Lessons From A Near Trainwreck: Healthcare Edition
Watching the last few weeks of the health care legislative process was like watching a train barreling down a dangerous track, plowing through obstacle after obstacle toward a fiery crash that would, in this case, take a chunk of the economy and millions of people’s lives with it.
It’s a meaningful testament to the organizing that took place that the only way McConnell could get anything to the floor was by breaking rules and norms at every step of the way. And it was good organizing on the part of Democrats and two very brave Republican women and a Republican man that saved us from the devastating crash.
Even in this moment of victory (or possibly just reprieve), it’s worth understanding what brought us to the precipice.
1. Republicans on the Hill fear the Trump base more than they fear Democrats. Republicans in the House and Senate are behaving as if they know that gerrymandering, the political calendar (which puts very few Republican Senate seats up for grabs in 2018), and successful efforts to disenfranchise traditionally Democratic voters have made their majorities quite safe. While Democrats have been awfully excited about the prospects of taking back the House in 2018, the smart people I’m listening to worry that it won’t be easy to swing Republican-held house seats left, even with abysmal polling numbers for the President. The early targets in GA, VA and MT bear that out even if they’re not illustrative of where all the targets exist.
If that’s true then the Republican risk is not “will our moderate voters turn against us on healthcare” but “will our base voters turn against us for not trying to pass meaningful legislation.” When you’re more worried about being primaried from a conservative candidate — possibly with the full-throated support of the tweeting President who remains quite popular with his voters — than you are about losing the general election to a Democrat than you get the kind of fight we’re in now. Democrats should see this as a sign that the 2018 elections will not be a cakewalk.
2. Facts really don’t matter. We’ve heard a lot of talk about the science of confirmation bias — how we hear the facts we want to hear, and reject those that don’t fit our political identities. But this may be the first time outside the 2016 election where we’ve seen this theory in action. Polling showed that Americans overwhelmingly disliked the increase in premiums or loss of coverage that repeal and replace offered.
But did polling show Republicans that if they yelled loud enough on the cultural identity issues (traditionally abortion, guns, gays and immigration), those voters would come back to them even if they repealed Obamacare? Especially if the hurt didn’t get felt right away? And with a President willing to lie and blame the hurt on Obamacare or the Democrats, did facts even matter in the debate? Voters may not like increased premiums but if they don’t believe the Republicans caused them, then what harm does it actually do to Republican base numbers? We need to look at those polling numbers closely and see whether opposition to repeal and replace was dug in enough to hold, or whether that opposition was soft because the facts didn’t comport with their beliefs (Republicans don’t want to hurt us and take away our health care, they want to make it better and Obamacare wasn’t working for us).
3. The smoky backroom deal is a thing again. Once upon a time, closed door deals were an anathema. I’m old enough to remember that when the Senate Judiciary Committee tried to decide how to handle the accusations of sexual harassment against then-nominee Clarence Thomas, a group of women from the House stormed the Senate to demand greater transparency and won that debate. And for at least a year Democrats rode that demand to wins for women in the House and Senate. Is that still a viable fight?
From the days of Hamilton, we the people have demanded to be in “the room where it happens”. But if bills can be constructed and passed in the literal dead of the night without public transparency and without tremendous outrage from the populace, (and limited transparency even among elected members of the Senate) does it follow that this is going to be the new normal? People are tired of a do-nothing Congress and perhaps they’d be willing to give up transparency for greater action. We can’t let that happen. This government only works if it can rely on the “consent of the governed”. And the governed can’t give that consent unless it is fully informed and engaged.
Depressing, I know. But here’s the “so what”: Democrats need to look this experience straight in the eye, understand what was underneath it, and come out swinging in the following ways:
1. In the 2018 election we need to walk and chew gum at the same time. There has to be a way to get Democratic voters engaged not just in “swing left” Congressional seats — where we can and should make some gains — but in Governors races, State House and Senate races, where redistricting decisions will be made in 2020 that will determine the Democratic Party’s future for another decade. The DCCC and DSCC have to work with the DGA and DLCC to come up with a unifying message and campaign that paints the larger picture for voters and activists about what’s at stake in 2018 and beyond. Want to see the Republicans running scared? Threaten their hold on the “down ticket” Governors, Secretaries of State and state legislative seats that ensure that even if they have a losing message they have a winning hold on the numbers through 2030.
2. Facts don’t move people, but stories do. Part of why we won Repeal and Replace was because people with stories flooded the halls of Congress, the district offices of members and told their stories about what the loss of health insurance would do to them personally. It moved beyond statistics and litigating the facts to personal, relatable stories. Now we have to tie those stories to voters’ political identities. You think government should stay out of people’s personal lives but you make major exceptions around that principle on abortion rights, national security and other cultural issues? How can we make taking away health care coverage one of those exceptions? How do we make this a value that voters vote on? Personal freedom, liberty and the right not to die poor because you got cancer. Seems like good Republican core values. Let’s push that.
3. Coopt what works, but don’t give up on our values. I’ve talked to lots of Democratic strategists who think we should co-opt Republican strategies and just be better at them. Maybe — but giving up transparency shouldn’t be on that list. Democrats can and should stand for greater transparency. Where we’ve gone wrong in the past is allowing voters to think that we care more about big money than we do about them as people. And those big money deals happen in closed rooms without transparency. So let’s throw open the doors, let the light in, do town halls not just in our safe districts, but in other districts and in states we don’t have majorities in. Let people see what transparency looks like and they will demand it from their own party.
I’m all about taking the weekend to celebrate last night’s near miss — the rescue just before the fiery crash. But let’s also take the weekend to understand why we won (if we really did win at all) and where the fight needs to go next. That’s the only way we’ll win in the long term, and we need to keep our eye on that ball.
Lara Bergthold is a Principal at RALLY, a communications firm that works to influence the way people think about and respond to political and social issues.
