PINKERTON: Trumpcare — The New Fight over Obamacare in the Era of Economic Nationalism


First in a series…

Everyone knew that Obamacare wouldn’t be repealed without a fight—and everyone was right. But how rough of a rumble will it be?  That’s the real question.


In his first hours in office, President Donald Trump signed an executive order easing the strictures of Obamacare (officially, the Affordable Care Act).  Trump’s executive action, of course, is a prelude to keeping his promise to repeal Obamacare and replace it with something better.  Indeed, virtually all Republicans in Congress are eager to join him in that effort, even if virtually all Democrats are strongly opposed.  And so we can see the battle lines being drawn.

Actually, to be sure, the battle began years ago.  Back in 2008, Barack Obama ran on a platform that included national health insurance, which, he promised, would cut the average family’s annual healthcare costs by $2500.  Yet once in office, that promise proved impossible to keep.  The 44th president signed the Affordable Care Act into law on March 23, 2010, and yet the nirvana of universal quality coverage at lower prices has never materialized.  Indeed, according to the Kaiser Family Foundation, the average cost of family insurance premiums has risen from $13,375 in 2009 to $18,142 in 2016.  In other words, what was advertised to be a substantial cut in family costs turned out to be a 35 percent increase.

Given these and other fiascoes, the fact that some 20 million Americans did, in fact, gain health insurance because of Obamacare was blanked out by the larger voter fury—fury over higher taxes and costs, intrusive mandates, abhorrent policy specifics, and, of course, incompetent websites.

And so as we all know, the Democrats bled enormously over Obamacare; they lost the House in 2010, and the Senate in 2014.  For their part, Democrats are well aware of the damage done.  As Sen. Chuck Schumer (D-NY), the new minority leader in the Senate, said in the wake of the 2014 midterms, his party “blew the opportunity that the American people gave them” in 2008 by focusing on health insurance, as opposed to trying to raise middle-class incomes. 

Yet today, all those hard feelings have passed.  The memories of midterm slaughters are, one might say, blood under the bridge.  Today, for Democrats, the new mantra is “Defend Obamacare!”  And if we stipulate that the primary goal of Washington politicians is to beat the other party, we can see why: The Democrats, minority that they now are, finally have an easy job. 

That is, when they were playing offense on Obamacare a half-decade ago, Democrats re-learned an old lesson, borrowed from military history; namely, that being on the offensive is hard, because your side takes heavy casualties against entrenched defenders—in that instance, the Republicans.  Defenders always have the easier task.  And so now, today, the Democrats hope, the situation is finally reversed: The anti-Obamacare Republicans are attacking, and the pro-Obamacare Democrats are defending. 

On January 2, an important Democratic strategy document for this new era was published in—where else?—The New York Times.  In that opinion piece, headlined, “To Stop Trump, Democrats Can Learn From the Tea Party,” three Democratic activists, all former Congressional staffers during the Obamacare fight, recalled the effectiveness of conservative and libertarian Tea Party activists in upsetting, and nearly derailing, the progress of the health-insurance legislation.  As early as February 2009, they remembered, “Small protests calling themselves ‘tea parties’ were popping up all over the country.” And then in April, “Tax Day demonstrations dominated the news.” And then in August, they noted, “Routine hometown events got unexpectedly rough for [Democratic] members of Congress.” 

Looking back on those years, the authors express a kind of grudging admiration for the Tea Partiers: 

Their tactics weren’t fancy: They just showed up on their own home turf, and they just said no.  Here’s the crazy thing: It worked.

We can say that it wasn’t crazy at all that the Tea Partiers were effective.  Politicians care intensely what their constituents think, and they pay especially close attention to activists who can get in the media—or make their own media.  So sure, the Tea Party was successful: To cite just one metric, not a single Republican, in either chamber, voted for Obamacare. 

Still, as we all know, Tea Party valor didn’t ultimately stop the legislation.  And yet, as we have seen, the Democrats paid a huge political price; the party today, having hemorrhaged so badly, is just a wilted wisp of what it was eight years ago.  

And now the Democrats aim to make Republicans, in turn, pay a similar huge price as they seek to undo Obamacare.  To that end, the Times authors debuted a new how-to manual: “Indivisible: A Practical Guide to Resisting the Trump Agenda.”

In explaining their determination to mirror Tea Party tactics, the writers were careful to insert plenty of liberal buzzwords, all aimed at soothing any reluctance on the left to imitate the Tea Partiers:

It takes a few pages from the Tea Party playbook, focusing on its strategic choices and tactics, while dispensing with its viciousness.  It’s the Tea Party inverted: locally driven advocacy built on inclusion, fairness and respect. It’s playing defense, not to obstruct, but to protect.

And they closed with the words, “Together, we can resist.” We might observe that “resistance” has become, in fact, the favored word of the Trump-era left. 

Since then, we’ve seen some of the results of this new lefty spirit of resistance.  On January 14, Rep. Mike Coffman (R-Colo.), who represents suburban Denver, was holding normal “office hours” for his constituents in Aurora; typically, such sessions involve a dozen or so citizens ambling in to complain about lost Social Security checks or to talk about getting a son or daughter into one of the service academies.  And yet this time, 100 or more people showed up, mostly to protest loudly against possible cuts in Obamacare and other government health-insurance programs, such as Medicare.  Was it all a set-up?  The political equivalent of an ambush?  Quite possibly, and yet the result was exactly what the authors of the Indivisible guide had in mind.  The story was big news in Denver, and big news nationally.  From their point of view, that’s a mission: accomplished.  

And then, of course, there was the huge January 21 women’s march on Washington.  And of course, the Main Stream Media was cheerleading and crowd-building every step of the way; it chose to lionize the marchers, both in Washington and around the country

In the meantime, clever bits of counter-programming from the right—such as this video on the foul language used by many of the celebrity speakers at the march, put together by The Washington Free Beacon—have received no MSM attention.  

To be sure, there’s nothing new here: The MSM has always opposed Republicans, and Trump is no exception, even as journos have now become, as they like to say, still more “oppositional.” 

So the question is whether or not professional Democrats, aided by the MSM, can stoke up powerful public antagonism to changes in Obamacare.  As of now, that’s an unknown unknown, but we do know this much: They’re going to try their darndest.  

Hence this January 23 headline in The New York Times: “Angry Democrats Study the Tea Party’s Playbook.”  The report detailed a meeting of donors and operatives convened at a posh resort in Aventura, Florida, by David Brock, the right-wing hit-man turned left-wing hit man.  Brock has said in the past that he wants to create a Koch Brothers-type network for the left, to, as he said, “kick Donald Trump’s ass.”  And, indeed, he has already started hiring people in order to, as he pledges, “create a Breitbart for the left.”

We’ll have to see about all that, but in the meantime, we might pause over this quote, in the Times story, from Democratic veteran James Carville, surveying the state of political play.  Speaking scornfully about Republican efforts against Obamacare, Carville said, “You can see this healthcare thing just unraveling right in front of them.” 

Carville, of course, knows plenty about a party unraveling over healthcare.  After all, he was a key player in the Clinton administration when it tried to enact its own healthcare plan in the early 1990s.  And for their trouble, the Democrats lost big in the 1994 midterms.  Obviously Carville’s hope is that the same thing will now happen to the Republicans in the 2018 midterms.   

To sum up his point, Carville told the Times, “The mover on healthcare loses.” He added grimly, “To do something is to lose.”  

That’s an interesting argument that Carville is making.  He is saying that to make a policy change on healthcare, any which way, is to fall into a trap.  And so here we see the same point about offense vs. defense in politics: The offense usually takes the heaviest casualties, even if, in the end, it prevails.   So Democrats hope to make the GOP bleed over changes in healthcare in the Trump presidency, just as they bled under presidents Clinton and Obama. 

Will that happen?  Will the GOP be staggered in the ’18 midterms the way the Democrats were in ’94, ’10, and ’14?  The future is impossible to predict, but this much we know for sure: The Republicans will have to be ver-r-r-y careful.  

To illustrate this point, we might examine some recent polling data.  According to Nate Silver’s FiveThirtyEight, support for Obamacare has always been well below 50 percent.  Okay, so that explains the Democrats’ troubles over the issue, which were still evident, even in the 2016 elections.  

And yet at the same time, support for certain portions of the legislation was, and is, strong.  Per a November survey from the Kaiser Family Foundation, a mostly centrist outfit, a full 85 percent of Americans support guaranteeing that young people under age 26 can stay on their parents’ health insurance policies, and 69 percent support guaranteeing health insurance for those with pre-existing conditions (such people, by the way, account for 27 percent of the US population). 

Thus a certain hesitancy has crept into the national consciousness on health insurance.  People don’t like Obamacare, but they’re also not sure that they wish to see a change in Obamacare—at least not a drastic change.  Carville had a point.  

So yes, the American people are indeed cross-pressured: CNN found, for example, that in Grant County, Nebraska, population 641, a whopping 93 percent of the voters pulled the lever for Donald Trump last year, and yet, at the same time, a full third of the county’s under-65 population has signed up for health insurance through the Obamacare exchanges.  So it would seem that there are a fair number of voters who are simultaneously pro-Trump and pro-Obamacare, at least parts of it. 

In fact, a January poll released by the same Kaiser outfit found that three-fourths of Americans don’t wish to see the law changed, or at least not changed until a satisfactory immediate alternative is put forward.  More precisely, according to that survey, 48 percent of Americans say that the law should not be repealed, period, and another 27 percent say it should not be repealed until a good replacement model is found.  Meanwhile, just 20 percent of Americans wish to see immediate repeal, with the replacement model (if any) to come later.

Of course, the GOP motto all along has been mindful of that that public-opinion reality.  Thus the familiar phrase, “Repeal and Replace.”  And soon—perhaps very soon—the Americans will get a look at what the Trump administration and the Republicans in Congress have in mind.  

As we wait to see its details, we might linger over the wisdom of Edmund Burke, the great 18th century conservative, writing in his 1790 classic, Reflections on the Revolution in France

The nature of man is intricate; the objects of society are of the greatest possible complexity; and therefore no simple disposition of direction of power can be suitable either to man’s nature or to the quality of his affairs.  When I hear the simplicity of contrivance aimed at and boasted of in any new political constitutions, I am at no loss to decide that the artificers are grossly ignorant of their trade, or totally negligent of their duty.

Burke was no enemy of progress; he believed that prudent and deliberative action could, indeed, improve the human condition.  And yet for him, the key words were prudent and deliberative.  

So let’s hope that we soon see the the best of prudence and deliberation, because otherwise, there’s the real potential for political bloodshed. 

Next: The New Republican Party in the Era of Trumpcare 


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