Here’s some good news: The Republicans are in disarray, especially over repealing Obamacare.
Liberals and progressives often assume that the GOP has its act together. In fact, they are looking pretty disorganized and incompetent right now. It is always dangerous to underestimate your opponent. So we should still be wary of Trump and the Republicans in Congress. Their intentions are bad. Most of them don’t care whether people suffer as a result of their actions.
Even so, after six years of demonizing Obamacare and demanding its repeal, the Republicans still haven’t figured out how to do it without inflicting huge political damage on themselves, because so many people in GOP districts and states now rely on Obamacare.
Republicans know what they’re against (taxes, regulations, helping the poor, and government in general) but they often don’t know what they’re for. President-elect Donald Trump campaigned on repealing and replacing Obamacare, but has no idea what he wants and it appears that his close advisors haven’t got a clue either. Trump’s idea of a policy proposal is a 140-character tweet. Health care is complicated and complicated is not Trump’s strong suit.
Representative Tom Price of Georgia, Trump’s nominee for Secretary of Health and Human Services, filed several bills to repeal Obamacare, but Republicans (especially in the Senate) recognize that his plan would be political suicide for many of their re-election chances. The major health care lobby groups — the physicians, the insurance industry, the hospitals — weren’t big fans of Obamacare, but they’ve learned to live with it and even profit from it. They’ve warned the Republicans that wholesale repeal would cause long-lasting harm to their industries as well as to the American people.
Many governors, including some Republican governors, recognize that repeal would be devastating in their states. They would lose hundreds of millions of federal dollars. Repeal would throw too many people under the bus. A report by the Urban Institute estimates that 956,000 people in Pennsylvania and one million each in Georgia and North Carolina could lose coverage. Many of them voted for Trump. Nationwide, 56% of those who would lose coverage are white and 80% have less than a college degree.
So the Republicans are stymied. Trump, Senate Majority Leader Mitch McConnell, and House Speaker Paul Ryan can’t seem to agree on what to do. All it takes is three Republican Senators to kill repeal. The New York Times has identified Susan Collins, Lamar Alexander, Bob Corker, John McCain, and even Rand Paul as potential defectors. Of course, it would help if the Democrats had a clear inside/outside strategy. Inside Congress, they can maneuver to delay a vote and try to recruit just three Republicans to join them. But equally important is having an outside strategy that includes mobilization and public relations.
During the battle for health care reform in 2009 and 2010, Health Care for America Now — a foundation-funded coalition of community, consumer, and labor groups — played a key role in mobilizing everyday people to challenge the insurance and drug companies who were lobbying against common sense reform. When it looked like reform was dead in Congress, HCAN helped revive it by organizing protests at the headquarters of major insurance companies and at the homes of insurance company CEOs. They generated lots of media coverage. This helped the victims of our health care system get their voices heard. After Obamacare passed in 2010, HCAN was dismantled. But now that the Republicans are trying to turn back the clock, we need a group like HCAN more than ever.
Thanks to Obamacare, over 20 million Americans now have insurance who didn’t have it before. Many more have better coverage as a result of Obamacare. Ironically, Obama was a terrible salesman for Obamacare.
So now it is up to the Democrats — and their allies among unions and grassroots community organizing groups, Planned Parenthood, and others, as well as their friends in the media and even within the health care industry — to do the selling job necessary to change the narrative and thwart the Republicans. They need to find ways to change the debate by getting people who have benefited from Obamacare — the middle class as well as the poor, especially those in Republican states and districts — to tell their stories in TV and radio ads, on TV shows, in newspaper stories and op-eds columns, at local town meetings, at City Councils, in churches and union halls, via radio talk shows and at public forums and rallies.
The message needs to be simple and easy to understand: “Repealing Obamacare would destroy my family’s health and bankrupt us.” And, “Without Obamacare, my patients would suffer enormous hardship.” And, “I couldn’t get insurance before Obamacare and couldn’t afford the medication I need. Now my diabetes/cancer/heart condition is under control.”
The Republicans have no response to this. They are the party of “no.” They can’t agree on what they want to replace Obamacare because they don’t really believe in government or in governing.
The battle to save or repeal Obamacare will be a dress rehearsal for future battles. If the Democrats can stop Trump and the Congressional Republicans from delivering on their big campaign promise to kill Obamacare, they will gain momentum for other fights over Supreme Court nominees, dismantling environmental and consumer protections, lowering taxes for the super-rich, defunding Planned Parenthood, and many others. This is a critical moment for the Democrats. Can they take advantage of the Republicans’ division and disarray?
They can’t just depend on Senator Chuck Schumer and Rep. Nancy Pelosi to lead them out of the political wilderness. They need to link arms with grassroots groups around the country to build a movement to protect Obamacare. They can acknowledge that it isn’t perfect but point out that saving Obamacare is a necessary defensive move before they can improve it. If they can take back the Senate in 2018 and the White House in 2020, they can take the next steps to get closer to universal and affordable health care, primarily by reigning in the power and profits of the insurance and drug companies.
Trump lost the popular vote. His favorability ratings are the lowest of any president-elect since polling began. He can’t get along with the Republicans in Congress, who can’t agree with each other. His pledge to repeal Obamacare will create enormous suffering among millions of Americans who voted for him. This is a perfect storm for the Democrats to hand Trump a big defeat soon after he takes office. Let’s hope they don’t blow it.
Peter Dreier is professor of politics and chair of the Urban and Environmental Policy Department at Occidental College. His most recent book is The 100 Greatest Americans of the 20th Century: A Social Justice Hall of Fame.