“Victory has a hundred fathers, but defeat is an orphan.”
Although that quote often is attributed to the late President John F. Kennedy concerning the 1961 Bay of Pigs fiasco, the better 20th century source probably was Count Gian Galeazzo Ciano, Foreign Minister of Fascist Italy from 1936-1943, who also was the son-in-law of Benito Mussolini. (That, too, didn’t end well, I’m told… so listen up Jared).
Clik here to view.
Senate Majority Leader Mitch McConnell (L) and Senate Majority Whip John Cornyn (R) speak to reporters at the White House following meeting with U.S. President Donald Trump and Senate Republicans on healthcare in Washington, U.S., June 27, 2017. REUTERS/Kevin Lamarque
It looks like the bandwagon (make that a party bus) for Hill Republicans’ parade to overturn Obamacare developed a few more empty seats yesterday, as a mounting number of senators jumped off and others checked out the exit door location. Senate Majority Leader Mitch McConnell was forced to pull last week’s hastily crafted Better Care Reconciliation Act from immediate consideration. As several of Henry VIII’s wives might have remarked, “That sure didn’t take long!”
Lacking the 50 Republican votes even to approve a motion to proceed, it was time to recheck the airline departure times for the upcoming July 4th recess. Repeal and Replace once again faced Fight or Flight, and soon retreated back to Delay and Depart.
A combination of “get me rewrite!” desperation and nearly $200 billion in extra savings under CBO’s ten-year scoring window (aka walkin’ around money to buy votes) still may not be enough to straddle the deepening divide among Senate, and then House, Republicans. There are less than forty shopping days (weekends included) before the next drop-dead date for the August recess. Political dismay springs eternal. So, class, what have we learned so far today, and this year, about health care politics?
- It’s always far easier to play prevent defense in resisting health policy change. See, e.g. Republican playbooks circa 1993-1994 and 2009-2016. Overturning permanent law that has been implemented and embedded for multiple years, no matter how badly it operates, is a daunting task — even if you know what you are doing.
- Republicans failed to update their scouting reports and game plans since the fall of 2013, when the rollout of healthcare.gov suffered from online frostbite. But far more subtly, they underestimated the lingering fear factors throughout the country after the combined effects of the Great Recession, modest economic growth, sticky wages, and reduced social mobility. Selling hypothetical freedom to millions of “vincibles” grasping primarily for a semblance of security just didn’t click. Too many personal clocks were striking Darkness at Noon rather than Morning in America. Hill Republicans were warned, but they persisted.
- If you don’t aspire to offer people something better and actually attempt it — while instead seeming to be taking away portions of what they may complain about but actually have — loss aversion always will trump vacuous promises to be great again.
- Arguing that existing entitlements are too generous and unsustainable always is hard. It’s even harder in the absence of imminent fiscal crises, stronger efforts to pay for them now rather than later, or more visible crowd out of competing claims.
- Fundamental flaws in basic political strategy involved both failing to divide the opposition and failing to unify potential supporters around a more centralized, positive theme. Although successful political visions usually require either stronger lenses or more powerful hallucinogenics, getting the division and multiplication functions backward produced more subtraction than addition.
- Republicans neither identified nor activated enough political losers under Obamacare (self-perceived or real) in order to prevail.
- Using budgetary reconciliation as a tool for ambitious policy change is frustratingly limited. With thin political voting margins and limited time on the clock, it might be the only route open, but unrealistic expectations collided with inadequate tools. Republicans may have promised to throw long touchdown bombs downfield but they ended up backpedaling and then tossing out short screen passes deep in their own territory.
- Republicans received minimal credit with the broader public for trying to end the individual and employer mandates and (in the House bill) extending individual insurance market subsidies to other groups that were left behind by Obamacare’s highly income-sensitive ones.
- Aside from some enhanced campaign contributions, Republican also got little if any popular payoff from trying to eliminate all of the Affordable Care Act’s taxes. (Did former speaker Boehner even thank them for ending the tanning tax?) Health industry groups that would have seen eliminated their “kickback” tax contributions under the ACA simply pocketed those gains and moved ahead with complaints that coverage subsidies from which they also benefit still might be trimmed.
And those are just some of the basic political miscalculations that have at least some Republican officeholders staring into the abyss this year. To do better, proponents of change that, eventually, might produce a better, more accountable, and sustainable set of health care options and operating rules should rethink much more before they reload. That might require recognizing some mistaken assumptions so that we can at least develop and try out some newer ones. Ahead soon, in part II.
The post Part I: I’ve seen more appeared first on American Enterprise Institute - AEI.