Two Stories About Health Care Repeal

Last week D.C. police arrested me and 175 friends for a nonviolent protest in the Senate. We had occupied Senate hallways as a last resort to stop the repeal of the Affordable Care Act, joining waves of other activists before us.

That afternoon, as I waited in the large, sweaty police barn, bound in my zip-cuffs, I had a lot of time to think about whether it had mattered. Getting arrested required some sacrifice for me, but I knew many others that had a lot more to lose. After I got out later that evening I had texts from friends, cousins, even my parents, saying that they were proud. But over the next few days a small part of me still wondered what good it did.

Today morning, when the news came out that repeal was dead, that question came up for me again as I saw lots of variations of this:

According to these stories, repeal failed due to Republican division, and one curmudgeonly, old “maverick.” In this tale, public outrage and protest is a footnote at best. Instead, the story goes, the last 7 months went like this:

• Early in 2017, Republicans in the House began crafting a bill to repeal and replace the Affordable Care Act — a long held dream of theirs. Majority leader Paul Ryan tried hard to get different factions of his party to agree but failed, withdrawing the bill in March. Despite his setback, Paul Ryan kept on working to build support for the bill. To the surprise of everyone he was able to muster enough votes to pass it in early May, sending the bill to the Senate.
• Mitch McConnell and other Republican Senators began drafting their version of the bill behind closed doors. This approach led them to lose support from many members of their party. Then, in July, John McCain, a presumed supporter of the bill, had to have an emergency surgery. This delayed the vote. Soon four moderate Republican Senators decided to withdraw their support, killing repeal again.
• However, Mitch McConnell kept reworking the bill to build support in his party. In the final week of July he decided to push forward for a vote. John McCain returned to the Senate, receiving a hero’s welcome, and voted yes to begin debate on the bill. It seemed that the tide was turning. Two bills to fully repeal or repeal and replace the ACA failed, but momentum grew for a third “skinny repeal” bill. On Thursday night, however, John McCain stunned many of his colleagues and the public when he voted against the bill, effectively ending repeal efforts for good.

That story might be clean and easy to digest. After all, it has all the elements of a good story: a clear setting (House and Senate meeting rooms and voting chambers), a clear cast of characters (Paul Ryan, Mitch McConnell, and John McCain), a simple plot (trying to pass repeal), and a clear sequence of events.

But, in my view, it isn’t the full story of why health care was saved, or even the most important one. There’s a second story, which is messier, and probably won’t be told by most news outlets, but which goes like this:

• Soon after the 2016 election, people began organizing because they knew what was coming. When the House introduced the health care repeal bill in spring 2017, groups like Indivisible mobilized thousands to make phone calls, hold meetings, and speak up at town halls to #KilltheBill. Health professionals protested, led by groups like National Nurses United, advocating for their patients. And countless other groups began working together to #StopTrumpcare, temporarily stopping the House bill.
• Unfortunately, that wasn’t enough to kill the zombie bill for good, and the bill came back from the dead to pass the House and head to the Senate. As Senators pushed forward with the bill, groups like Democracy Spring, #AllOfUs, and Our Revolution escalated the fight, coordinating sit-ins in DC and in offices across the country. And, in an action that put the moral crisis front and center, disability-rights activists from ADAPT put their bodies on the line, inspiring a new wave of organizing.
• In the final weeks, groups like the Center for Popular Democracy and Housing Works organized wave after wave of civil disobedience in the Senate. More than 300 people got arrested in a few weeks, clergy from Repairers of the Breach highlighted the moral failure of the bill, and activists drowned out the motion to proceed in the Senate. In a last ditch effort, Senate leaders voted on three different repeal bills — but all were voted down.

This story doesn’t have one clear hero. It doesn’t even take place in just one city. But in this story—in my opinion the more accurate one—politicians didn’t vote to protect people’s lives — people organized and won it.

Unfortunately the story that tends to get told more often is the first one.

Why is this the case? Understanding that depends on understanding how most of us view of power. In his book, The Politics of Nonviolent Action, movement scholar named Gene Sharp introduced the idea of two views of power: monolithic and social. In the monolithic view of power, power is seen as flowing from the top downwards. In the U.S. Senate and House it means the majority leaders are at the top, followed by committee chairs, and so on. In this view, which we’re taught from a young age, politicians are individuals who mostly act of their own accord. In this view, John McCain being the “maverick” that he supposedly is, bucked his party and voted against repeal.

Image credit: Momentum

In the social view of power, however, power flows from the bottom up to the top. It views the President, Senators, and House members, as dependent on the tacit consent of many, many other people to carry out their work. The reason for this is simple: we all exist in a web of social relationships. Even a so-called “maverick” like John McCain still has staff he relies on, janitors that keep his office clean, friends and family who help take care of him, constituents from his state that vote for him, and so on. Those are the people who have the real power. In this view, without the cooperation of these people, politicians have no real power.

The key insight that Sharp had, and many successful movements from the Civil Rights movement to the Arab Spring have shown in practice, is this: with a social view of power you succeed not by directly convincing politicians to support your cause, you succeed by targeting the public because that inevitably influences the people around them.

It’s impossible to predict what specifically will lead to an individual’s political decision. But the reason protests, marches, rallies, and, yes, getting arrested, all seem to work, is because they force politicians to choose between standing with those they depend on, or lose their support. It is hard to say with any certainty who exactly that is or how that will play out — which staffer or constituent or family member or friend will be the one that tips a particular Senator or House member over the edge — but throughout our country’s history, when a movement has reached scale, it has won.

In the coming months and years, when we tell the story of what happened over the last 7 months, and how one of the most destructive pieces of health care legislation in a generation was stopped, it’s important to remember that it matters which story we tell. It matters because the stories we tell about the past shape our sense of possibility about the future. And this story is definitely a story worth telling.