The buildup of anger and frustration across the whole of middle America during the financial crisis was palpable, on both the left and the right. Populist sentiment across the board was fervently against wall street welfare. This was a momentary opportunity for left, center, right and middle America to unite for a common cause, to unite against “the establishment”. This opportunity disappeared as quickly as it appeared, both ideological sides retreated to their corner and began operating in the vacuum of partisan beliefs. Operating in the politics of satisfying their passionate (sometimes rabid) bases.
Conservative Divergence: Part 1 of this article ended with the a conversation about “The Opposition Strategy”, the seeds of the Tea Party and Grassroots movement.
“They began to talk about what had gone wrong. And what they decided was that they had — That Republicans had walked away from their own principles. And they were referring to the big spending that took place under the Bush administration principally.” ~ Robert Draper
Progressive Divergence: “Elections have consequences.” It’s the political way for winners to tell losers: “Tough luck, you lost. Get over it.”
President Obama infamously espoused this view shortly after his 2009 inauguration, during a meeting with congressional Republicans about his proposals. Mr. Obama was later quoted as telling GOP leaders that “elections have consequences,” and, in case there was any doubt, “I won.”
With the battle lines drawn, the fleeting moment for any type of bipartisan participation on the health care reform was forever lost. The strategy for both sides was about to play out;
Democratic Strategy: Knowing there is a finite window for any kind of legislation, they had to act promptly and hastily to get a deal done before the 2010 mid-terms. They KNEW any kind of bipartisan deal making would prolong the process and in all likelihood kill the deal in 2010.
Republican Strategy: A full court press, with minimal (no) power to do anything in congress or the White House they were left with only the ability to publicly challenge EVERY move the White House and Congress makes. The full court press was a strategy to also buy time until 2010.
Anti-establishment sentiment among conservatives (grassroots and Tea Party) is handed a loaded weapon when President Obama and democrats do much of the deal behind closed doors. The insurance lobby and big pharma were critical players in the process, the deal could not and would not get done without these lobbies.
The tug-of-war is now a full blown battle. Publicly, the message from the democrats was to achieve the goal of “Affordable Health Care“. Politically, he was fighting in large part for a class of people, the poor and disenfranchised, that he promised not only affordable health care but ACCESS to that affordable health care. As the Insurance and Big Pharma lobbies exerted their influence, policy goals and objectives had to be compromised.
The insurance lobby, with the help of their chief lobbyist Karen Ignani, issued the ultimatum that the only way insurance companies would play along is if there was an individual mandate. The individual mandate was NOT part of Obama’s plan yet this created a very important decision and watershed moment for health care reform. Publicly, Obama was bashing the insurance industry while behind closed doors he was giving in to their demands.
The political goal of access to affordable health care for the disenfranchised and more affordable health care for the middle class were in reality in direct conflict and competing against each other. The individual mandate and the insurance lobby wins. This victory now sets in motion policymakers the unenviable task to draft a strategy to cover the costs.
To partially offset costs, discussions of taxing “Cadillac Health Plans“ started to surface as one of the instruments to defray costs. Cadillac plan taxation was a shot right across the bow of unions and the health plans they provide to their members. Anyone with a pulse back in 2010 would remember the unprecedented meetings between President Obama and labor union leaders. Unions received exemptions and tax relief, which had the effect of leaving a big hole in the proposed budget for health care reform.
With all of this “sausage making” going on with health care reform, coming out the other end was not the product that was originally intended. Instead we have;
The lens through which I see the results of the 2016 election is the lens of ACA as the fuel driving middle America towards Donald Trump. While immigration, security and border control are capturing a lot of the headlines, these topics are just catalysts, the real showdown will be ACA.
There is a resentment among middle America, a perception (real or unreal) they are being held both socially and financially responsible for the costs of supporting 20 million people in the current ACA framework. These feelings are both masked and manifested in public conversations when we hear news about security, immigration and border patrol. Some of the sentiment has slowly boiled to the surface over time that conservatives fear migrants are receiving too many entitlements at the expense of the middle class and migrants are taking more from America than they are contributing.
While we wait and debate the immigration and security issue, the big guns are being held in reserve for the real war, ACA. It might be a discussion of repeal, it could be a repeal and replace deal, the reality is that the straw man (20 million Americans with access to free or subsidized healthcare) is a pretty large political force.
Politics WILL inevitably play a leading role in the fate of ACA, what middle America asks for (rather demands) is that they no longer be ignored, at the expense of the 20 million person strong straw man, at the expense of powerful insurance and pharma lobbies or at the expense of business as usual establishment politics in Washington DC.
There is an intangible and immeasurable force in America, the middle class. A force of people that do not pledge allegiance to democrats or republicans, rather every 4 years they listen to to the sales pitch from both sides and decide what is best for them, for their families and for their future.
8+ years ago, on the heels of a financial crisis and with skyrocketing healthcare costs, the middle enthusiastically turned to hope and change, turned to Barack Obama. The bloody mess of the wall street crisis, corporate welfare and the sausage making of ACA left a distaste with much of the middle.
The tides started to turn in 2012, we experienced a movement starting to accelerate from progressive policy towards “alternative policy“. Middle America took a couple bites of Romney in 2012 and chose to spit it out. Pre-2012 establishment republicans REFUSED to listen to the message, the middle is still unsatisfied with the status quo of establishment politics and establishment candidates. Democrats chose to ignore these signals as well, the seeds of dissent for establishment democrats was just as strong, yet stubbornly the democrats charted a course for Hillary Clinton for 2016.
HERE WE ARE – The unthinkable is now real (many republicans and probably 99% of democrats could not imagine Donald Trump beating Hillary Clinton), Donald Trump is president and middle America has someone to cling to for 4 years, for 8 years? My bet is that the economy and how the Trump administration manages ACA will be the measuring stick in 4 years. The divide between people on immigration and security issues is just the appetizer for the main course, repeal (and replace?) ACA.