The Political Costs of Obamacare

August 16th, 2016

In Unraveled, I develop the theme of the political cost of Obamacare. No–not the never-ending efforts of Republicans to repeal the ACA. Rather, what were the costs to the Democrats, and our polity at large, of forcing through this massive transformation of our society on a straight party line vote.

The Washington Post analyzes several of these “What Ifs?” in a series on President Obama’s legacy. The story begins in 2009, as his closest advisors urged him not to focus on Health Care right away.

The debate roiled Democrats, including some inside the administration, from the earliest days of the presidency. At the time, the nation remained beset by the economic turmoil sparked by the 2008 global financial meltdown, and many wondered whether health-care reform should be the top priority.

“I begged him not to do this,” former chief of staff Rahm Emanuel told a reporter in 2010, airing his preference for a hard focus on jobs and the economy even after the passage of the stimulus bill.

On Capitol Hill, many Democratic lawmakers, aides and consultants wondered — openly and not — about the political costs of the dogged pursuit of health-care reform. The costs were to be measured not only in congressional seats but in policy priorities.

However, by focusing on the ACA with majorities in both houses, the President put aside other major policy goals:

What would this mean for other major items on the Democratic agenda, ones requiring major outlays of presidential political capital? What about cap-and-trade, union “card check,” the Dream Act or the Employment Non-Discrimination Act — each one a major priority for key parts of the Democratic base?

None of those bills would pass the 111th Congress, even though for the first time in more than 40 years one party held the presidency and dominant majorities in both houses of Congress.

I distinctly remember in 2010 talks about the President turning to cap-and-trade, card check, and the Dream Act once health care was done. Didn’t happen.

As a result of the ACA, many Democrats lost their seats:

The GOP leveraged Obamacare into massive political gains, and they didn’t end with the profound Democratic losses in the 2010 midterms. By the last year of the Obama administration, his party had lost 14 Senate seats, 68 House seats, 12 governorships and hundreds of state legislative seats.

One academic paper suggested that the Obamacare vote alone cost the Democrats roughly 25 House seats — the difference between a historic landslide and two more years in the majority.

The Senate remained under Democratic control until 2015, but a Republican House majority, with an ascendant cadre of hard-line tea party conservatives unwilling to compromise, meant that Obama’s progressive agenda was a dead letter two years into his presidency.

And the rest of his presidency focuses on keeping the government funded:

Card check and cap-and-trade were out. A series of high-stakes fiscal cliffhangers were in, starting with a showdown over a potential U.S. credit default that ended in a deal forcing years of spending cuts that reined in Obama’s domestic ambitions.

Rather than take a Clintonian move to the middle, instead Obama turned to his pen and phone.

Fifteen years earlier, President Bill Clinton took his own midterm lumps and proceeded to make a centrist peace with new GOP House Speaker Newt Gingrich (Ga.), cutting deals on welfare reform, crime and other bills. With the exception of a brief and unsuccessful attempt at a fiscal “grand bargain” in 2011, Obama did not seek compromise at a Clintonian scale — the gulf between his progressive agenda and a hard-right House majority was too wide, and seemingly unbridgeable.

When he did seek to push a controversial priority though Congress — notably, seeking to expand firearm background checks — he lost. Instead, he shifted his efforts away from a branch of government he did not control to the one he did. His domestic legacy would be written in policy memos and the obscure pages of federal agency rulemakings.

The Keystone XL pipeline would not be built; power plants would emit less carbon dioxide; investment advisers would adhere to higher standards; and environmental regulators would have new authority over U.S. waterways. The Obama administration did those things by itself over the loud objections of the Republican Congress.

I’ll have an entire chapter on this theme in the book–stay tuned.