Pinkerton — Lessons from the GOP’s Obamacare Fail: Republicans Were Long on ‘Repeal’ and Short on ‘Replace’

First of Three Parts

The Power of Party Politics  

Every high school athletic coach says it for a reason—because it’s true: “There’s no ‘I’ in ‘team.’”  That is, in team sports, each individual, no matter how talented, must work in harmony with the rest of the team; otherwise, the team won’t win.

We might add that the same point applies to another kind of team sport: politics.  There’s no “I” in “party.”  It’s the team, the party, that matters most.  So each party member who wants to win must work cooperatively, so that the team can win.

In politics, without the team as a whole, each team member has nothing; they’re just scattered individuals, alone and weak.  So that’s the choice: Work together and hope to win, or fall part and be sure to lose.

We might recall that back during the American Revolution, Ben Franklin described the choice that the American patriots faced: “We must all hang together,” Franklin quipped grimly, “or we will hang separately.”

Today, happily, the situation for Republicans isn’t anywhere near as dire.  And yet still, as another American Revolutionary patriot, Tom Paine, once put it, “These are times that try men’s souls.”

In particular, the headlines coming from the healthcare debacle in the wee hours of Friday morning are across-the-board discouraging to Team GOP.  On the left, New York Times columnist David Leonhardt headlined his piece: “Phew: The Health Bill Fails.”  And on the right, The Washington Examiner’s Philip Klein reluctantly bannered his story, “Obamacare is safe.”

And somewhere in the vague liberal middle, speaking for the D.C. Beltway, Politico’s “Playbook” offered its own capitalization-happy take: “HEALTH CARE BILL GOES UP IN FLAMES.”

Surveying the wreckage, Republican rank-and-filers might be tempted to break ranks and abandon the team.  And since party affiliation is voluntary, there’s nothing stopping anyone from giving up.  Nothing, that is, except the prospect of a guaranteed victory for the other team.  

So that’s why most Republicans, including activists, will stick around; they feel that they have to do so, to advance what they believe in, and to thwart what they don’t believe in.  Such common interests are what keep parties, together.

Sentiment Is Not a Strategy

Yet at the same time, team members deserve the best possible leadership, including the best possible strategy.  And we can surely agree on this: While individual Republicans fought hard, and while Republican tactics were aggressive, the overall Republican strategy on health care was weak.

Yes, Republicans have long been united in opposition to Obamacare, but opposition is a sentiment—it’s not a strategy.

With the benefit of hindsight, we can see that Republicans were never together—were never operating as a team—to pursue an effective anti-Obamacare vision.  Most glaringly, the GOP was long on “repeal” and short on “replace,” even as the country clearly expected both repeal and replace.  As Reason magazine’s Peter Suderman tweeted in the wake of the health bill crack-up:

No repeal. No replace. No skinny repeal. Despite years of promises, Republicans had no shared health policy goals, and it showed.

— Peter Suderman (@petersuderman) July 28, 2017

The American people could see that the GOP knew what it was against, but not what it was for.  And in politics, like team sports, you need a defense, as well as an offense.  That is, you need to be able to defend your own plan, not just attack the other guy’s plan.

In particular, over the last seven years—since Barack Obama signed the Patient Protection and Affordable Care Act into law on March 23, 2010—the conservative and libertarian intelligentsia needed to come up with a persuasive Republican narrative for the healthcare issue, including a competent defense of the GOP alternative.  And that narrative couldn’t just be, Our plan is not as bad as you think.  It had to be, Our replacement plan is better!

And as we all just saw, the critical vulnerability for Obamacare repealers was the issue of the uninsured; all those Congressional Budget Office studies purporting to show that 20 or 30 million Americans would lose their health insurance were wounding, and they went mostly unanswered.  Faced with devastating math, the strong attackers of past years became the weak defenders this year.

In the witty yet wistful words of the Galen Institute’s Doug Badger, “‘Repeal and replace’ made Republicans electoral Supermen; ‘pre-existing conditions’ were their kryptonite.”

The Lost Child—and a Lost Teachable Moment

So what could Republicans have done differently in the healthcare debate?  Well, for one thing, they could have reclaimed the mantle of “compassionate conservatism.”

For example, Republicans could have highlighted the tragic case of little Charlie Gard, the desperately sick British infant who became the object of worldwide attention and compassion after the British government’s National Health Service (NHS) chose to write him off.  Here in the U.S., his case could have been a “teachable moment” for the GOP.

We can see that Baby Charlie was the chosen victim of what’s euphemistically called an “end of life decision-making process”—or what might also be called a “death panel.”  That latter phrase, of course, was the evocative coinage, back in 2009, of Sarah Palin.  As she put it eight years ago:

Healthcare by definition involves life and death decisions.  Human rights and human dignity must be at the center of any health care discussion.

Palin, herself the mother of a special-needs child, understood full well that if the government were ever to gain control of health care, “death panels” could easily be part of the equation.  Indeed, in the UK, under the bureaucratic management of the NHS, it’s been estimated that 29 percent of all hospital deaths occur under the dicta of “care pathways” which are, in fact, non-care pathways.  They could also be defined as “death panels.”

This year, many pro-life conservatives, including Republican Members of Congress, took up Charlie Gard’s case, seeking to bring him to the U.S., hopefully to get better medical attention.  (Charlie died on July 28; just a few days before what would have been his first birthday.)

Still, Charlie’s case led some to ask: What about American children with a similar plight?  Were medically needy kids in the U.S. going to get that sort of humane attention under the Republican healthcare approach?  If so, that would have been a good thing to highlight; it would have given the Republican effort the sort of kinder, gentler sheen that it was conspicuously lacking.

In the absence of such a positive and large-hearted vision—the ennobling spirit that Richard Nixon once called  “the lift of a driving dream”—the Republican rationale for the repeal effort seemed to be little more than a glum expression of duty, the need to offer a sacrifice to some austere god of bean-counting.  The 2017 GOP message could be boiled down to, “We promised, and so we have to do this.”  As Sen. Bob Corker of Tennessee said of the wearying healthcare vote-slog on July 25, “The mood is nothing.  It’s perfunctory.”

We can observe that it’s right and proper for a party to attempt to keep its promises. Yet at the same time, the voters have a right to change their collective mind, as new concerns, such as the opioid epidemic, demand new responses.

Indeed, over the last six months, out in Middle America, public opinion polls showed support for Obamacare rising to record levels, and the polls also showed that by a 2:1 margin, or even 4:1, people didn’t like what the Republicans were trying to do.

Meanwhile, media-savvy opposition to the GOP healthcare effort mushroomed; every day, it seemed, a significant constituency group came out visibly and noisily against the Republicans.  Indeed, on the news every night, it was opponents, not supporters, who were thronging around Republican lawmakers in the Capitol.  Of course, one should never discount media bias as a factor in making the left look strong, but the plain fact was that on health care, activists for the left team out-played the right team.

Indeed, in light of all this strenuous activism, it’s amazing that the Senate Republicans held together as well as they did.  As a matter of fact, it’s a tribute to their “coach,” Senate Majority Leader Mitch McConnell, that only three GOP Senators—Susan Collins, John McCain, and Lisa Murkowski—peeled off.

It had been clear for months that a dozen or more Republican Senators would have been happy if the Obamacare issue had just gone away.  Yet even so, almost all of them stuck with McConnell, out of loyalty to him and to the team.  And after the team fell just short of a majority on Friday, McConnell laid it out:

What we tried to accomplish for the American people was the right thing for the country and our only regret tonight is that we didn’t achieve what we had hoped to accomplish.  It’s time to move on.

Yes, it’s time to move on.  The wise coach is always mindful that there’s more than one game in a season, and so he doesn’t wear out all his players in the first outing.  McConnell gave it his best effort—nobody shirked, that’s for sure.  In the words of The Washington Post’s Paige Winfield Cunningham:

McConnell’s chief aim was to show he’d tried his darndest to pass an Obamacare repeal bill, that is something the leader appears to have accomplished.

Yet now, having tried his darndest, Coach McConnell had to think about the next game, and the game after that, and the rest of the season.  He called it a day on health care, not because he likes losing, but because he likes winning.  So, in other words, give the team a chance to recuperate, and pull together with an eye toward  the next win.

Because one thing seems painfully clear enough: The public as a whole doesn’t want to see a victory for anything close to the current Republican healthcare plan.  A Reuters/Ipsos poll, taken after the Senate vote, found that 64 percent of Americans said they wanted to keep Obamacare either “entirely as is” or else see only tweaks in “problem areas.”  Indeed, we might note that since January, support for Obamacare has jumped ten points.

Reuters further added, only 29 percent of Americans wanted Congressional Republicans to continue their current healthcare course.

Needless to say, some might wish to reject this poll as “fake news,” but it seems evident that most lawmakers, in both parties, accept its general outlines.

The Democrats, having been crouched down for the past six months in the political equivalent of a “prevent defense,” are now looking to make a deal.

In fact, within an hour of the defeat of the healthcare bill, the top Democrat on the Senate Finance Committee, Ron Wyden, had tweeted out his oft-expressed willingness to parley with the Republicans on health care and other issues.  And the next day, July 29, came this headline in The Hill: “Dems pivot to offering Obamacare improvements.”

On the other side of the aisle, in the face of such offers, it will be hard for Republicans to refuse the opportunity to at least explore health improvements.  Indeed, pragmatic operators such as  Sen. Bill Cassidy of Louisiana and Rep. Tom Cole of Oklahoma are already in active bipartisan-negotiation mode; it’s a safe bet that they’ll be joined by many other GOPers, eager to carve out a better deals for their constituents.

Yes, now that the repeal-siege has been lifted, the majority of lawmakers will resume doing what they most enjoy: wheeling and dealing.  So, is this a victory for “The Swamp”?  Perhaps.  But it could also be a victory for better health care.

Of course, not everyone seems to favor the idea of Congress being Congress.

Most notably, at the other end of Pennsylvania Avenue, President Trump doesn’t seem to be on board with any such pivot to dealmaking.  Over the weekend, in a flurry of tweets, he criticized the methods of McConnell’s Republican Senate team; he even went so far to assert that “they look fools” for not “nuking” the legislative filibuster—something McConnell has conspicuously refused to consider.  As Trump put it:

Don’t give up Republican Senators, the World is watching: Repeal & Replace…and go to 51 votes (nuke option), get Cross State Lines & more.

Some will note, of course, that the immediate issue on health care had nothing to do with the filibuster.  Under the arcane “reconciliation” rules—which could not include the issue of insurance sales in any case—all McConnell needed was 51 votes—and yet even so, he couldn’t hit that number.  (Even the best Congressional coaches often find themselves using the phrase “herding cats.”)

In fact, the filibuster, as is stands, has deep support from many conservatives.  Breitbart News’ Joel Pollak, to name one, has politely but firmly defended the filibuster on both political and constitutional grounds.

At the same time, a former top aide to Mitch McConnell, Josh Holmes, was decidedly less polite in his response to the President’s tweets; Holmes tweeted that the White House should “search for the idiot who keeps putting the President on irrelevant and counterproductive crusades.”  Ouch!

We might add that any time a well-connected former Hill aide ventures forth in such a bold manner, onlookers will speculate if that aide is acting at the behest of his former boss.

If that were to be the case here, then Holmes’ tweet might be seen as a sort of brushback pitch, aimed at the White House.

Indeed, all those who work at 1600 Pennsylvania Avenue might do well to remember that Congress, if it chooses to assert itself, has more clout than does the President.  Indeed, a clue about clout is right there in the Constitution: The powers of the legislative branch are delineated in Article One, while the powers of the executive branch are listed in Article Two.  As they say in D.C., the President proposes, and Congress disposes.

With that in mind, it might be worth noting another tweet from Holmes, calling attention to a quote from him that appeared in The Washington Post after the vote.  Offering advice on next steps for handling the healthcare issue, Holmes was blunt:

Quarantine it … You can let it destroy your entire agenda and your entire party as a result of inaction by continuing to dwell on something that, frankly, they’ve proven unable to do.

In other words, Holmes was saying the same thing that McConnell had said a few hours earlier: It’s time to move on.

To be sure, such advice will not sit well with every Republican—including, seemingly, the President.  Or is that a premature reading of Trump’s ultimate intentions?  After all, the President prides himself on his flexibility, even unpredictability.

So were 45’s tweets over the weekend a signal that he truly wants another round on health care?  Or were they just the blowing off of some presidential steam, in anticipation of a shift to other agenda items?

We’ll take a look at those questions in the next installment.