DOMEocracy

hardline political news and analysis

Month: May, 2013

Will Congress Prune Back Farm Subsidies?

For much of our history, no group of Americans enjoyed a more revered status than the farmer, and especially, the farm family.   And justifiably so.  Enduring back-breaking work, enduring the uncontrollable uncertainties of weather, blight, infestation and markets, farmers borrow vast amounts of money to put seed in the ground with little assurance their financial risk and hard labor will produce a livable income at the end of the year.  And then they get to do it all over again the following year, and the year after that, continually.

Little wonder that farm families have been fleeing the farm.  In an age of jet transport and duty-free international trade agreements, the risks to farmers have been compounded rather than eased, even as consumers enjoy bountiful, and affordable, food and fiber year-round.  Little more than a century ago, 70 to 80 percent of Americans lived and worked on farms and in rural areas; today, about 2-3 percent of Americans claims to earn their income from farming.

The combination of respect for hard and precarious labor, together with the nostalgia of farming (and the foresight of the Founders in assuring that the least populated farm state would also have two senators) has yielded federal policies that provide agriculture with a unique insulation from the budgetary scrutiny and scalpels applied to most federal spending.  But tough re-examination of all farm programs is long overdue.  Many agriculture support programs have grown exponentially in costs while some of the beneficiaries do not even remotely resemble the hard-working family farmers for whom the programs were intended. As critics have said for years, a small number of farmers (or more accurately, agribusinesses and those posing as “family farmers”) have grown more adept at farming the U.S. taxpayer than their own land, if they even own land.

Few issues expose the duplicity of deficit-conscious conservatives more graphically (or expensively) than this taxpayer subsidization of the farm economy.  Like the 17-year locusts beginning to descend on the East Coast, farm legislation regularly appears every few years (usually 5), always accompanied by promises of  “reform” – if not this round, then surely in time for the next gargantuan farm bill.

What makes farm policy so stunningly hypocritical is not the ability of the agricultural industry to vacuum in tens of billions of public dollars for private profiteering, but the fact that many of those who benefit from this taxpayer largesse – in and outside Congress — are the loudest critics of government spending.  Their cause, we are told, is different because farming is an uncertain occupation susceptible to the unpredictabilities of weather, the economy, international supply, and the willingness of bankers to make loans.  All genuine risks, but hardly unique to agriculture. 

Reforming the agriculture subsidy programs has always been a challenge because farmers enjoy the protection of their senators (and representatives) who position themselves strategically on the respective Agriculture Committees and spend a career guarding the subsidies that flow to milk, cotton, sugar and other crops.  States with small populations long ago learned how to utilize their two senators and the congressional rules that protect entrenched minorities; and the various components of the agriculture community display an impressive sense of solidarity, defending benefits for each commodity because they know that an attack on one opens the barn door to a broader assault.  Western farmers not only enjoy crop insurance, commodity supports, income stabilization and other federal farm benefits, but also receive hundreds of millions (if not billions) of dollars a year in heavily subsidized irrigation water and power (used for pumping) from the government courtesy of the federal Reclamation program, often to grow crops that qualify for additional public subsidies and insurance protections.

Surely the gods of irony are having a great time listening to conservatives defend the multi-billion dollar subsidies to farmers while denouncing subsidies to help working people afford health insurance premiums.  That dichotomy adds a timely and entertaining feature to the cyclical debate over the wisdom of perpetuating the farm support programs which have cost taxpayers nearly $300 billion since 1995.  Uncle Sam supports farm income, support farm prices, support farmers when disaster hits, support farmers when they produce too much, supports farm loans – all with taxpayer money.

This year, it is possible the federal government will make record payments to farmers.  According to some reports, 2013’s payments may be the highest in 50 years, driven up because we now support not only commodity prices, but farmers’ income as well.  Taxpayers, who supposedly benefit by keeping food and fiber prices low, now pay an average of more than 60 percent to subsidize the purchase of crop insurance.  Cotton farmers, who in the West also enjoy that irrigation and power subsidy through the 1902 Reclamation Act, will soon enjoy an 80 percent subsidy.  Last year, the crop insurance program paid out more than $12 billion, all of it heavily subsidized by taxpayers.

Farm subsidies, like the federal Reclamation program in the West, are always justified by the need to protect the struggling family farmer.  But the Environmental Working Group, among the most knowledgeable critics of farm subsides, recently reported that just 10 percent of subsidized farms (not surprisingly the largest and richest operations) have received three-quarters of all subsidy payments since 1995, while over 60 percent received nothing at all.   Corporate farmers in California, in particular, long ago figured out how to circumvent the 160-acre per farm cap on operations eligible for generous water subsidies, allowing operations of tens of thousands of acres to receive heavily subsidized water under the guise of being “family farms.”  Sure, they are challenged in court, but the money and water keep flowing during the litigation, which costs a fraction of the benefits the subsidies provide. 

Fight over the cost of farm subsidies may be the latest chasm opening up within the ranks of conservatives.  Just as some deficit hawks were willing to allow sequestration to slice into Pentagon spending, some now are embracing efforts to carve up farm subsidies.  An amendment just adopted in the Senate would get tough and cut subsidies for those with an adjusted gross income over $750,000, though the super-farmers would still receive a subsidy of nearly 47 percent!  Talk about government helping the 1 percent!  (Of course, Mitt Romney, desperate to maintain support in the farm states, termed farm supports a national security program.) 

Sen. Pat Toomey (R-PA) has joined New Hampshire Democrat Jeanne Shaheen in proposing that no farmer receive more than $50,000 in premium support.  Toomey notes, “You can be among the wealthiest people in the world and you quality for a taxpayer subsidy of your crop insurance…I don’t know how that is defensible.”  Who said it is defensible, or has to be, in order to be protected in Congress?

After all, if Congress decided to support programs that actually enjoy beneficial cost ratios, we certainly wouldn’t be cutting food stamps, early education, WIC or child care, would we?  But farmers, and the businesses that support them, are politically savvy; their elected representatives sit on the right committees and defend their parochial interests to the death.  And it isn’t just farmers: agribusiness beneficiaries of federal largesse include the 15 insurance companies who sell crop insurance, receiving not only $1.3 billion a year in federal payments, but enjoying federal support if the program goes bad.   In fact the subsidies are so generous that farmers tend to over-purchase insurance, raising the cost to taxpayers to about $100 billion over the next decade.

To be fair, this is not a problem of an exclusively Republican making.  Farm subsidy programs are also vigorously defended by some Democrats from farm states, though there are a lot fewer of them.   As a party, however, Democrats have regularly put substantial changes in farm subsidies on the table as one substantial source of deficit reduction.  All of the deficit packages proffered by Rep. Chris Van Hollen (D-MD), the Democratic House leader on budget and deficit negotiations, have included serious reforms, and President Obama has similarly called for billions in savings.   Even Democrats from big farm states, like Sen. Dick Durbin (D-IL), have proposed substantial changes that reduce subsidies for the wealthiest farmers.

What is different about Republicans, and conservatives in particular, is that they are so untroubled by their hypocrisy in demanding massive cuts in key domestic policies while defending (or expanding) benefits for a small segment of the economy.  For a party that can detect the tiniest scintilla of “socialism” in any policy proposed or defended by President Obama or congressional Democrats, the shameless enthusiasm of fiscal conservatives for government to intervene directly in the farm economy in order to manipulate prices and stabilize incomes is breathtaking.

Now, I am prepared to be proven wrong, but I am pretty confident that when the dust settles, farmers will have made out just fine.  At least the big farmers.  I remember during one of the more recent farm bill “reform” efforts, Congress adopted a new program designed to provide money to farmers up front as a way of ending the need for massive emergency farm disaster appropriations.  I advised a staff colleague not to spend the “savings” because the farm interests would surely appear yet again for more emergency money when the next disaster struck.  They did. 

In fact, cutting deals with the farm community has proven to be a daunting proposition.  Years ago, liberal San Francisco Congressman Phil Burton, one of the shrewdest of all congressional dealmakers, secured support from reluctant Democratic colleagues for tobacco subsidies, but only after tobacco state Members pledged support for expansion of the nutritional assistance programs which are included in the farm legislation (and which benefit farmers by purchasing vast quantities of their production). We are still providing insurance subsidies to tobacco growers, but needless to say, those representing tobacco growers are in general not helpful on preserving the nutrition programs.  How many conservatives who line up behind their farm safety net programs never blinked when voting to slash unemployment benefits or food stamps at the depths of the recession?

A substantial responsibility for cleaning up this mess falls to the House Speaker, John A. Boehner (R-OH).  Assuming the Senate will pass a farm bill, as it did in the previous Congress, Boehner will have to exercise leadership to bring a House companion bill to the floor, pass it, and go to conference.  Boehner has been a longtime critic of farm subsidies, and, if memory serves me right, has never voted for a farm bill in nearly a quarter century in the House.  In the 112th Congress, the House couldn’t even bring its committee-passed bill to the floor, let alone go to conference with the Senate bill, because Boehner knew enough Republican Tea Party conservatives would join most Democrats in supporting cost-cutting reform amendments that the farm community would oppose.  Denied the opportunity to offer those amendments by a restrictive rule, conservative Republicans would join Democrats in defeating the rule to bring the bill to the floor.

For Boehner, the problem is that he again risks looking like he cannot persuade members of the conference to come his way on a major issue with significant budget and deficit implications.  Paring back farm programs offers conservatives an alternative to raising taxes, which Boehner is loath to do, but the Speaker seems unwilling or unable, at least up to this point, to exert the kind of influence a Speaker must in order to persuade a recalcitrant caucus to follow his lead.  Pushing recalcitrant colleagues to make tough but necessary decisions, as Nancy Pelosi had to do throughout her four years as Speaker (including George Bush’s TARP legislation) doesn’t appear to be part of Boehner’s managerial style.  As he recently told Politico, “I don’t need to be out there beating the drum every day… It doesn’t need the heavy hand of the speaker all over everything.”  Actually, as one who was there in the Speaker’s office for 4 years, yes, it does. 

If Boehner fails again, and substantial farm reforms are not achieved, we will likely witness continued costly subsidization of counterproductive behavior on behalf of wealthy individuals who do not deserve taxpayer subsidies.  In fact, farmers’ net income last year was the second highest in three decades, over $80,000 a year, more than 25 percent above the average non-farm income.   Sure, that is an average, and many farmers are barely scraping by.  Fine.  Let’s help those rural families stay on the land and in business, and if it means a little socialization of the rural economy, no real damage is done to the sacredness of private enterprise. 

But maybe agribusiness and its congressional defenders can also help out single working mothers, low-income employees needing health insurance, and those needing extended unemployment compensation when they look to Congress for a little compassion and instead get lectures about self-sufficiency and the sacredness of the private sector.

The Power and Importance of the Arts

 Five days into the new year of 2009 – and three weeks before his first inauguration – President-elect Barack Obama came up to the Capitol Hill office of House Speaker Nancy Pelosi.  The topic was crafting the urgently-need economic recovery legislation (the “stimulus”) essential to preventing another Great Depression.  As the two leaders talked about the components to be included in the bill – tax cuts (in vain hopes of securing Republican votes), infrastructure job creation, health services, alternative energy R&D – the Speaker requested a small, but important addition: funding to prevent local arts programs from collapsing.

In a bill that was likely to cost $800 billion, the support for theater, symphonies, community arts programs, museums and the like was too infinitesimal to even merit a discussion.  Maybe $50 million.  Pelosi invoked the legacy of arts funding under the New Deal, such as the Public Works of Art project that employed artists to create scenes of America for public buildings.  In San Francisco, Pelosi mentioned, Coit Tower boasts iconic Depression-era murals paid for with federal relief dollars.  Federal aid under FDR had helped sustain a community that was starving, even by artists’ traditional standards.

Over the next few weeks, as negotiations over the final design and cost of the stimulus dragged on, Pelosi never waivered from her request that arts funding be included.  Aware of the perennial battles over the National Endowments for the Arts and Humanities because of their funding of controversial exhibitions and productions, Administration officials resisted.  They raised the memory of the “midnight basketball” provision that was used by Republicans to ridicule the 1994 crime bill, which some believe contributed decisively to the Democrats’ loss of the House later that year.  They suggested, as an alternative, a much larger amount for inclusion in the next presidential budget, an offer far from being good enough to accept.  It wasn’t that Administration negotiators opposed funding for the arts; they wanted to deny Republicans an easy target for attacking the stimulus package, which they had already announced they would oppose regardless of its provisions.  Pelosi cited compelling evidence that local theaters and museums not only provided jobs to thousands of workers in addition to those on stage, but also demonstrated that theaters and other arts venues often served as the essential anchor for neighborhood investment and revitalization.

Those familiar with the Speaker’s persistence will not be surprised:  the $50 million arts funding was included, and Republicans predictably heaped ridicule on the arts “boondoggle.”  Of course, they also opposed the entire bill, so the attack on arts funding received little attention.  The grants provided by the stimulus funding rescued dozens of community arts programs across the country, saving thousands of jobs and preserving vulnerable cultural resources that would almost certainly have disintegrated without the federal grants.

“So what?” a reader might wonder, taking a lyric out of a Kander and Ebb song from the 1960s musical Cabaret, a local production of which prompts me to write this story.  The show was performed by the reliably outstanding St. Marks Players in Washington, D.C. whose talented ensemble of actors, directors and musicians always includes budget analysts, think tankers, Hill staff and a wide variety of other astonishing amateur (and sometimes not-so-amateur) talent.  (My 17 year old was a cast member, but that’s not really the point.)

Playing to nearly full audiences through its two-weekend run, this production was Exhibit #1 of the power and value – economic, emotional and intellectual – of the arts in society, and why those $50 million were dollars well spent.  Virtually everyone in the audiences was familiar with the storyline of Cabaret, which recounts the slippage of decadent Weimer Germany into the horror of the Third Reich, viewed through the lens of a seedy Berlin nightclub and two star-crossed couples.  The power of the 40-year old show was stunning despite the comfortable familiarity of the songs and plot.  Often audiences were too shocked by the juxtaposition of the gaily singing chorus line and the eruptions of Nazi violence to remember to applaud, and even some of the cast were moved to tears by the emotion of the message.

More than one audience member speculated about the implications of the increasing vitriol and polarization so apparent in today’s politics and society.  Germans and other Europeans (my Polish grandparents included) in the 1930s could not believe the Nazi fulminations would actually overwhelm the established order and consume sophisticated, modern Europe and themselves, but they did.  Is there a contemporary lesson about the need for every citizen to confront intolerance and extremism rather than letting it run its course or assuming that rationality will always prevail?

Backstage, after the final performance, one participant reconsidered his recent thoughts of leaving the exhausting, stress-inducing world of community theatre because, he told me, the production rejuvenated his enthusiasm for the power of the arts.  Another tearfully speculated that, after years of serious health concerns, the show led him to consider formalizing his longstanding relationship with the marriage that neither Sally and Cliff, nor Fraulein Schneider and Herr Schultz could enjoy, because the show reminds us how life and love are uncertain and need to be embraced without equivocation.

Charmingly oblivious to the tumult building daily around her, flapper Sally Bowles cheerfully asks her increasingly anxious boyfriend what politics has to do with the two of them.   Here, too, is a lesson for today: however exasperating or annoying it is to deal with our political  frustrations, we are all going to live with, and be affected by, the consequences of the divisive and bitter mess that has come to embody American politics.   We can’t deceive, or drink, or flee our way out of that mess the way the characters in Cabaret futilely attempted; as the play reminds us, disengagement allows the engaged to prevail, regardless of how mean-spirited and destructive they may be.

The lesson of this single local production is to demonstrate again how the arts stimulate the thought and conversation, and even action, that are vital to our country and our communities.  Long after people have tired of the bloviating debate on the floor of Congress or the hyperbolic ravings of a talk show host (or a blogger, for that matter), the arts retain the power to create community, challenge convention, and provoke action.  They deserve the ongoing support of the politicians who are quick to seek the endorsement of artists for their causes and their candidacies.  And if those artists create troubling images or controversial messages, well, that’s show business; life can’t always be a cabaret, old chum.

One Fine Day

A completely non-political post for today — one fine day for a longtime friend and living legend, Carole King, who is being given the Library of Congress’ Gershwin Prize for Popular Song.  (I’d planned on tweeting about this, but my twitter icon got messed up and I am left resorting to DOMEocracy; but since this is a Library of Congress award, I think I am preserving the integrity of the site.

Carole’s career has spanned five decades during which her songs have been covered by over 1,000 artists.  And of course, she recorded many herself, including the groundbreaking (and recordbreaking) Tapestry which set the standard for singer-songeriters for two decades or more.

Everyone knows Tapestry and You’ve Got a Friend, but what is truly amazing about Carole’s work is its scope.  Her songs have been recorded by everyone many of the greatest names in popular music, beginning with the Shirelles (Will You Love Me Tomorrow).  In her concerts, Carole often would play what she called the “I didn’t know you wrote that!” set  — songs including Up On the Roof, Take Good Care of My Baby, Crying in the Rain, Natural Woman, Pleasant Valley Sunday, and Go Away Little Girl. 

So, congratulations Carole on a well-deserved honor from generations of fans who hum, sing and respect your incomparable contributions to music.  The Gershwin Award makes this One Fine Day for you and your tens of millions of fans around the world!

A Scandal in Benghazi?

The partisan bias in the investigation of the deaths of U.S. Ambassador Christopher Stevens and three others last September 11 in Benghazi is obvious.  As with the huge increase in the federal deficit, issues that raised nary a GOP eyebrow during the presidency of George W. Bush are fueling GOP outrage and accusations during the Obama Administration.   After all, during the Bush presidency, there were at least 11 attacks on U.S. embassies and consulates around the world, and not only did Republicans launch no investigations, they cut funding for embassy security efforts. 

Certainly, there are legitimate questions about the state of security in Benghazi and what, if anything, might have been done to prevent the loss of American personnel.

But the investigation needs to focus on a series of decisions and events that preceded the attack and the subsequent drafting (and revision) of emails and talking points.  In particular, we need to know more about how Stevens came to be in such a very vulnerable situation, in a lightly defended consulate, in a very dangerous city, on the ominous date of September 11. 

Critics are obsessed with changes made to emails and talking points by the STate Department, CIA or FBI, but such cautious editing and selection of words is essential.  Not everyone involved in the chain of writing memos or talking points might be fully informed about certain security implications as those who must approve and release them.  Extreme care is needed to safeguard U.S. personnel and allies since disclosure of information could expose and jeopardize valuable covert sources.   Prematurely revealing that the Benghazi attackers might have had connections to Ansar al-Sharia, a group with links to al- Qaeda, for example, might well have exposed how we came to know that information, to the extreme peril of informants.  One report has noted that CIA Deputy Director Michael Morrell removed references that were classified, and that the FBI was concerned exposure could undermine an ongoing investigation. Would that the CIA analysts who put together materials on the reception awaiting the Bay of Pigs invaders, the Gulf of Tonkien “attack,” or the certainty of Iraq’s possession of weapons of mass destruction had done a little more fact checking and editing. 

Not in dispute is that the situation in Benghazi was extremely perilous, and had been throughout the revolution and its aftermath.  Only a few months earlier, I had visited in Libya as part of an official congressional visit. The instability of the country, and the danger posed by multiple, well-armed militias within Tripoli, let alone elsewhere, was readily apparent.  Our delegation moved only under heavy guard even in areas under the nominal control of the central government.  There was not even a remote possibility of traveling to the eastern side of the country, where the anti-Gaddafi uprisings had begun and the authority of the central government remained extremely tenuous.  We were only allowed to stay in the country briefly, and an overnight stay, or trip outside Tripoli, were out of the question. 

Benghazi was an extremely unstable and dangerous city, lacking either a strong U.S. or Libyan government military security capacity.   In Benghazi, CIA cables note, there had already been five prior serious attacks against foreign interests by September.  Ambassador Stevens certainly was well aware of the weak security in Benghazi, having sent a telegram to the State Department in mid-August, expressing his concerns.   And while critics have focused on the decision by State not to send additional security in response to his warnings, it should be remembered that throughout the Libyan uprising and following the fall of Gaddafi, the Obama Administration wisely decided to minimize the visibility and presence of U.S. forces.  Even in Tripoli, one had the impression the armed U.S. presence was composed mostly of contractors and other non-military personnel.  

Indeed, one source suggests that a reluctance to raise the visibility of the U.S., especially in a remote site like Benghazi, may be why Ambassador Stevens reportedly declined offers for additional security forces for Libya.   As one very familiar with the country and its warring political factions, he knew that few sights could unify distrustful militias as much as the presence of U.S.  boots on the ground.  During the summer of 2012, Ambassador Stevens reportedly twice declined an offer of additional security support from Gen. Carter Ham, who headed the U.S. Africa Command, which controlled operations in Libya.  As reported by Nancy A. Youssef of McClatchy, Stevens “didn’t say why. He just turned it down.”

One of the key questions needing to be answered is why Ambassador Stevens ventured into a city he knew was highly unstable without the level of security  routinely employed by ambassadors, other diplomats and congressional delegations visiting much less volatile foreign sites.  Once in an unprotected situation, he surely knew he would vulnerable to malevolent interests who undoubtedly would learn of the presence of a U.S. ambassador, even one as highly regarded locally as Stevens.  If he was ordered into the city by higher-ups who knew security was inadequate, that’s a serious failure; if he proceeded to Benghazi knowing of the paucity of support, and without a substantial security team traveling with him, that is another matter altogether. 

Once the assault on the Ambassador’s location in Benghazi began, it is likely that rescue options were extremely limited by virtue of the small U.S. presence in the country capable of a such an operation.  Critics have focused on the apparent decision by the State Department not to send several rescuers to Benghazi.  Obama critic Gregory Hicks apparently requested that Special Operations forces be sent in to “rescue” Stevens and the others, and that F-16s be deployed against the Benghazi attackers.  But such actions would have caused the appearance of the militarization of the mission, and the result might well have been more dead Americans, and likely a lot of dead Libyans, with catastrophic implications for the role of the U.S. and NATO  in post-Gaddafi Libya.

The media and press, let alone Republicans on their perpetual mission to undercut the Obama Administration and now Secretary Clinton, desperately want to find a scandal in Benghazi, but the actual explanation of what happened is likely to disappoint any fair observer. Scrambling to write a report in the midst of chaos and following the death of a popular ambassador, it is hardly surprising that theories and explanations were tossed around, investigated, edited, and debated.  Being cautious about using terms that raise specters of terrorism by al-Qaida makes good sense, especially if doing so could compromise intelligence sources.

So, yes, let’s have the full investigation and ask all the tough questions.  Was there good reason to decline requests for additional security forces prior to the attack in Benghazi?  Was the situation in that city safe enough to permit a visit by a high profile American diplomat, and if not, who made the decision made to go anyway, particularly on such a volatile date as September 11?  And was there any practical way to extricate Stevens and others once the attack in Benghazi on September 11th had begun?  All reasonable and important questions, as compared to the hysterical search for scandal that has been the hallmark of the so-called “inquiry” thus far.

May 20, 2013

Blood Pressure Rising on Health Care Implementation

In the summer of 2011 – nearly a year and a half after President Obama signed into law the Patient Protection and Affordable Care Act (ACA) – I found myself engaged in a health care discussion with another fervent supporter of both the President and the new law.   I was on vacation in Nantucket, and not terribly interested in discussing the finer points of reimbursement differentials for regional disparities, but neither was the person with whom I was speaking.  He had a much more basic question in response to my extolling the landmark achievement: “If the law is going to do so many good things for so many people, why isn’t anybody talking about the benefits?  Where’s the message?”

 

A couple of days later, my younger son fell while ice skating (yes, in August) and managed to put a two-inch gash into his chin.  While sitting in the emergency room, a young mother brought in her newborn for a well-baby visit and was told by the receptionist, “No charge, at least, not unless they repeal the new health law.” The mother’s face looked completely blank.  No one had informed her about the cost-free well-child care visits included in the law.

 

They may not have been sold on the virtues of the health care law, but I got the message.  Returning to my Capitol Hill office, I asked our communications team to put together a brief pamphlet detailing the benefits under the ACA in effect already, and those designed to phase in over the next three years.  The resulting four page brochure was used not only by Leader Pelosi and her staff, but disseminated to all House Democrats who were being peppered with constituent inquiries and needed simple, accurate answers about the law’s provisions.

 

We are now closing in on October 1, when key implementation actions begin for the remaining provisions of the law, including the requirement that businesses and individuals purchase coverage.  And yet according to a new Kaiser poll, two-thirds of those without insurance still are without information about how the law will impact them.  Other polls put the number of befuddled beneficiaries at 3 out of 4.

 

I recently delivered the Levitt Lecture at the Eagleton Institute of Politics at Rutgers on the subject of the benefits of the ACA (@ http://www.youtube.com/watch?v=x7X4BDmWKzc&list=UUIf2Khjp8_gTGuoiBw6aBzA&index=1).  I recounted the challenges surmounted in passing the law through Congress, its key provisions, and its beneficial impact on the economy and the delivery of health care services.  I also spoke to Eagleton funders, taught a class on politics, and participated in a dinner with New Jersey health care experts, public and private, Democratic and Republican, supporters of the ACA and maybe a few doubters.  Surprisingly, the question asked at each venue was not what I had anticipated – “Why did you give up (sic) on the Public Option/Single Payer?!” – but rather,  “Why isn’t anyone talking about the good things in this law?  Where’s the message?” 

 

I wish I had a better answer.  But the fact is that with full implementation drawing closer daily, it is less a strategic or historic question than very practical concern.  People in the Administration may think they have effectively spent the last three years selling the ACA and its benefits, but if so, they are assuredly the only people I have encountered who would agree.

Effective messaging about the law was high on the agenda of congressional Democrats even before the law was passed or signed.  Many legislators felt burned by the White House’s lethargic promotion of the American Recovery and Reinvestment Act (ARRA) that President Obama had signed on February 17, 2009.   Negotiations on the stimulus established the formula for all major legislation that followed in the 111th Congress: virtually total Republican opposition, despite substantial concessions to Republicans on the size of the package and its design, which poured hundreds of billions of dollars into tax cuts rather than specific job creation efforts.  Facing GOP intransigence, Speaker Pelosi and Majority Leader Sen. Harry Reid struggled to keep on board Democrats who wanted a bigger package, including more job creation.

 

Yet almost immediately after the enactment of ARRA, Members began asking why the new Administration’s promotion of the law seemed so fainthearted.  Vice President Biden was put in charge of the effort to publicize the law’s benefits, but he seemed to lack a strong commitment from others in the White House.  As weeks went by, the grumbling began in earnest: when was the Administration going to really sell the recovery package?

 

Wary that this unsatisfactory experience might be repeated, we sought a commitment to a rigorous health care messaging effort in numerous meetings with Administration officials up to and including the President himself, even before the law was signed. Without fail, we were assured, no effort would be spared to sell the legislation.  Promises like, “You will see an effort like you have never seen before” were made to concerned legislators.  They are still waiting.

 

The White House initially promised to support an independent organization to proselytize the health care message, but it fizzled before accomplishing anything.  Senior staff were reportedly assigned to manage the selling of the new law, also with little or no apparent impact.  Others were drawn off to the expanding re-election campaign.  When I asked one senior White House aide why no one was working on selling the most important initiative of the President’s first term, I was told, “We were working on the policy and the message sort of got lost.”  My response was, “Why were the message people working on policy?”

 

Now, three years after the fact, there is growing apprehension that the October 1 date for open enrollment will arrive without legislators or the general public knowing exactly what to do.  More than half the states are contributing to the confusion by refusing to create insurance exchanges, bucking the responsibility to the federal government.  Members of Congress who faced angry (if misinformed) constituents at town hall meetings in the summer of 2009 now worry they will reappear, and in greater numbers, at their district offices asking for help with signing up for insurance coverage. Members definitely do not feel prepared to provide needed instruction.

 

The Administration assures that facilitators are being trained and will be sent to regional offices of the Department of Health and Human Services to assist in the enrollment  campaign later this year, but many Members are skeptical that will be sufficient.  A lot more than a facilitator here and there is going to be needed to respond to the barrage of complex questions Members know are heading their way.

 

Efforts have emerged to ease people through implementation, in particular Enroll America, a 501(c)(3) whose board of directors includes key players in the coalition that helped achieve enactment of the ACA including Ron Pollack of Families United and Sister Mary Carroll, who defied the Catholic bishops to support enactment during critical days of the ACA negotiations.  Representatives from the health care and insurance industries also serve on the board.  HHS Secretary Sebelius has been vocal and effective; at a House hearing, she recently decimated clueless Republican questioners who were diligently reading the alarmist (and inaccurate) accusations prepared by their staffs.  But nothing will substitute for an aggressive and persistent effort from the White House, and specifically, from the President.  Yet too often, questions about the President’s role in an ACA messaging campaign were answered with a terse, “He’s going to be giving a speech.” 

 

We all know that the detractors will be assiduously working the House and Senate floor, the op ed pages, blogs and cable shows, wagging their fingers on TV and reminding Americans that they had warned Obamacare would be problematic.  We all know the media and press will highlight the defiant “patriot” who will refuse to sign up for care and dare the government to impose a fine.  We have long known those push backs would crescendo this fall – because House Members, who go home to their districts every week, have endured them ever since the law was signed.  The question now is: will there be a persistent, concerted and sophisticated effort at marketing and education that has so far been more a promise than a plan? 

 

Or is everyone still working on policy?