Did the System Actually Work?

by John Lawrence

There is a lot of snickering – and even more relief – going around in the wake of the failure of the long running Republican “repeal and replace” Obamacare farce. After seven years of pledging instantaneous repeal, Senate Republicans were exposed as clueless gasbags on health (as well as on deficit reduction, tax “reform,” immigration reform, and a host of other grandiose but unfulfilled promises).

The relief may be premature. McConnell could resurrect a health bill at any point up until January, 2019, with the current Senate. And the next Congress could be worse because of the disproportionate exposure of Senate Democrats facing re-election. Drop a couple of those seats without compensating by taking out a few Republicans and Mitch McConnell begins the 116th Congress even stronger than he is today.

Demoralizing as the health care debate has been of late, two observations provide some measure of optimism. In a somewhat perverse, distorted and infuriating way, the failure of Trumpcare illustrates a success for the American political system as it was designed 230 years ago. A multi-layered system with divided powers and checks and balances provided the time needed to expose the flaws and implications of a poorly conceived idea. Moreover, the collapse of the Republican plan illustrated that even in this era of super PACs, 501c3s and hyper-partisanship, enraged and engaged voters were able to rise up and influence (and occasionally intimidate) their elected leaders. It’s not a model of government efficiency, but it actually worked.

Lamentations about the failures of Congress as an institution are nothing new. “Congress,” declared George Galloway, is “an oxcart in the age of the atom,” hopelessly incapable of functioning efficiently within the modern world. It is worth recalling that Galloway’s obituary for the First Branch of government was written in 1946. Political scientists and historians, not to mention columnists and the general public, have generally agreed. Sen. Joseph Clark (D-PA) labeled Congress the “sapless branch” in 1965, and Tom Mann and Norm Ornstein coined the term “the broken branch” nearly a half-century later.

Unquestionably, there is a lot about Congress that doesn’t work, which makes it even more important to make note of when the system functions as intended. To balance a competition of views that they knew would be inevitable (even more so in an 18th century legislature that lacked permanent parties to impose discipline), the Founders created a multi-tiered system of entities with distinct but also overlapping functions to check each other, slowing the process of law-making, ensuring the rights of the minority and in doing so, compelling compromise. At least, that was the general idea.

What happened to the Republican health scare is that it fell prey to the delays, accountability and criticism that the Founders intended would prevent popular but ill-conceived proposals from swiftly becoming law. True, the design of the House may encourage such ill-conceived lawmaking on occasion because its members, due to their two-year terms, are constantly accountable to constituents. That is why the Senate, with terms three times longer, was described by George Washington as the saucer that cools the hot tea of the House, slowing down the momentum, empowering the minority time to compel debates, compromise, and even CBO scores (OK, that arose slightly after Washington’s time.)

Sen. Shelley Moore Capito of black lung-ravaged, opioid-overwhelmed West Virginia heard from constituents who would be devastated by a “yes” vote on McConnell’s travesty. “My position on this issue is driven by its impact on West Virginians,” she declared. “With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.” Ditto for Lisa Murkowski in Alaska and Susan Collins in Maine. They also undoubtedly heard from Republican governors who warned them of the cataclysm awaiting their states should expanded Medicaid be rescinded.

The collapse of the Republican strategy also illustrates that despite all the fundraisers and commercials, hit pieces and targeted attacks; the power of the grassroots was again affirmed. Yes, the opposition of the American Medical Association played a role, as well as AARP and other health care organizations. But so did individual citizens, and groups of constituents, who wrote the letters and emails, made the phone calls, signed petitions and attended (or demanded) town halls and public discussion with their elected officials. At their core, representatives and senators are people who need approval (and enjoy admiration); they do not enjoy having to listen to a distraught parent who, in a public setting, castigates them for jeopardizing their child’s access to life-saving care.

Still, Mitch McConnell is not going to go quietly into the darkness with a well-earned besmirched reputation. He will force the Senate to vote on legislation to repeal the entire ACA, a brazen act of political petulance that would deprive 34 million Americans of health care. McConnell will, for no particularly good reason, force his conference members either to vote to rescind health insurance for millions of their constituents or to expose themselves to relentless condemnation by conservative activists who will be enraged by a vote against repeal.

Such heavy-handedness exposes McConnell’s frequent nastiness, though this time, turned against his own party colleagues. In meetings at the White House during the Obama Administration, during which party leaders would at least fake pledges of cooperation, McConnell – who often spoke last – could always be counted on to deliver a pointed and partisan rebuke of the president. One can only imagine his unspoken sentiments towards the three female senators who consigned Trumpcare to the well-deserved dustbin of history, taking with it McConnell’s reputation as a savvy floor leader.

But this is no time for celebration. Almost certainly, McConnell will try again, and the House GOP budget, revealed this week, proposes additional health care (as well as Social Security) cuts. Moreover, Trump has announced his intention to undermine the implementation of the Affordable Care Act, harkening back to Newt Gingrich’s proposal to allow Medicare to “wither on the vine.” All the more reason for health care beneficiaries and proponents to recall John Philpot Curran’s admonition in 1790, “The condition upon which God hath given liberty to man is eternal vigilance.” Public engagement and a complex legislative system served our country well this time; undoubtedly, both will be called upon in the near future.

 

 

 

 

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