The Paul Ryan quote from “Face the Nation” on Sunday so appealed to the speaker’s press office that it became the headline of a Monday morning press release. Referring to Obamacare, Ryan said, “We made a promise to the people who elected us, we would repeal and replace this law. … And now we are keeping our word.”
Promises made, promises kept. It sounds so inspiring. But for all the political pride in adhering to campaign promises, what usually matters far more to the voters are their personal priorities rather than those of politicians.
That was the mistake that Barack Obama and the Democrats made with the Affordable Care Act.
In his book on the early days of the Obama administration, “The Promise,” Jonathan Alter reminds us that the 44th president made the decision to press health care despite the objections of his top advisers. The key moment came when Obama told a small group of aides, “Life’s unpredictable and we’re all living on borrowed time. Let’s figure out how to get [health care] done.”
In truth, it was the Democratic congressional majority that was living on borrowed time. When Obamacare passed in 2010, the nation was still reeling from the worst economic downturn since the Depression. Too many Americans saw the legislation as a symbol that the Democrats in Washington cared more about their historical achievements than the voters’ economic pain.
It is rare when the same set of issues dominates two off-year congressional elections in a row. Until Obamacare devastated the Democrats in 2010 and 2014, the only post-war parallel was the way that the GOP championed law-and-order and took advantage of the white backlash against civil rights in 1966 and 1970.
Now health care could be poised for a record-setting three-peat. While political predictions have the shelf life of a Donald Trump tweet, it is easy to invent a scenario in which the Republicans pay a political price for repeal and replace in 2018.
Part of it is the same problem that Obama faced in 2010 — most voters are content with their current health coverage.
A national CNN-ORC poll, conducted earlier this month, found that 78 percent of Americans are satisfied with the quality of their health care and 68 percent give a thumbs up to the their health insurance coverage. And, despite all the scare headlines and political rhetoric, 46 percent are even satisfied with their personal health care costs.
For most voters, the debate over repeal and replace is about other people because they themselves are not currently troubled by their health care coverage. Sure, most Republicans revile Obamacare, but it remains largely an abstraction like the trade deficit and the national debt.
Of course, anyone who depends on the Medicaid expansion or the Obamacare subsidies for their health insurance is likely to grow nervous as the legislative grim reaper threatens their benefits. Few will be soothed by Ryan’s claim, “By having the things that we’re talking about — tax credits, risk pools, health savings accounts — you dramatically increase the access to health care.”
Message to the speaker: People who are starving want food rather than a system that supposedly provides them with “access” to food.
The theory in Trump-land is that any upheaval in the insurance marketplace can be blamed on Obama’s failing program. Of course, that is merely an extension of the president’s philosophy that anything — even phantom wiretaps — can be blamed on Obama.
The enduring truth is that everything that happens during a president’s term of office is part of his legacy. It was John F. Kennedy who vowed to put a man on the moon, but it was Richard Nixon who spoke to the astronauts on the lunar surface. Trump himself reflected this when he gleefully took credit for the continuation of the Obama recovery as the economy added 235,000 jobs last month.
So too with health care.
Ryan can insist all he wants that “Obamacare is collapsing. If we just did nothing, washed our hands of the situation, we would see a further collapse of the health insurance markets.” But voters know that the Republicans control the levers of government — and it will defy logic to blame the potential chaos and pain from repeal and replace on Obama and Nancy Pelosi.
Counterintuitively, the best political outcome for the Republicans may be the swift failure of the health care legislation in the House. Conservative Arkansas Sen. Tom Cotton got it right when he said Sunday, “I would say to my friends in the House of Representatives … do not walk the plank and vote for a bill that cannot pass the Senate and then have to face the consequences of that vote.”
Ryan may get some blame for failing to hold his fractious Republican majority together. But GOP legislators should offer sighs of relief if they can avoid voting on a bill that is both Obamacare Lite and a policy disaster, slashing benefits and leaving an additional 14 million people uninsured in 2018, according to the Congressional Budget Office.
Legislative sequencing matters. George W. Bush might have passed immigration reform in 2005 if he did not get sidetracked with a foolhardy attempt at Social Security privatization. In my view, the Democratic Party would be in stronger shape at the moment if Obama had made the 2012 election a referendum on a health care plan that he would have tried to pass in 2013.
If Trump ever has a reflective moment, he might muse about his missed opportunity to start his presidency by challenging the Democrats to support a bold infrastructure plan. Instead, the president allowed Ryan and the congressional Republicans to try to keep their campaign promises — no matter what the voters wanted.
Roll Call columnist Walter Shapiro is a veteran of Politics Daily, USA Today, Time, Newsweek and the Washington Post. His book on his con-man great-uncle was just published: “Hustling Hitler: The Jewish Vaudevillian Who Fooled the Fuhrer.” Follow him on Twitter @MrWalterShapiro.