The biggest political error committed by Democrats over the last four years has been to run away from their signature legislative accomplishment, the Affordable Care Act. As a result, they’ve allowed Republicans and conservatives to depict a measure that improves the lives and health of millions of Americans as harmful, even un-American.
Sen. Charles E. Schumer (D-N.Y.) disagrees about the Democrats’ mistake. He thinks their mistake was passing the healthcare law in the first place, or at least putting it at the top of the Obama administration’s first-term agenda.
It’s a startling admission of political spinelessness. Schumer gets the positive impact of the legislation wrong, he gets the politics of it wrong, and he displays a shocking ignorance of the problems facing the American middle class. The only good thing about his remarks is that they confirm how bad today’s Democrats are at messaging. Let’s put it this way: Franklin Roosevelt would never have tried to discredit his own policies the way Schumer just did.
Schumer made his observations in a speech Tuesday at the National Press Club in Washington. Here he is, at length:
“Unfortunately, Democrats blew the opportunity the American people gave them. We took their mandate and put all of our focus on the wrong problem -- healthcare reform. Now the plight of uninsured Americans and the hardships caused by unfair insurance company practices certainly needed to be addressed, but it was not the change we were hired to make. Americans were crying out for the end to the recession, for better wages and more jobs, not changes in healthcare.
“This makes sense, considering 85% of all Americans got their healthcare from either the government, Medicare, Medicaid or their employer. And if healthcare costs were going up, it really did not affect them. The Affordable Care Act was aimed at the 36 million Americans who were not covered. It has been reported that only a third of the uninsured are even registered to vote.
“So when Democrats focused on healthcare, the average middle-class person thought the Democrats are not paying enough attention to me. Again, our healthcare system was riddled with unfairness and inefficiency. It was a problem desperately in need of fixing. The changes that were made are and will continue to be positive changes, but we would have been better able to address it if Democrats had first proposed and passed bold programs aimed at a broader swath of the middle class.”
What shall we make of this? Let’s start with fundamentals. Healthcare reform directly impacts the middle class, for the better. People who get their health coverage from an employer or the government aren’t immune from financial problems caused by medical issues. As this crucial study found, medical issues were major contributors to more than 62% of all bankruptcies in 2007. That was a sharp rise from a 2001 survey that placed the figure at 46.2%. (Among the researchers contributing to the studies was future Sen. Elizabeth Warren (D-Mass.), then a professor at Harvard Law School.)
The majority of these debtors were “well educated, owned homes, and had middle-class occupations,” the authors stated. About three-quarters had medical insurance at the time they filed for bankruptcy, but often had experienced a lapse in coverage within two years of filing; presumably the lapses occurred because they had lost a job or couldn’t afford offered employer coverage.
In other words, the American system of tying insurance to employment and pricing non-employer insurance out of reach, often because of preexisting medical conditions, was very much a middle-class crisis. If insurance was especially important to those below the middle class, one reason was that medical expenses had pushed them out of the middle class.
Schumer’s assertion that the core beneficiaries of health insurance reform were low-income non-voters merely illustrates his detachment from his own constituents.
He also displays a shocking detachment from the effects of his own law. Provisions of the legislation will standardize health benefits and outlaw limitations that were creeping into employer plans. The measure appears to have reduced the premium growth rate -- up 3% this year, less than half the average rate over the last 10 years -- while stemming the long-term decline in the percentage of workers offered employer plans.
Moreover, the flexibility the healthcare law gives workers to leave their jobs to care for family members or start new businesses -- by removing the threat that they’d be unable to find affordable coverage in the individual market -- is a boon to many in the middle class, who were stuck in unrewarding jobs simply for the health coverage. The Congressional Budget Office estimated that the end of “job lock” could affect as many as 2.5 million workers by 2024, many of them in the middle class.
Finally, the law provides premium subsidies for households earning up to 400% of the federal poverty level. For a couple with two children, that’s $95,400, a middle-class income by any measure.
What’s most disturbing about Schumer’s spiel is its view of political strategy. What made healthcare reform “the wrong problem” for Democrats to focus on in 2009 and 2010, he suggests, is that the voters wanted the focus to be on economic recovery and job growth.
This is a familiar complaint. But leaving aside that Congress and the White House should be able to walk and chew gum at the same time, the notion that the pursuit of healthcare reform resulted in the abandonment of economic growth policy is bizarre.
As Brian Beutler and Scott Lemieux cogently observe, President Obama had already gotten the Recovery Act through Congress before work began on the healthcare law, and he wasn’t going to get more stimulus from the GOP on Capitol Hill no matter how hard he tried. No one who expresses the view that Obama should have worked harder on jobs has ever, as far as I can discern, come up with a proposal that Democrats could have worked on instead of the healthcare legislation that could have been enacted into law.
Meanwhile, it was always clear and widely remarked that healthcare reform, if it was to be done at all, had to be done early in the first term, before its powerful opponents got up a head of steam. This Democratic goal had foundered going back to the Truman administration, most spectacularly under President Clinton. If it failed again, the window could be closed for an additional couple of decades at least.
If Democrats have suffered at the polls because of the Affordable Care Act -- and that’s arguable, even given the results of the last election -- the reason isn’t that the reform doesn’t do enough for the middle class, but because Democratic officeholders have been terrible at communicating how much it does benefit the middle class.
Schumer’s words exemplify the party’s pusillanimous stance. Insurance abuses and unavailability “certainly needed to be addressed,” he acknowledged, but ... not now. Yes, he said, “our healthcare system was riddled with unfairness and inefficiency.” Yes, it was “a problem desperately in need of fixing.” But no, “it was not the change we were hired to make."
But no, the Democrats weren’t “hired” to do just one thing, or do things one at a time. That approach more often than not ends with nothing being done at all. Schumer’s complaint might be correct if the Democrats had focused on healthcare reform and failed to achieve it. But they did achieve it. You did good, Sen. Schumer. Stand up and take a bow, and stop cringing already.