Editorial Law and Policy

Democrats Had a Wobbly Start Defending the Affordable Care Act, But Here’s How They Can Do Better

Jodi Jacobson

The Democrats have the high ground here, and they should occupy it proudly and without apology.

For the past six years, GOP leaders have been promising us that, given the chance, they would “repeal and replace” the Affordable Care Act (ACA). Knowing they could rely on President Obama to veto them, House Republicans spent six years symbolically passing more than 50 bills repealing the law. Now, they control both chambers of Congress and, after January 20, will control the White House too. So for the past few days, they’ve been rubbing their hands in undisguised glee at the prospect of killing a law that has provided health insurance coverage to historic numbers of Americans.

This week, however, it became clear the GOP is heavy on “repeal” and light on “replace.” Questions from reporters at a press conference on Wednesday with Vice President-elect Mike Pence and GOP leaders brought forth a recitation of every complaint, every lie, and every obfuscation of the facts about Obamacare ever uttered by a Republican, but not a single answer regarding what the GOP planned to do once it has repealed the law. It’s clear they have no plan.

In a surprisingly coherent response to this circus, Democrats, led by Senate Minority Leader Chuck Schumer (NY) and House Minority Leader Nancy Pelosi (CA), presented a united front against the GOP, asserting that they would not help Republicans dismantle the ACA.

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For example, Schumer said: “Republicans are plotting and will soon be executing a full-scale assault on the three pillars that support the American health-care system: the Affordable Care Act, Medicare, and Medicaid. The Republican plan to cut health care wouldn’t make America great again, it would make America sick again and lead to chaos instead of affordable care.”

Schumer is right. Repealing the Affordable Care Act would lead to chaos. Instead of repealing it, Congress should be working to both amend it to fix its existing problems, and to expand it to encompass millions more people. Republican governors need to help in their states by making it easier to set up insurance exchanges and expanding Medicaid coverage there, among other steps.

But for all their unity, the Democrats still offered muddled and confusing messages about their position. They can, and must, do better.

The Democrats want to expand health coverage and make it even more affordable; the Republicans want to take it away. End of story.

These critical points were totally confused, however, by a huge sign on the podium of the Democrats press conference that said “Make America Sick Again,” with the “sick” highlighted and in bold. My first response was: Huh? The Democrats want to make America sick again? Obviously, the point was to echo the sentiment Schumer used and play on Trump’s slogan, “Make America Great Again,” by pointing out that repealing Obamacare would leave more people uninsured and, by extension, more people sick.

But the visuals were awful. The fine print of the poster, barely legible unless you strained to see it, made it clear that it was the Republicans’ plan to repeal Obamacare that would “make America sick again,” but the optical presentation on every news show I scanned was that the Democrats were pledging to “make America sick again,” endlessly replayed on news shows with only the large type visible for all to see. Not a good strategy for a party recently plagued by misstatements about “getting rid of coal jobs” and calling people “deplorables.”

While “Make America Sick Again” is a great retort to the GOP, Democrats need a clear, proactive, and forceful message about their own intentions, such as focusing on “Expanding Affordable Care,” “Fixing the Affordable Care Act,” “Getting Everyone Covered,” or “Making Care More Affordable.”

Furthermore, as part of their outreach, Democrats should be unapologetic and forceful in responding to future questions from reporters with the solid facts underlying their strategy. How can they do so? Here are some examples:

Question: Are Democrats going to be obstructionists on health care just like the Republicans were for the past six years?

Best answer: We are not obstructing. We are protecting health care for millions of people. The Republicans have promised to repeal Obamacare, and now they have the votes to do it. If they do so, they should face the consequences. We will not help the GOP in their quest to deny health insurance to millions of Americans.

Question: What do you say to Republican complaints that Obamacare was “rammed down their throats” and that it passed without a single GOP vote?

Answer: That is false. It’s revisionist history. Democrats went out of their way to accommodate GOP amendments to the ACA, a number of which were vociferously opposed by many of our own constituents. The GOP insisted on those changes in return for their support, and then did a bait and switch. As a result of their amendments, we have fewer people covered than we otherwise might, and GOP leaders are still attacking the ACA. We need to fix the ACA so it works for everyone, not repeal it.

Question: So you won’t work with the GOP to replace the law if they repeal it?

Answer: No. If the GOP repeals Obamacare, millions of people will be left without health insurance. We will not accept that. After all this time of attacking the law and limiting the benefits, that is their problem, not ours.

There is an effective, sane way to do this: Fix the law. You don’t need to repeal it. That is a political ploy.

Question: Polls show that Obamacare is unpopular. What do you tell the American people about why you support it?

Answer: The only thing that is unpopular is the word Obamacare, because Republicans have spent the past seven years spreading misinformation and doing as much as they can to thwart the full benefits of the law from reaching millions of people. Those same polls show that the actual policies of Obamacare are wildly popular. For example, 85 percent of the public, including 82 percent of Republicans, support allowing young adults to stay on their parents’ insurance plans until age 26; 83 percent of the public, including 77 percent of Republicans, support elimination of out-of-pocket costs for many preventive services; and 80 percent of the public, including 67 percent of Republicans, support providing financial help to low- and moderate-income Americans who don’t get insurance through their employers to help them purchase coverage.

Let’s stop playing word games. Let’s stop misinforming people. We call on the GOP to recognize that Americans need health care, and we are ready to work with them to improve the law. Now. Today. We will not help them repeal it and then replace it with something that provides less coverage for millions of Americans in need. If that is what they want to do, it’s on them.

Repealing Obamacare will cause suffering throughout this country, and the GOP knows it. After years of doing everything they can to outright deny health care to people and simply attacking the plan without offering viable alternatives, the GOP now has to put up or shut up. The Democrats have the high ground here, and they should occupy it proudly and without apology.

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