After the 2016 election, Republicans figured that they could have a bill repealing Obamacare on President Trump's desk by inauguration day. Nine months later they still haven't done it.
If you're a Democrat, this is all pretty fun to watch. Schadenfreude is a hell of a drug. But politics is cyclical, and one of these days, Democrats are going to be back in the majority, trying to pass their own big piece of legislation. Maybe it's a single-payer health care plan, or a progressive re-write of the tax code, or something else entirely.
When that happens, we don't want what just happened to the GOP to happen to us. So we should take a look at why exactly the GOP couldn't get their act together, and try and learn from their mistakes instead of just laughing at them.
There are a number of lessons we could draw from the GOP’s legislative faceplant.
For example:
"Don't make impossible promises to the American people, because someday you'll be asked to keep them."
Or:
"Don't try and use parliamentary tricks to railroad through an awful bill in the name of 'getting a win,' because some of your members might actually care about the dignity of the legislative process."
These are good lessons, but I want to focus on what we can learn from the actions of Senator Rand Paul.
Rand Paul teaches us that, in a democracy, you can refuse to compromise and stand for unyielding ideological purity, or you can get stuff done, but you can't do both.
"Who is Rand Paul?"
Paul is a hard-core libertarian who is famous for refusing to compromise on his core beliefs about the evils of big government and the virtue of freedom and individual responsibility.
The GOP needed 50 votes in the Senate to pass any repeal effort, and they only have 52 seats. Since Sens. Susan Collins and Lisa Murkowski have been skeptical of repealing the ACA in general, Paul's vote was extremely important. But he opposed almost all of the GOP's repeal efforts, because, in his mind, they didn't go far enough: they didn't repeal all of Obamacare.
In July he announced his opposition to the GOP's "Health care Freedom Act," forcing Mitch McConnell to cancel the vote to pass it, and go back to the drawing board. The best McConnell could come with was the so-called "skinny repeal" which Paul reluctantly backed, but which John McCain famously torpedoed.
In September he did it again, announcing his opposition to the new "Graham-Cassidy" repeal bill because it was, of course, insufficiently conservative. Along with the help of John McCain and Susan Collins, that was enough to sink this last-ditch effort at repeal.
Conservatives Refuse to Compromise on Health Care and Liberals Rejoice
If you’re a liberal who likes the idea of universal health insurance coverage, then you're most likely thrilled about what Paul did. Multiple times, the GOP were inches away from rolling back President Obama’s signature legislative achievement, and taking away healthcare from millions of Americans. The Democrats didn’t have the votes to stop them but, fortunately, the ACA was spared by a small group of GOP defectors: Susan Collins, Lisa Murkowski, John McCain, and...Rand Paul.
These four Republicans, joined forces with 46 Democrats and two independents to save Obamacare. Huzzah! From my liberal perspective, I don’t care why Paul voted against repealing Obamacare. He could say he voted against it because he only supports legislation printed on polka-dot paper for all I care. When it comes to actions, he cast the same vote as Bernie Sanders, Elizabeth Warren, and Kamala Harris.
If Rand Paul is making someone like me happy, then he must have screwed up somewhere.
But this isn't the first time refusal to compromise has killed a major health care bill.
Liberals Refuse to Compromise on Health Care and Conservatives Rejoice
Obamacare was a "big 'effing deal" when it passed in 2009, but it didn't need to be. America could have had (nearly) universal health insurance coverage back in 1971. That was when President Nixon proposed the "Comprehensive Health Care Plan," which would:
- Require employers to buy health insurance for their workers,
- Provide subsides to unemployed and low-income Americans to help purchase insurance
- Expand Medicare to offer more benefits to older Americans
This is a Republican President remember. And Democrats controlled both the House and Senate.
But liberal Democrats rejected Nixon's plan. They wanted to hold out for a single-payer system, and, like Rand Paul, felt that Nixon's plan didn't go far enough. They thought that if they stood firm they wouldn't have to compromise, and could pass the single-payer bill they really wanted.
Of course they were wrong. They missed their shot and had to wait almost 40 years to just pass a bill that isn't that different from what Nixon proposed in 1971. And we're still waiting on single-payer.
But liberal Democrats rejected Nixon's plan. They wanted to hold out for a single-payer system, and, like Rand Paul, felt that Nixon's plan didn't go far enough. They thought that if they stood firm they wouldn't have to compromise, and could pass the single-payer bill they really wanted.
Of course they were wrong. They missed their shot and had to wait almost 40 years to just pass a bill that isn't that different from what Nixon proposed in 1971. And we're still waiting on single-payer.
Later, Senator Ted Kennedy said that walking away from Nixon's deal was one of the biggest mistakes of his life.
You can bet that the conservative Republicans of 1971 were just as giddy as Democrats are today. Each side was saved by the other side's dogged commitment to ideological purity.
What About Next Time?
Single payer wasn't popular enough to pass in 1971, but it's popularity has been rising since the GOP started trying to dismantle Obamacare. It's possible that by the time the Democrats are back in control of Congress, passing a single-payer health care plan might actually be a feasible goal.
But if a single-payer bill ever passes, you can trust it will be messy. It won't look anything like the "Medicare for all" bill the Senator Bernie Sanders just proposed. When you know your bill won't become law, you can make it as pure and unrealistic as you want, and people in your party will vote for it to "send a message."
This is what the GOP Congress was doing when they voted 50-odd times to repeal some or all of Obamacare - knowing that there was no chance these bills would ever be passed.
The GOP has learned, of course, that things get a lot harder when you're playing with live ammo. All of a sudden people actually care about what the bill will, do, how much it will cost, and what sorts of unintended consequences it might produce. And you can bet that something as big as a single payer bill is going to spawn a bunch of tough questions, like:
"How do we pay for it?"
and
"What do we do about the 500,000 or so Americans who currently work in the private health insurance industry?"
If and when the time comes to actually do something about single-payer, a lot of liberal Democrats who were all happy to vote for a piece of political theater are going to disagree with one another about how to answer these and other questions. The only way to resolve these disagreements is with a bill that nobody is completely satisfied with.
That's actually how Democracy is supposed to work. We all disagree about politics, so if one group or faction got everything they wanted, then everyone else would be miserable. Think about how you would feel if someone like Trump (or Mitch McConnell, or Rand Paul) could pass a bill that was exactly what they wanted, without having to compromise at all.
Fortunately, the American system of government is specifically set up to make it almost impossible for that to happen. But the price we pay for forcing Trump, McConnell and Paul to compromise is that we also have to compromise if we want to do anything ourselves. That's just how it works.
The Art of Negotiation
The point here isn't that we should immediately compromise any time there's a tough legislative battle. Having principles and standards is obviously important, and if you cave at the first sign of resistance, or take the first offer put on the table, then your ideological opponents are going to walk all over you.
The trick is to know when refusing to compromise might actually get you a better deal, and when it just makes your enemies give each other high-fives. You're never going to get exactly what you want, but the art of negotiation is knowing how close you can get without shooting yourself in the foot.
Democrats in the 1970s and Republicans in 2017 both screwed this up.
Rand Paul wanted the Obamacare repeal bill to be a lot more conservative, but some simple math should have told him that there was no way that was ever going to happen. In the Senate, the GOP could only afford two Republican "no" votes to pass a bill, but there were already three Republican Senators - Susan Collins, Lisa Murkowski, and Dean Heller- who opposed the GOP's earlier attempt to repeal the ACA because it was too conservative - and even that bill was not conservative enough for Paul. It should have been obvious to Paul that any bill which was conservative enough for him would never get enough moderates GOP votes to pass.
In the 1970s the Democrats forgot that, as we've already said, politics is cyclical. The early 1970s were a high watermark for economic liberalism and concerns about inequality in America, and a conservative reaction was just around the corner.
A good rule of thumb in American politics is that if your side is ever doing really well, you should assume that bad times are just around the corner. So think really hard before you say, "I'll bet we can get an even better deal in a year or two."
Laws and Sausages
The Affordable Care Act itself was a good example of how a balance of compromise and principle is needed to get stuff done.The ACA did a lot of good, but as a piece of legislation, it was pretty ugly. It was almost sunk by a moronic typo, and the bill was filled with lots of shady kickbacks and earmarks written to bribe specific Senators into voting "yea," since the Democrats couldn't afford to lose any votes in the Senate. It also didn't include a "public option" which liberals Democrats, like Bernie Sanders, were clamoring for. If he wanted to, Sanders could have been like Rand Paul and "stood firm," refusing to vote for any bill that didn't contain a public option, which would have killed the ACA.
But he didn't.
When it came time to actually vote on the flawed, imperfect, kickback-filled, no-public-opinion ACA, Bernie Sanders voted "yea," He compromised. And that's why Obamacare exists today.
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