Today, the House of Representatives will take up GOP Rep. Fred Upton’s proposal to “fix” Obamacare by undermining it, and the vote is being widely cast on a referendum on whether Dems will continue distancing themselves from the law. Meanwhile Senate Dems are also still considering fixes of their own that could undermine it, though that’s subsided.
A senior Democratic leadership aide tells me to “expect Dems to be largely opposed to Upton.” Let’s hope so. Either way, more Obamacare challenges may well follow.
So perhaps it’s time to step back and note this: However much Dems are right to worry the President could drag them down, the failure of the health law could damage them a whole lot more, and could badly harm the Democratic Party long term. In other words, the president may matter less than the policy.
Here’s how Politico sums up the thinking among some angry Dems:
The Obamacare debacle has been bad enough that it’s tough for Democrats to take on faith that the president can fix the problems. His one-time allies are no longer sure that it’s wise to follow him into battle, leaving Obama and his law not only vulnerable to existing critics, but open to new attacks from his own party. “I don’t know how he f—-ed this up so badly,” said one House Democrat who has been very supportive of Obama in the past.
But come on. If the president can’t fix Obamacare’s problems over the long term, then the Democrats’ political woes will be serious enough later that any maneuvering now just won’t matter. This isn’t about whether to follow Obama into battle; it’s about whether to stand up for the policy upon which Dems have staked so much.
This isn’t to minimize the anger Dems feel over the disastrous rollout, or the immediate political risk they face over it. They’re right to be angry and worried. Nor is it to say Dems should eschew messaging votes if they don’t seriously undermine the law. Dems want a vote on something; that’s understandable. Politico also reports Dem leaders may offer their own, less harmful alternative fix for them to vote on. That may work. And I agree with Brian Beutler that talk of Dem divisions is overstated and that Dems don’t seriously appear ready to jump ship yet.
But Dems need to keep it that way, and in a broad sense, going forward, this really is a gut check moment for Democrats. As Ron Brownstein notes in a must read, failure of the law could seriously undermine the party over the long term:
For decades, Democratic strategists have viewed universal health care as their best opportunity to reverse the doubt among many voters, especially whites, that government programs can tangibly benefit their families. Now the catastrophic rollout of the health law threatens instead to reinforce those doubts. That outcome could threaten Democratic priorities for years…
As the health law teeters, the stakes are so great because the struggle encapsulates each party’s core argument. It embodies the Democratic belief that society works better when risk is shared—between young and old, healthy and sick—and government intervenes in private markets to try to expand both security and opportunity. The fury of the Republican resistance reflects the party’s insistence that markets work best unfettered, that centralized government programs cannot achieve their goals, and that Democrats are unduly burdening the “makers” to support (and politically mobilize) the “takers.”
If most Americans conclude Republicans are right about the health care law, that judgment would inevitably deepen doubts about other government initiatives.
I don’t know if I’d go quite this far, but Brownstein’s overall point is important. The Upton proposal goes right at the tradeoffs and government intervention Brownstein places at the core of Obamacare. As Jonathan Cohn explains, a vote for it is a “vote for everything you hate” about the old, pre-reform system.
But this goes well beyond the Upton proposal. In a general sense, the handling of Obamacare’s rollout in the weeks ahead has the potential to be a defining moment for Democrats. Health reform has been a chief goal of Democrats for decades. It’s the latest effort to build on the great reforms that defined the party in the 20th century, in a way that will update the liberal project for the 21st. Will Dems stand by the law and against serious efforts to undermine it, even if it requires walking through political fire to do so? Hello, Dems? Remember what’s at stake here? Isn’t this worth fighting for?
* NEW YORK TIMES GOES BIG WITH OBAMACARE/KATRINA COMPARISON: The New York Times weighs in with a big story that’s bound to drive discussion, pinning the Katrina comparison directly on Obama’s handling of the botched health law rollout. It’s hard to argue with this conclusion:
The difficulties have put Mr. Obama on the defensive at exactly the moment he might have seized political advantage in a dysfunctional Washington. If not for the health care disaster, the two-week shutdown of the government last month would have been an opportunity for Mr. Obama to sharpen the contrast with Republicans. Democratic lawmakers expressed growing frustration on Thursday with the opportunities the party had missed to hammer home the ideological differences between the two parties. The lawmakers say there is intensifying anxiety within the Democratic caucus that the poor execution of the health care law could bleed into their 2014 re-election campaigns.
As understandable as the anger among Dems at Obama is, it would be folly to opt for short term political fixes that undermine the law’s long term prospects, since their fates are in many ways tied to them. As for the Katrina comparison, the competence question is certainly a serious danger to Obama, but it seems a bit premature too pronounce the law a disaster overall (though it certainly could fail over long term).
* ABOUT THE OLD HEALTH CARE SYSTEM: TPM has another great investigative look at insurance industry behavior.
* INSURERS UNLIKELY TO GO WITH OBAMA’S “FIX”: Insurance companies are now saying Obama’s proposal to allow them to continue offering plans for another year is probably too logistically hard and too administratively expensive for them to bother with:
Carl McDonald, an analyst with Citigroup, said the president’s plan created an “enormous administrative burden” for insurers and predicted many would choose not to extend coverage. “The complexity of trying to uncancel millions of canceled individual policies with only six weeks left in the year is staggering,” he wrote in a report.
Congress is unlikely to pass any legislative fix, and indeed its hard to know how much impact any such proposal would have. Which leaves us where we were before: Pretty much everything rides on whether the administration can get the damn website fixed and make the law work over time.
* BIG PICTURE MEANING OF OBAMA’S FIX: Jonathan Cohn has another must read explaining that it’s very hard to “fix” the law by minimizing disruptions to the individual market without putting the law’s reforms for those who really need them in jeopardy. Cohn also notes, crucially, that there really is a case to be made for trying to fix the law to help those who feel adverse impacts from it, but:
These are the kind of modifications that large legislation routinely needs and Obama has made clear he’s willing to discuss them. But he’ll need a willing partner — one willing, at the very least, to acknowledge the benefits that the law provides. Republicans could be the partner, but they’ve never shown such interest.
Right. The current “fix” Republicans are pushing, the Upton bill, would cripple the law.
* OBAMA’S FIX COULD THREATEN LAW OVER LONG TERM: Also, the Post has a good editorial noting that while the fix probably won’t have much of an impact, the worst case scenario is truly a troubling one, because it risks “draining the new system of enrollees it needs to function well”:
Insurers who decided to act would try to hold onto their healthiest customers — those who don’t make many claims, if any. But the Obamacare marketplaces need those relatively healthy customers. If the system struggles in its opening years, the pressure to pull the plug will only grow. This outcome is unlikely, but anything that poses a threat to the integrity of the system’s risk balancing rightly worries health-care policy experts.
* THE MEDICAID EXPANSION MATTERS, TOO: USA Today does right by devoting some attention to the good news about Obamacare, i.e., the nearly 400,000 who have been deemed eligible for Medicaid, and notes this key context:
That’s a boon for needy Americans seeking help for their health care, but an early sign the Affordable Care Act is so far more of a social welfare program than a way to get people to buy their own health insurance. Still, health experts say, their ability to get insurance could drive down everyone else’s costs.
The goal of the Affordable Care Act is to cover more people, and like it or not, the Medicaid expansion is a crucial way the law is going about it, even if the low enrollment numbers to private plans is sucking up all the attention.
* DEMS PROD GOP GOVERNORS ON MEDICAID EXPANSION: Meanwhile, the White House-allied Americans United for Change is out with a new memo recapping the policy reasons Republican governors should opt in to the Medicaid expansion. There’s no telling how much higher this would be if more GOP governors opted in. With some already doing just that, it may become harder for others to resist accommodation with this element of the law.
* AND MORE ON THE GOP ESTABLISHMENT/TEA PARTY DIVIDE: National Journal reports that conservatives are putting candidates on notice: If the GOP establishment sees you as their candidate in Senate races, because you are electable, the conservative grassroots could very well see you as a RINO. It remains unclear how deep or consequential this divide will be, but it bears watching.
It’ll be particularly interesting to see if the “establishment’s” determination to prevent hard liners from hurting the party’s political chances will result in any meaningful differences over policy, which just haven’t been visible yet (with the exception of immigration).