Disgruntled (if not former) Democrats Pat Caddell and Doug Schoen are the latest to join in offering advice to President Obama and Congressional Democrats to abandon their health reform quest before it causes catastrophic damage to the party. Caddell and Schoen close their Washington Post article with the following warning: “Unless the Democrats fundamentally change their approach, they will produce not just a march of folly but also run the risk of unmitigated disaster in November.”
The case Caddell and Schoen make parallels the one made the previous day by Karl Rove in the Wall Street Journal, and that is made daily by a parade of Republican pollsters and lawmakers: The Democrats’ health reform plan is wildly and deeply unpopular, mirroring the unpopularity of Washington and big government. If it passes, it will result in a huge political backlash, especially if Democrats use reconciliation, which Caddell and Schoen call manipulation and liken to the “nuclear option” that Senate Republicans threatened during the Bush administration. For Rove, the use of reconciliation will open the way for Republicans to use the same technique to repeal health plan when they recapture the majority.
We fundamentally disagree; the surest path to political debacle for Democrats is to fail to enact health reform, and the best way to avoid a rout in November is to show that the party in charge can actually govern. The reconciliation process is entirely appropriate for amending the Senate-passed bill; in any case, the public will judge the Democrats on the basis of the results, not the inside-baseball process. In fact, the Democrats most reluctant to support health reform–those from more conservative, Republican-leaning districts and states–are the ones most likely to lose in November if health reform is defeated.
The obvious first antecedent to examine is 1994. Democrats went into the midterm elections after a presidential contest in which they grasped the full reins of power in Washington for the first time in a dozen years. Early momentum disappeared when first President Bill Clinton’s modest stimulus proposal went down in the Senate and then his deficit-reduction package staggered to the finish line after eight long months and without a single Republican vote in either house. It looked more like a setback than a victory. This was followed the next year by a lengthy struggle to enact sweeping health care reform that ended in a complete collapse, without even a vote on the Clinton plan. A shocking loss in the House on a crime bill, though ultimately reversed, reinforced the image of a president and party that could not govern competently.
What followed was a disastrous midterm for Democrats—losses of 54 seats in the House and eight in the Senate. Heading into that election season, House Minority Whip Newt Gingrich, described the Democrats’ condition bluntly: “Imagine it’s October, and the Democrats are going to get up and make the following case: ‘We’ve run the House for 40 years, we’ve run the Senate for eight years, we have the White House, and the Republicans are so much more clever than we are that they’ve obstructed us. We need you to elect more dumb Democrats so we can overcome those clever Republicans.’” Conservative Democratic Senator John Breaux, of Louisiana, echoed that point on health policy, saying, “We can blame the Republicans for filibustering, but we have the responsibility to govern.”
To be sure, there were many reasons for Democrats’ massive losses in 1994, including scandals and angry gun owners. But the failure to fulfill their responsibility for governing contributed mightily to the debacle. That was the conclusion of pollsters from both parties in the aftermath of the November contests. Two weeks after the election, Republican pollster Bill McInturff found that “one of the most important predicates for Republican success was not having health care pass.” He noted that the collapse of the plan reinforced voters’ belief that Washington was in a dysfunctional state of gridlock. At the same time, Democratic pollster Mike Donilon, who worked on the losing campaign of Pennsylvania Senator Harris Wofford, said he believed that Wofford would have won had health reform passed.
It is undeniably true that a Washington plan to reform health care is not overwhelmingly popular. But that’s mostly because Washington is unpopular these days. When the component parts of the Democrats’ plan are parsed out, surveys show high approval for nearly all of them, including removing preexisting conditions, ending lifetime benefit caps, providing tax credits to small business to get them to cover employees, subsidizing low- and middle-income families to enable them to buy insurance, and creating a health-insurance exchange to shop for policies.
We also know that voters are warming somewhat to the idea of a reform plan, in part because the president has ramped up his efforts on its behalf beginning with the State of the Union and the health-reform summit—letting voters know what is actually in the bills. The actions of insurance companies like Anthem and Wellpoint, raising premiums sharply before enactment of reform, has also contributed to a public receptiveness to change. And we know that there was a noticeable bump in public approval when bills passed the House and the Senate—voters like action, and like success. Even where we are skeptical about the benefits of government programs, we want government to work.
It is also true that the health-reform plan, contrary to conventional wisdom, will not simply frontload the costs and backload the benefits. The plan will move quickly to erase the unpopular “doughnut hole” that results in a costly jolt for many seniors buying prescription drugs, to end discrimination based on preexisting conditions for children, to ease the insurance burden on those losing or leaving their jobs, and to enable parents to carry children up to the age of 26 on their family policies.
Many House and Senate Democrats are understandably nervous about voting to enact health reform. We are convinced that the political damage will be far, far worse if they fail to do so.