new technologies whose effectiveness is not evaluated.
“We welcome and intend to make a significant contribution to the national discussion of how to blend public and private strategies to achieve a uniquely American solution that can work and be enacted,” Ignagni said.

Health insurers will have a lot to say about how health care reform unfolds in 2009 under a new president and a new Congress. But during the campaign, it looks as if we won’t have a discussion about health care. We’ll have a battle.

Richard Kirsch, national campaign manager for Health Care for America Now, is not concerned that he may be torching a stakeholder—insurers—that his allies will have to work with when Washington gets down to business on reform.

“You can’t burn a bridge when they’re trying to set the whole health care system on fire,” Kirsch said in an interview after the July 8 press conference.

It will be interesting to see how, or if, the health care passions stoked during the campaign will cool into consensus next year.