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Playing the Hand

Patient-ProtectionI’m not sure, but this photo may be the last time Democrats smiled about the Affordable Care Act or, if you prefer, Obamacare. President Obama put his signature on his signature legislative accomplishment on March 23, 2010 and, until the last few weeks, from a political standpoint the news has been pretty awful.

First the admissions: Democrats – thank Nancy Pelosi as well as the president for this – completely lost control of any coherent message about the law. Republicans did a masterful job of characterizing the ACA as government run amok. Obama, so the story goes, has Socialized health care in America and shredded the Constitution in the process. Sarah Palin chimed in with her nonsense talk about “death panels.” Democrats failed to respond or failed to respond effectively. Obama fumbled, screwed up, mislead, fabricated (chose your word) the business about liking and keeping your health plan. The roll-out was a first-class mess and we all know about the stupid website. Fundamentally the law, thanks to log rolling in Congress with the drug companies, the device manufactures, doctors, hospitals and insurance companies, is a massively complicated pile of legalize. It was almost as though the president and his supporters were saying, “We could tell you how it will work and how you will benefit, but you’d have to get sick first…”

More importantly from a political point of view the supporters of the law, chiefly including the Commander-in-Chief, never adopted a coherent, consistent, engaging message that might have allowed them to talk to the American people about an issue that has been on the agenda of every Democratic president since Franklin Roosevelt. The debate became about process, ideology and partisanship and not about a better more secure future.

In politics, as in corn flakes, you can’t sell an idea without a believable message. The failure to offer a coherent, believable story about the law is nothing short of political malpractice. Critics will say, of course, that the law is such a mess that it can’t be defended or marketed, but I don’t buy that. Even George W. Bush, initially at least, sold the invasion of Iraq. Creating a system for millions of Americans to have health insurance and a more secure life is surely an easier sell than a war.

Still, four years later the law is the law, upheld by the Supreme Court (or at least by five justices), a survivor of a hundred different efforts by Republicans to repeal it or, better yet from their perspective, use it as a blunt instrument to pummel Democrats in another mid-term election. Apparently – crank up the irony meter – Americans now hate the law so much they have signed up in numbers that have even surprised the law’s biggest supporters. The polls tell us the law is a huge loser – although repeal is even more unpopular – and yet the GOP has placed nearly all of its mid-term eggs in the “we hate Obamacare” basket. All of the party’s 2016 hopefuls have bought into the notion that Obama’s law is the worst things since, well, maybe since Social Security, yet they offer nothing in the way of a better alternative.

In one of his pithy and incisive essays Garry Wills points out that supporters of the law will likely never turn the opponents around. Obama, Wills writes, “made the mistake of thinking that facts matter when a cult is involved. Obamacare is now, for many, haloed with hate, to be fought against with all one’s life. Retaining certitude about its essential evil is a matter of self-respect, honor for one’s allies in the cause, and loathing for one’s opponents. It is a religious commitment.”

Wills reminds us that Social Security was once almost as hated as the ACA, but somehow nearly 80 years on it still stands. “Repealing Obamacare will eventually go the way of repealing the New Deal,” Wills opines. “But the opposition will never fade entirely away—and it may well be strong enough in this year’s elections to determine the outcome. It is something people are willing to sacrifice for and feel noble about. Creeds are not built up out of facts. They are what make people reject all evidence that guns are more the cause of crime than the cure for it. The best preservative for unreason is to make a religion of it.”

The editorial page of the Wall Street Journal with an almost daily discourse on the “failures of the law” or any given George Will column easily serve as the Bible for this new religion. Will’s most recent column excoriating the law and the president concludes with this sweeping indictment of all things Obama: “progressivism is…a top-down, continent-wide tissue of taxes, mandates and other coercions. Is the debate about it over? Not quite.” Reads like a sermon to me.

But let’s talk politics. If Garry Wills is right (and George Will is his proof point) and it follows that Republican voters who have made a religion out of hating Obamacare are the most likely to turn out and vote in the November Congressional elections, what are Democrats to do?

They have two basic choices: Continue to flounder around and try to pretend they can whistle their way past the political graveyard without defending Obama’s law or they can embrace the obvious and begin – finally – to vigorously defend the law and its impact. One of this year’s imperiled Democrats, Louisiana Sen. Mary Landrieu, has adopted Option Two.

“It’s a solid law that needs improvement,” Landrieu told the Washington Post. “My opponent [Republican Bill Cassidy] offers nothing but repeal, repeal, and repeal. And even with all the law’s setbacks, we’re seeing benefits for thousands of people in Louisiana.”

Landrieu continued, “I think the benefits that people have received are worth fighting for.” She citing an end to discrimination against preexisting conditions and extended coverage for young adults on parents’ plans. ”I think Bill Cassidy is going to be at a distinct disadvantage. He has insurance, but he’s also denying it to the 242,000 people” who would qualify if Louisiana expanded Medicaid as it can opt do under the Affordable Care Act.

Her opponent, Landrieu says, “also wants to take coverage away from tens of thousands who have gotten it for the first time.”

There is an old adage in politics that holds “being for something is better than being against something.” Democrats don’t have a choice. They can try to campaign this year by being for a law that admittedly is very controversial and almost universally misunderstood, but that is also of obvious advantage to millions of Americans or they sink again into the defensive crouch they have largely adopted since that smiling day back in March 2010.

Republicans are agin’ it. We know that for certain. Yet, voters must be just as confused about where Republicans stand on issues – providing health care for millions of uninsured, expanding Medicaid, keeping young folks on their parents insurance plans longer and providing coverage for preexisting conditions – as they are confused about what is and isn’t part of the controversial law. This is ground, as Sen. Landrieu suggests, for a real election year debate.

Democrats may not win a religious fight this year over Obamacare, but they won’t even have a chance unless they start throwing a few punches rather than trying to absorb those the other side will continue throwing. Defending a law that more than eight million Americans have embraced and that holds out the hope for a much improved quality of life for millions more seems like something worth fighting for because it really is better to be for something than against everything.

Many Republicans of the generation that created Social Security never came to fully embrace the program, but time, events and public opinion overtook them. Franklin Roosevelt, the father of modern American politics, loved to taunt his opponents by asking them what they would do differently and whether they had an alternative. Those are still good questions.