The Democrats actually want to 'own' health care. But not how Donald Trump means it.
Posted July 19
The Senate Republican health care bill is dead and the prospect of a show-me vote on full repeal without replacement is a zombie stalking the halls of Capitol Hill. Over at the White House, President Donald Trump began Wednesday with a pair of tweets demanding some kind of resurrection, but even now, what he truly wants is an open question.
Mostly sidelined during the Majority Leader Mitch McConnell's ill-fated sausage-making, Trump on Tuesday passed the health care buck back across the aisle. "We'll let Obamacare fail," he said, harking back an old campaign trail threat, "and then the Democrats are going to come to us."
The logic here -- that voters will blame Democrats for troubles in a market the Republican President is now openly rooting against -- is dubious in its own right. The polling goes further. More than six-in-ten people surveyed by the Kaiser Family Foundation this spring said they would fault the GOP "for any problems with the Affordable Care Act going forward."
Comments by top Democrats over the past 24 hours suggest they are approaching the dynamic with a giddy caution. Their public overtures to Republicans in the aftermath of the Senate bill's collapse may be completely genuine, but also have a tinge of Schadenfreude. "The door to bipartisanship is open right now," Minority Leader Chuck Schumer likes to say. "Republican leadership only needs to walk through it."
But an overindulgence in the daily politics risks obscuring an equally plain and potentially more significant outcome. With the GOP's failure to deliver on its years-old promise to ditch Obamacare in favor of some amorphous upgrade, the future of health care policy in America now firmly resides with the Democrats and their resurgent left.
Taking hold of the issue, one that cuts so cleanly across class, race and cultural lines, comes at an obvious risk. Action requires significant majorities in Congress and control of the White House, meaning real change is still a ways off and only possible in unique moments of shared purpose. Defense -- or opposition -- requires unity and discipline. Offense, however, demands creativity and compromise. Guess which comes easier.
Kansas Sen. Jerry Moran, whose defection alongside fellow Republican Mike Lee, of Utah, on Monday night effectively ended the "replacement" debate on the right, said in his statement, "We should not put our stamp of approval on bad policy." In its place, Moran wrote, the party should pursue "innovative solutions" to all the familiar inefficiencies.
It was a neat summation of the GOP's current position -- and lack of specific solutions. The Affordable Care Act, as Massachusetts Sen. Elizabeth Warren reminded the Wall Street Journal a few weeks ago, was the product of a "conservative model that came from one of the conservative think tanks that had been advanced by a Republican governor in Massachusetts." Perhaps Republicans could never cook up a viable substitute because the current law is, fundamentally, drawn from their own past blueprints.
In the meantime, as Republicans struggle with moving on from "repeal and replace," defend and extend is a useful shorthand for the working game plan among Democrats in Washington. Organizers, chastened by the premature celebrations that followed the House bill's initial stutter, exist in a state of constant alarm, bags packed for a return to the barricades. But at the same time, they are champing at the bit to launch an offensive of their own.
The opportunity is coming even if the possibility of legislative actions is years away.
Some Democrats -- and one very notable independent -- are itching to press their advantage. Vermont Sen. Bernie Sanders, who traveled the country the past month defending Obamacare, will release a new single-payer, or "Medicare for all" plan, in the coming weeks. Ambitious officials with their eyes on 2020, like Warren and New York Sen. Kirsten Gillibrand, have recently doubled down on their support for the policy, broadly defined.
"With the defeat of health care repeal, the people will demand the real solution: Giving every American access to Medicare," Progressive Change Campaign Committee co-founder Adam Green said in an email Monday night. "Americans deserve to see bold solutions in this moment -- not just small-bore technocratic tweaks."
Progressive groups like the Working Families Party and Our Revolution, the political organization spawned by Sanders' 2016 campaign, are saying the same, all primed for the pivot. MoveOn.org, which marched with Sanders in June, is a likely ally. Less ideological outfits like Indivisible and the disability advocate group ADAPT, which saw its protesters arrested by Capitol Police after a die-in outside McConnell's office, also figure to be key players in shaping Democratic policy through the coming midterm season and into 2020.
But the room where it happens -- will be crowded. Other, more cautious liberal organizations like the Center for American Progress, along with moderate elected officials who lead with their pro-business credentials and faith in markets, have very different ideas about where the movement goes next -- and how it should get there. There is room for compromise, at least in the short term. Even Sanders, the firebrand, has floated more modest, incremental changes, like pursuing a public option and lowering the entry age to Medicare. Still, the solidarity of the past months will be tested.
But there is little argument expected on one crucial point: the next radical effort to overhaul health care in America will be coming to a soapbox near you from the left -- and soon.