Admit it, fellow Minnesotans — this latest outbreak of insanity in Washington caught you by surprise. Sure, you know our Congress is incapable of anything but inaction and bitter partisanship these days. You have learned not to expect any substantive policy-making from them. But a government shutdown and a real possibility of default on the federal debt – all over Obamacare? What is this, 2010?
There’s a good reason that the latest round of bluster and brinksmanship in Washington – all-night speeches, predictions of Armageddon, desperate attempts to delay Obamacare for a year – has taken many of us in Minnesota by surprise. Much of the country remains in a kind of political time warp, rehashing again and again the crazed debates we remember from a few years ago, in which a vast expansion of commercial health insurance somehow figures as the arrival of “socialism.”
But here, we’ve moved on. For the last three years, Minnesota has moved steadily forward with the daunting, complex task of implementing Obamacare (officially, the Patient Protection and Affordable Care Act). We made progress even during the two years when Republican legislative majorities in St. Paul resisted implementation. And today the state’s new health-insurance exchange, MNSure, begins enrolling people in coverage, with the cheapest average premiums anywhere in the country. Tens of thousands of Minnesotans will each receive thousands of dollars in new tax credits to help them pay for commercial insurance in 2014. Our twin public programs for low-income Minnesotans – Medical Assistance and MinnesotaCare – will expand to cover more than 200,000 new people.
Minnesota’s contrast with many other states
The contrast elsewhere in the country could not be more stark. More than half the states have chosen not to build health-insurance exchanges, opting instead to have the Obama administration establish exchanges for them. It’s a bizarre turn for states driven by the anti-federal-government political sentiments of the Tea Party and other extremists. And nearly half the states have rejected hundreds of millions of dollars in new federal support for expanding Medicaid eligibility. Elected leaders are preventing their states’ poorest citizens from accessing free health-care coverage with generous benefits, even though it would cost their states almost nothing to provide it.
That’s how much opponents of Obamacare hate this law. Their threats to shut down the government and possibly even tank our whole economy by defaulting on the federal debt are just the latest expressions of this abiding hatred.
So why the 2010 time warp? Why haven’t they moved on?
Are they just crazy?
I think the answer is no. There’s a method to their madness.
To be fair, there’s ample supporting evidence for the “they’re-just-crazy” theory. House Republicans have voted 41 times to repeal or otherwise dismantle Obamacare. In zero of those cases did they have a remotely plausible theory of how they’d get the Senate and president to agree.
When Sen. Ted Cruz made his all-night speech against the government spending bill a few nights ago, he likened defenders of Obamacare to British Prime Minister Neville Chamberlain arguing for appeasement of the Nazis. He then decided to vote in favor of the same bill he’d spent 21 hours attacking.
But the fierce political opposition is a lot less crazy than it may seem.
Ronald Reagan and Medicare
To understand why, let’s turn to our own political history. When the most popular government program we’ve ever known, universal health-insurance coverage for seniors (Medicare), was a proposal before Congress, here’s what Ronald Reagan had to say about it: “We are going to spend our sunset years telling our children, and our children’s children, what it once was like in America when men were free.” Medicare, if passed into law, would herald the end of freedom. Reagan even recorded a 10-minute LP record for mass distribution offering a “history lesson” on how socialists designed Medicare as a ploy to destroy American capitalism. Sound familiar?
Ronald Reagan was no Ted Cruz. He was an extraordinarily effective politician, with a keen ear for the sentiments of independent voters in the middle of the American electorate. But Reagan’s reasons for using such incendiary, loony-tunes rhetoric against Medicare in the 1960s were more or less identical to the reasons today’s Republicans in Washington are doing everything in their power to obstruct Obamacare. They learned a simple, clear political lesson from FDR’s Social Security: When Democrats create new government programs that offer tangible, much-needed benefits to voters, voters remember it and vote more Democrats into office.
The strongest proof of the political importance of this lesson is that in congressional elections – to which we are subjected, mercilessly, every two years – both sides spend hundreds of millions of dollars accusing the other party of planning to cut Medicare.
Republicans simply cannot afford to have millions of voters associate this 2014 expansion of health-insurance coverage with Democrats. Even with all its imperfections (and there are many: This reform is not nearly as strong and straightforward a piece of progress as Medicare or Social Security), Obamacare represents a long-term political threat to Republicans, and they know it.
We should be grateful that here in Minnesota, we haven’t been mired in the resulting political paralysis. We’ve not only implemented Obamacare, but also built upon some of its strengths to push toward more comprehensive progress in providing affordable, high-quality health care to all Minnesotans. It’s sad that so few other states have seized the opportunities Obamacare presents for innovation, progress and further reform.
Furor likely will continue
The truly bad news for anyone surprised by this week’s apparent lunacy in Washington is that the furor over Obamacare – the political time warp – is not likely to die down anytime between now and the November 2014 elections. Even if – let us pray – they stop threatening government shutdowns and debt-defaults, opponents of Obamacare will almost certainly continue with their denunciations of it as “socialism” and their desperate efforts to delay or repeal it.
But eventually the dust will settle. Some of the newly insured will still struggle to afford the costs of insurance, and there will surely be many other problems still in need of fixing in our health care system. But at the end of the day, tens of millions more Americans will have health insurance. For many of them, it will be dramatically more affordable than anything they could get before Obamacare. It will keep many families out of bankruptcy. And it will save no small number of lives.
The real kicker, in the end, is that even after the dust settles Republicans will never get to pretend to be champions and defenders of these benefits, like they did with Medicare. Voters might well have forgotten, after a few years and a few billion dollars in attack ads, which party supported the “Patient Protection and Affordable Care Act.” But thanks to the Tea Party’s scornful rechristening of that wonky law – a name resisted at first by Democrats, for some reason, but now widely embraced – voters will have an awfully hard time forgetting which president passed it.
Phillip Cryan is the organizing director of SEIU Healthcare Minnesota, a 16,000-member health-care workers’ union. From November 2011 to January 2013, he served on the task force that advised Gov. Mark Dayton on design of the state’s new health insurance exchange, MNSure. He holds a master’s degree in public policy from the Goldman School at the University of California-Berkeley.
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