The upside of the epic failure of the Senate to pass any semblance of repealing and reforming the Affordable Care Act (ACA) is that it highlights three structural impediments to achieving not only health care insurance reform, but most of the Trump agenda as well.
1. Misalignment of Interest
The first problem is realigning Congress’ interests with voters’. It is especially important as a general principle that Congress abide by the laws it passes — a principle that was egregiously violated in the case of Obamacare.
Nothing exerts influence on members like their spouse and staff. Americans who want to see repeal must tell the Trump administration to undo the Obama Administration’s 2013 illegal exemptions and subsidies which shielded members and staffers from the effects of Obamacare. If Congress wants relief for members and their staff — most of whom are either exempt from the law or else enjoy heavy subsidies unavailable to ordinary Americans — then Congress should get it at the same time as everyone else on the exchanges, and under the same terms.
2. Abuse of Senate Rules
The second challenge concerns the reason legislation so often passes the House but then dies without a vote in the Senate. The Senate must eliminate the Senate’s incumbent protection racket, where deliberation on legislation is avoided to spare Senators — of both parties — tough votes.
For the last 30 odd years, the once pro forma “motion to proceed to consider,” which moves legislation onto the floor for debate and a vote, has been routinely misused by the minority. Legislation in the Senate is supposed to require only 51 votes to pass, except in rare cases. Moreover, the two bracketing filibusters, which create the 60-vote threshold — the first requiring 60 votes to start debate on legislation, the second requiring 60 votes to stop debate and move to a vote — once demanded that Senators be physically present on the floor.
Now a Senator can prevent debate on legislation without having to be present at all — while at an out-of-town fundraiser, for instance, or by having his or her staffer phone it in. How convenient — and unconstitutional. Our founders wanted some checks on majority rule, but they did not want the minority to be able to obstruct the will of the people by fiat.
GOP Senators who argue for preserving the filibuster say that when Democrats return to the majority, Republicans will be defenseless. But Harry Reid went on record in 2016 stating that if the Democrats win the Senate and the presidency, they will change the Senate rules to prevent minority obstruction and return to majority rule. So much for any rationale for holding on to this anti-democratic rule.
If voters and donors want to see legislation get a hearing and a vote in the Senate — unlimited and undistorted by reconciliation, which has made getting even 51 votes so difficult — they need to let their Senators know that preserving this self-imposed procedure is unacceptable. If Senators don’t feel up to taking tough votes on the administration’s agenda, they should find another line of work.
If Sen. McConnell still won’t amend the rules and restore the proper functioning of the Senate, making it once again “the world’s greatest deliberative body,” then Vice President Pence, the President of the Senate, should take the lead.
3. Political and Policy Malpractice
The third obstacle is the massive failure of the Right to sell its ideas. In the battle for hearts and minds on Obamacare repeal, for instance, a quick survey of news reports shows that since May, at least 11 groups — including the Democratic Senatorial Campaign Committee, the Democratic National Committee, and Save My Care — have targeted at least 16 GOP Senators and 24 states. On the Right? All you hear are crickets, except for kudos to the American Action Network and the Congressional Leadership Fund, which educated about and advocated for the American Health Care Act.
Why? A cynical explanation is that the GOP is much like a union – for all the high principle on policy invoked to donors, it runs first and foremost to defend its hefty dues-paying members and grow their ranks — from redistricting to fundraising to campaigns. Issues become mere tools used to elect politicians, rather than using politicians as tools to win on issues. That may help explain why over $30 million was spent trying (unsuccessfully) to defend Sen. Luther Strange in a primary, while nothing was spent to clarify and defend Graham Cassidy in the Senate.
A more charitable explanation is that Republicans believe that they try their best to defend repeal and replace, and as is typical, they just failed to build a case and effectively persuade. Republicans are notorious for focusing on dry, inscrutable numbers — recall Jeb Bush’s “4 Percent Economic Growth” mantra — and failing to counter the narrative of the Left or explain how their policies benefit people.
The only conclusion is that Republicans either don’t believe in persuasion or don’t know how to do it.
At Independent Women’s Forum and Independent Women’s Voice we know better. For instance, in Wisconsin in 2016 (and again more recently in Georgia-06), simply talking about health care reform differently — then measuring attitudes against a real-time control group of 40,000 households — yielded statistically significant shifts in issue knowledge and preference. Without advocating for any candidate, we nonetheless saw corollary double-digit shifts in candidate favorability and voting preference as compared to a comparable control group. That translated into over 200,000 more votes for Sen. Johnson and President Trump in Wisconsin than they would have otherwise received.
Anyone paying attention during the last 10 years knows that effective campaigns can and do change public opinion. It is political malpractice, to say nothing of violating fiduciary obligations to donors, for conservative and GOP organizations to spend all their resources on getting people elected and then provide no effective support in backing the very issues that won them those elections.
If conservative donors and voters wish to achieve policy wins, they need to hold their political, policy, and messaging professionals accountable. If the professional persuaders fail to persuade the public, then they need to step aside. And if the politicians won’t put their obligations to the Constitution and their constituents ahead of their own interests, then donors and voters should find others who will.
Ms. Higgins is CEO of Independent Women’s Voice and runs the Repeal & Reform coalition.