A fascinating take by Thomas Edsall in the Times about how Obamacare has pigeonholed the Democrats, and forced them to defend a law that is benefiting a small corner of their constituency, and making many others materially worse off.
The ability of the Democratic Party to convince middle-class voters that it is on their side is by no means guaranteed. In mid-November, 2008, just after Obama first won election, 55 percent of voters had a favorable view of the Democratic Party. In the immediate aftermath of the recent election,according to Gallup, the favorability rating of the Democratic Party had fallen to a record low of 36 percent.
During a September pre-election panel discussion on the continuing political repercussions of the Affordable Care Act, Charlie Cook, editor of the Cook Report, put his finger on the health care problem facing Democrats when he pointed out that the public perception of the party has been indelibly imprinted by Obamacare.
The Affordable Care Act has “framed where the Democratic Party is,” Cook said. “If I would sum up my assessment, it was huge, it did play a central role in framing everything.” By 2014, health care reform “lost a little bit of its oomph, but it still is more important in setting things up than any other issue was over the last six years.”
Although the Republicans have spent the last 6 years fighting Obamacare to the death, seeking to repeal the entire thing, Democrats have spent the same amount of time defending a fundamentally flawed law. Both sides are locked in this stalemate. While at one point, arguments about entrenchment seemed to favor Democrats, the laws sustained unpopularity (which I thought was fade) may tilt the other way.
Obamacare remains an increasing political liability.
Of the 60 Democratic senators who voted for Obamacare in 2010, 28 are no longer in office. Of course, not all of the retirements and defeats can be attributed to the advent of Obamacare, but the numbers are striking. The electoral scorecard suggests that Schumer may have less opposition than anticipated to his bid to shift the central concern of the party to more overtly economic issues.
Insofar as Democrats try to reduce hostility to Obamacare, they face two problems. The first is a Republican Party unwilling to support any legislation making the A.C.A. more palatable. The other is the danger that tinkering with any of the provisions that have provoked the strongest opposition could eviscerate the legislation. Among the provisions that have stirred opposition are the requirement that most Americans get coverage, the tax on medical devices and the excise tax on expensive, high-quality private health coverage. Removing existing provisions would require replacing lost funding with new revenue sources, which could provoke anger from multiple constituencies.
As if Democrats do not already have enough trouble, data released by the Centers for Medicare and Medicaid Services shows that many, if not most, of the seven million people who purchased insurance through the A.C.A. will either have to pay higher premiums or higher deductibles, or submit themselves to the complex process of switching plans.
More pressingly, the law certainly helps a small percentage of people, makes more worse off.
A Brookings Institution analysis of the winners and losers from Obamacare found that the program redistributes costs to the top 80 percent of the income distribution in order to provide benefits to the bottom 20 percent. The analysis, shown in Figure 1, reports that
incomes in the bottom one-fifth of the distribution will increase almost 6 percent; those in the bottom one-tenth of the distribution will rise more than 7 percent. These estimated gains represent averages. Most people already have insurance coverage that will be left largely unaffected by reform. Those who gain subsidized insurance will see bigger percentage gains in their income.
Could it be that Obamacare breaks the demographics strategy?
Even though midterm elections favor Republicans, the 2014 results show middle- and working-class dissatisfaction with the Democratic Party rising to dangerous levels, which threatens the party’s growing demographic advantages.
erhaps most notably, Republican House candidates in 2014 won 37 percentof the Hispanic vote, their highest percentage since Republicans rejected immigration reform in 2005, and a slight majority, 51-49, of Asian-American voters, who had been moving decisively in the Democrats’ favor. Asian-Americans and Hispanics are crucial to future Democratic presidential victories.
In combination with the growing Republican allegiance of whites, these trends raise the possibility that the Democratic plan for victory by demographics could implode, which would make the case for a full scale re-evaluation of its strategies and policies glaringly obvious.
Whatever you think of Senator Schumer, you begin to understand why he spoke out as forcefully as he did.
I think back, again again, to the speech President Obama gave at the Capitol Center Visitor Center the day before the House voted on the ACA, where he urged his members to vote for his because it was good policy, and good politics. As I recount in Unprecedented:
Obama had given the pep talk many times before and did not need notes. He appealed directly to those still on the fence. “Now, I still know this is a tough vote, though. I know this is a tough vote. I’ve talked to many of you individually. And I have to say that if you honestly believe in your heart of hearts, in your conscience, that this is not an improvement over the status quo . . . then you should vote no on this bill.” Yet he implored the legislators to do the right thing for America. “But if you agree that the system is not working for ordinary families, if you’ve heard the same stories that I’ve heard every- where, all across the country, then help us fix this system. Don’t do it for me. Don’t do it for Nancy Pelosi or Harry Reid. Do it for all those people out there who are struggling.”
The president also told his fellow Democrats that he thought their vote for the ACA would be pragmatic as well as principled. “I am actually confident—I’ve talked to some of you individually—that it will end up being the smart thing to do politically because I believe that good policy is good politics.” Obama’s forecast that this vote would be good politics proved inaccurate—many Democrats would lose their seats in 2010, largely owing to their ACA vote, and Nancy Pelosi would become the leader of the Democratic minority.
Obama closed with an impassioned plea. “It is in your hands. It is time to pass health care reform for America, and I am confident that you are going to do it tomorrow.” The president left the podium to a rousing round of applause.
Obamacare, born in acrimony, and bred in divisiveness, may go down in history as one of the most narrow-sighted political blunders of the 21st century. No one, on either side is happy with it. Chuck Schumer and Tom Harkin are finally speaking out. I suspect others will join soon. As I wrote in the Epilogue of Unprecedented:
For now, we are stuck with a rushed, incomplete version of a law that was never meant to be the final bill. And with the bloody political battle behind us, it is unlikely that any bipartisan support can be mustered to fix this “bug.” Although President Obama is proud that historians will call the ACA “Obamacare” and refer to it as his “legacy,” I think we should let history decide its fate.
This will be fodder for many more books to come.