Representatives had a chance to work together to improve parts of the Affordable Care Act that needed improving and jettison elements that were not working. Had they done that, they would have improved the lives of the American people, improved their own standing with voters, and improved the image of Congress itself. Instead, just enough Republicans banded together to pass a bill that has little chance of becoming law. Republicans wanted to head into recess saying “we repealed Obamacare” — regardless of the relative accuracy of the statement and regardless of the potential policy implications.
The ability to claim political victory was more important than actually accomplishing anything, much less accomplishing anything productive. This is unfortunate.
After two attempts to reshape our health care system that never even made it to a vote, Republicans narrowly passed a bill that the independent office that measures the fiscal and social impact of policy did not review and that many legislators did not read. (I worked on the Affordable Care Act — both my boss and I read the bill; he carried his marked-up copy to town hall meetings, and my marked-up copy is in a box in my basement).
After their failed fixes, Republicans could have said “we have made our political points, let’s get to work on those things we agree on, see if we can find ways to agree on other pieces, and keep disagreeing about bigger issues.” This approach would have improved the lives of the American people, would have demonstrated to voters that Congress can in fact work, and would have allowed partisans to remain publicly partisan as many of their voters want them to be.
Good PR: A lot of Americans see political disagreement as a bad thing. They view partisan attacks as theater, and view public debate as failure. As political scientists John Hibbing and Elizabeth Theiss-Morse write, “A surprising number of Americans feel dismissive about such core features of democratic government as deliberation, compromise and decision-making by elected, accountable officials.” Those feelings can be forgiven when most of what voters hear from Washington is why it’s the other team’s fault that everything in America is broken. An approach focusing on fixing the fixable, discussing the potentially fixable, and leaving the rest alone, would not demand that partisans abandon partisanship — those who support a single-payer system could still advocate for a single-payer system and those who want a complete free-market could still advocate for that.
Because people disagree about big things doesn’t mean they can’t agree about little things at the same time. Members of Congress agreeing where they can and disagreeing where they must prove to voters that elected officials are effective problem solvers and also strong value-driven partisans.
Good for democracy: The U.S. House and Senate are arguably the greatest deliberative governing institutions ever invented. The debates have always been raucous and rude, and passions have often run high. But more often than not, Congress worked. That has not been the case in recent years. The anger and spite, the mocking chants and cheap shots, have helped create a vicious circle in which problem solving is so far from the norm that some lawmakers have set up a Problem Solvers Caucus within Congress. Congress is supposed to be a problem solving body; that we need a subgroup just focused on solving the problems because the larger body has abandoned that most basic task is as clear a sign as you can get that something is wrong. By focusing on what many can agree on, Congress can start to reverse the trend of failure and (hopefully) start a virtuous cycle in which Congress lives up to its promise.
Instead, Congress passed a bill that will almost certainly never become law. If a version of the bill passes the Senate (a big if) then the House and Senate will have to craft a compromise bill that can then pass both bodies (a much bigger if). The President is sadly irrelevant. Trump clearly has no understanding of health care (beyond marveling at how complicated health care is, he recently praised Australia’s single payer system as better than America’s; the man just wants to declare victory and doesn’t seem to much care what that victory is).
The vote will allow Republicans to say they voted to repeal and replace Obamacare without having to take responsibility for actually having done anything. Even if this version of the bill becomes law, many of the difficult decisions will be punted to the states, which are unlikely to adopt many of the policies. If I were really cynical, I would suggest that House Republicans are banking on Americans not knowing how their own government works — they may be counting on voters thinking the House vote changed policy, and since the core elements of the Affordable Care Act are popular, voters will attribute those popular elements to House Republicans rather than President Obama (or Congressional Republicans in the 1990s, or the long list of others who have suggested the policies).
I have been in a lot of senior political conversations. I would bet my car the following phrases were used to get the last hold-out Republican House votes: “The president needs a win,” “We’ve been telling voters we’d repeal Obamacare for a decade, if we don’t pass something they will rightly have our heads,” “They’ll fix it in the Senate,” and “We’ll you give cover back home — the President rewards his friends and won’t hesitate to attack people who cross him.” Phrases that almost certainly were not heard include: “What’s the best policy option?” “Let’s work with Democrats on some easy fixes,” and “Let’s wait for everyone to have a chance to read and think about the bill and get some outside analysis.”
If I were running for office I would seize the opportunity handed me by House Republicans. Voters want leaders with strong values who solve problems. So I would talk about values (everyone should have quality, affordable health care) and propose policy solutions (streamline the ACA, adopt some of the many of the proposals kicking around). Voters don’t like politics, so I would not talk about politics. If I’m tired of hearing about health care politics — and wow I am tired of hearing about health care politics — I can only imagine how the rest of America feels.
My unsolicited advice to Congress is to fix what you can while you continue to posture where you must. My unsolicited invitation to candidates if Congress doesn’t take my advice — give me a call.