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Chuck Schumer says Democrats shouldn’t have bothered to reform health care

Today, Sen. Chuck Schumer (D-N.Y.), who among other things is in charge of messaging for the Senate’s Democrats, delivered a speech about the Democrats’ message at the National Press Club. His central theme was that Democrats must be the party that advocates for government’s role in making people’s lives better, a sentiment with which I heartily agree. But there was another part of the speech that is getting some attention, in which Schumer says that it was a mistake to pursue health care reform early in President Obama’s first term.

This isn’t an entirely novel argument; I’ve heard it here and there from other liberals. And anyone with a passing familiarity with the 100,000 or so words I’ve expended on the Affordable Care Act over the past five years (a rough guess) knows that I’ve had plenty of criticisms of the law, both substantively and politically. But this argument, particularly the way Schumer presents it, is not only incredibly weak as a matter of analysis, but also it runs in direct contradiction to the core values of both the Democratic Party and liberalism more generally.

Schumer says that rather than move to reform health care, Democrats should have spent more energy lifting up the middle class. But, you might ask, didn’t they pass a $787 billion stimulus program just a month after Obama took office, something that required overcoming a Republican filibuster? Well, sure. And didn’t they also pass the Lilly Ledbetter Fair Pay Act and student loan reform, and save the auto companies, and extend unemployment insurance, and pass a payroll tax cut? Meh, says Schumer:

After passing the stimulus, Democrats should have continued to propose middle class-oriented programs and built on the partial success of the stimulus. But unfortunately, Democrats blew the opportunity the American people gave them. We took their mandate and put all of our focus on the wrong problem – health care reform.
The plight of uninsured Americans and the hardships caused by unfair insurance company practices certainly needed to be addressed. But it wasn’t the change we were hired to make; Americans were crying out for an end to the recession, for better wages and more jobs; not for changes in their health care. This makes sense considering that 85 percent of all Americans got their health care from either the government – Medicare or Medicaid – or their employer. And if health care costs were going up, it didn’t really affect them.
The Affordable Care Act was aimed at the 36 million Americans who were uncovered. It has been reported that only a third of the uninsured are even registered to vote. In 2010, only about 40 percent of those registered voted, so even if the uninsured kept with that rate (which they likely did not) you would still only be talking about 5 percent of the electorate. To aim a huge change in mandate at such a small percentage of the electorate made no political sense. So when Democrats focused on health care, the average middle class person thought “the Democrats are not paying enough attention to me.”
Again, our health care system was riddled with unfairness and inefficiency; it was a problem desperately in need of fixing. But we would have been better able to address it if Democrats had first proposed and passed bold programs aimed at a broader swath of the middle class.
Had we started more broadly, the middle class would have been more receptive to the idea that President Obama wanted to help them; the initial faith they placed in him would have been rewarded. They would have held a more pro-government view and would have given him the permission structure to build a more pro-government coalition. Then, Democrats would have been in a better position to, eventually, tackle our nation’s health care crisis.

There’s some pretty striking cynicism in this passage — the uninsured don’t vote, so why help them? And why, exactly, did working on health care reform preclude a second stimulus? There were people advocating it at the time, people who thought the Recovery Act was too small. If only Chuck Schumer had been in the Senate back then, so he could have written such a bill and pushed for its passage. Oh wait — he was, and he didn’t.

Schumer says some other things that I’d take issue with, including this: “Neither the Obama administration nor Democrats in Congress paid much attention to the messaging of health care because we were so busy with its passage and implementation.” That’s just false. There was plenty of attention paid to messaging, it just didn’t end up working as well as it should have, for a variety of reasons. But this “Whoops, we forgot we were supposed to sell it” line is bogus.

And the idea that health care reform “wasn’t the change we were hired to make” is equally wrong. Health care reform was a huge topic of discussion in 2008, both in the primary and the general election, so much so that John McCain, who couldn’t care less about health care reform unless you could convince him we ought to invade it, felt compelled to offer his own detailed reform plan. Beyond that, it was one of the central Democratic priorities for decades, and not because the party thought it could gain an advantage in the next midterm election out of it. It was a priority because of the nightmare of the American health care system, which alone among developed countries left tens of millions of people without insurance and millions more with no guarantee of coverage. Improving the lives of millions of people — even some who don’t vote! — is supposed to be the kind of thing Democrats stand for, and the kind of thing power is supposed to be used to accomplish.

So yes, after the stimulus passed, Democrats moved on health care reform. And yes, while the benefits of things like the elimination of denials of insurance for preexisting conditions help everyone, the most immediate benefits flowed to those who were less wealthy and more vulnerable. And yes, the particular design of the ACA — a new set of benefits and regulations layered on top of an already absurdly complex private system — contained the seeds of its political weaknesses, even if that design was the only thing that could have passed. But to say that Democrats shouldn’t have bothered on the off chance that they could have passed some more stimulus and maybe minimized their losses in 2010 makes one wonder what the point of electing Democrats is.

Schumer would reply, “To help the middle class!” But when he got to the point in his speech where he was ready to offer all his terrific ideas for doing so, he punted, saying, “I’d like to outline not WHAT policies Democrats will propose but rather HOW we should build our party’s platform to appeal directly to the middle-class and convince them that government is on their side.” What followed was some mundane PR advice.

That’s something there’s no shortage of, and, to put it in Schumer’s terms, the voters didn’t hire him to dispense messaging tips. If he really wants to help his party, he ought to get moving on those middle-class proposals he keeps talking about. When do we get to see them?