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What the Affordable Care Act can teach Democrats about climate-change policy

Obamacare is both a blueprint for, and a cautionary tale about, ambitious legislation.

President Biden stops to talk to the media as he drives a Ford F-150 Lightning electric truck at Ford Dearborn Development Center, Tuesday, May 18, 2021, in Dearborn, Mich.
President Biden stops to talk to the media as he drives a Ford F-150 Lightning electric truck at Ford Dearborn Development Center, Tuesday, May 18, 2021, in Dearborn, Mich. (Evan Vucci/AP)

As President Biden begins to shift from a single-minded focus on covid-19 to his broader policy agenda, promoting policies to slow climate change will be at the top of his list. Fighting global warming will be a fraught task, however, both because of the scale of the challenge and because Republicans will mount fierce political resistance — as they long have in this area.

As Biden embarks on this effort, he could learn from the successes and failures of the last Democratic attempt at a major policy overhaul: the battle for the Affordable Care Act, also known as the ACA or Obamacare. The political price Democrats paid then offers a cautionary tale now for a party that wants to enact far-reaching policies to slow global warming.

The ACA has proved to be an enduring and increasingly popular accomplishment that Republicans have been unable to undo, despite controlling Congress and the White House in 2017 and 2018. Democrats who pledged to defend the ACA also did well in the 2018 midterms. By this spring, 54 percent of Americans viewed the law favorably, according to a Kaiser Family Foundation poll, compared with 39 percent who had an unfavorable opinion. But the law’s recent popularity contrasts starkly with its standing in its early years, when it cost Democrats dearly at the polls. If Biden and Congress want to pass important climate legislation while building momentum for even bigger, more challenging action later, they should pay attention to those early stumbles.

After a contentious legislative battle, President Barack Obama signed the ACA into law in 2010. But its popularity quickly eroded: In general, from 2011 to 2015, more Americans disapproved of it than approved, according to the Kaiser Family Foundation. Researchers estimate that House Democrats who backed the ACA lost a striking 8.5 percentage points of support in the November 2010 elections relative to Democrats who did not.

The result was sweeping Republican victories at every level: Democrats surrendered control of the House with a historic loss of 63 seats and lost six Senate seats (though they retained control there). Republicans gained full control of governments in many states, including Michigan, Ohio, Pennsylvania, Tennessee and Wisconsin, giving the GOP the power to gerrymander congressional districts for the next decade. Ultimately for Democrats, passing the ACA led to the loss of the ability to advance other major proposals for years to come. The law’s main provisions weren’t implemented until 2014, but even their arrival failed to bolster the Democrats: That November, they lost nine more Senate seats and control of that chamber, along with 13 more House seats.   

So where did Obamacare’s architects go wrong — and how can the Biden administration avoid these land mines while advancing its climate agenda?

How peer pressure can help stop climate change

One clear problem was that the ACA was very complex, making extensive use of regulations that were difficult for everyday Americans to follow. Insurance companies that spent too little money on health care offered rebates to customers, for instance — but few voters knew about this; and, anyway, it wasn’t the kind of measure that attracts passionate support. The ACA’s complicated exchanges also relied on a mix of public and private insurance, which obscured the government’s role in helping people afford coverage. The law was also designed to be implemented partially by states, adding another level of complexity and creating additional sources of tension: Some states were openly hostile to the law, even pursuing litigation to repeal it.

To avoid this pitfall in the climate fight, one common-sense approach would be to push policies with straightforward mechanisms that the public can easily understand and that are harder for special interests to interfere with. One starting point is undoing the Trump administration’s moves to weaken fuel efficiency standards. What could be simpler? More fuel-efficient cars go farther on a gallon of gas and therefore emit less pollution. The transportation sector is the top source of U.S. greenhouse gas emissions, and 71 percent of Americans back tighter fuel efficiency standards, according to a May 2020 Pew Research Center poll, so this would be a great place to push hard.

Conversely, while cap-and-trade programs and carbon taxes have proved successful in reducing carbon emissions at the regional and international levels, their complexity makes them a tough sell nationwide. Democrats discovered this with a failed bill, co-sponsored by then-Reps. Henry Waxman (Calif.) and Edward J. Markey (Mass.) in 2009, that included a cap-and-trade system along with various other clean-energy policies.

Under a carbon tax, companies are charged for every unit of carbon that they emit. Under a cap-and-trade program, companies are sold or allotted permits to emit a certain amount of carbon, and they can then trade or sell the permits. Carbon pricing is an economically efficient approach, and it works. But such systems can be confusing to the public and difficult to implement. Cap-and-trade programs, for instance, often include provisions to limit price spikes and exempt specific industries. And it can be hard to convey the fairness of allowing industries to purchase “offsets” from other parties rather than just cutting their own emissions.

In such complex schemes, voters are unlikely to see any direct benefits for themselves. And as with the ACA, hammering out complicated provisions would require cooperation from a range of players, including state officials and oil companies, some of whom would fight or sabotage legislation or undermine its implementation.

Another lesson is that the ACA took things away from voters, making it less popular. One of the most enduring findings in social science is that losses sting more than gains give pleasure. The ACA canceled millions of noncompliant health insurance plans whose coverage was deemed substandard. While these were replaced with more substantive plans — a gain to many voters — what stuck with people was the “loss” of the prior plans. Additionally, those who opted to be uninsured had to pay a tax. Many aspects of the ACA had support above 60 percent in polls — including the requirements that insurers cover preexisting conditions, provide subsidies to lower-income Americans and cover preventive care. Still, the individual insurance mandate was viewed so negatively that it defined the law for millions. When a law uses sticks alongside carrots, it’s the sticks that voters are most likely to remember, the ACA experiment shows.

The Biden administration could avoid this problem by looking for policies that have positive short-term effects on people’s pocketbooks while addressing climate pollution. This could include promoting efficiency standards for appliances such as commercial dishwashers, air purifiers, lamps, faucets and shower heads. These regulations significantly reduce harmful emissions or conserve resources while saving consumers money; voters would see only an upside.  

Incentives to help communities that produce coal, oil and natural gas to transition to cleaner fuels would also be viewed positively. And expanded tax incentives for installing solar panels or purchasing electric vehicles would be more warmly received than, say, policies that raise prices for fossil fuels. Carrots, not sticks.

The third lesson from the ACA battle relates to political strategy. When the substance of a bill becomes unpopular, its advocates often cite the failure of their messaging strategy — or the success of their opponents’ talking points. For example, GOP vice-presidential nominee Sarah Palin’s use of the phrase “death panels” to describe a measure that would reimburse doctors for having discussions about end-of-life-care was thought to be particularly effective rhetoric. Left-leaning commentators, meanwhile, criticized Democrats for not highlighting the law’s benefits often enough. But public opinion formed relatively early during debates over the bill, and after that, people weren’t very responsive to different messages. In May 2010, 44 percent of Americans felt unfavorably toward the law while 41 percent supported it, margins that held steady into 2015. Simply put, public relations can’t save an unpopular policy. (The numbers didn’t turn positive for the ACA until the first year of President Donald Trump’s administration. Voters may have been galvanized by the prospect of losing the benefits the law provided.)

This means we should take initial polling on policies seriously. For example, in a summer 2019 poll conducted by The Washington Post and the Kaiser Family Foundation, 51 percent opposed a hypothetical $2 monthly tax on electric bills, suggesting that policies that impose direct costs on consumers start out at a major disadvantage.

Ditching meat isn’t the answer for climate change. Better farming is.

Biden is already doing something clever: subsuming part of his climate plan into a broader infrastructure package. The proposal includes electric-vehicle charging stations, a modernized electric grid, more energy efficient homes and expanded public transportation. By linking investments in clean technologies with popular proposals to improve roads and bridges, Biden may be blunting the polarized responses that a stand-alone climate bill might provoke.  

Addressing climate change will also require future steps that are difficult or politically challenging, including measures such as a carbon tax. Biden has said he wants 100 percent of U.S. electricity production to be carbon-free by 2035. And it’s not clear that the steps we’ve outlined here will move us quickly enough on that path. But just as the ACA didn’t solve the nation’s health-care crisis, no single piece of legislation will solve the climate crisis. And that’s especially true if, as with Obamacare, a legislative victory sweeps Republicans back into power, slamming the door shut to further action.

The ACA offers both a blueprint for and a warning about advancing ambitious legislation at a time of stark political divides. Building lasting public support for climate action will require policymakers to prioritize plans that are easy for the public to understand, to highlight those policies’ tangible benefits and to treat the political climate with as much seriousness and care as the physical climate.

The Biden administration seems to be taking some of those lessons to heart — at least so far. Its climate efforts are more likely to be successful and enduring if they continue to avoid punitive approaches and complex regulatory schemes in favor of incentives that nudge Americans toward renewable energy. That’s not a recipe for weak tea: It’s a recipe for lasting progress.

Twitter: @dhopkins1776


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