That included Lambrew and Nancy-Ann DeParle, who had been in charge of Medicare and Medicaid during the Clinton administration, as well as Zeke Emanuel, a physician, bioethicist, and prolific writer on health policy.
The key Democratic lawmakers had similarly deep benches of seasoned policy advisers. And as the legislative effort got under way in , those advisers were in constant communication with one another and with the White House.
There were daily and sometimes twice-daily conference calls led by DeParle or Lambrew, in order to coordinate messaging and keep the proposals from diverging too much. Those calls were not always fun, and Lambrew, during her frequent trips to Capitol Hill, usually drew the duty of listening to staff from each chamber vent about the other. But the back-and-forth meant that each committee and chamber understood the absolute limits of what the others could tolerate.
Despite all of these conversations and all the preparations that came before them, the journey of the Affordable Care Act through Congress was halting and difficult, and on several occasions the whole project seemed on the verge of failure. That was no small thing, as Republicans were about to discover. Following the midterms, and big Republican gains in Congress, DeMint filed a new version of his legislation.
This time, every single GOP senator signed on as a co-sponsor. This was an indicator of how much the caucus, and party as a whole, was signaling support for the ultraconservative, anti-government worldview of DeMint. It also revealed how de rigueur a commitment to full, uncompromising repeal had become. And this was a sign of things to come. Although a handful of conservative intellectuals worked on proposals and although a handful of GOP lawmakers, such as Senator Orrin Hatch of Utah and Representative Tom Price of Georgia, wrote legislation, these proposals never got sustained attention from either GOP leadership or members.
Republicans had nothing like the detailed, ongoing discussions with outside advisers and interest groups that Democrats and their allies had undertaken in the years before —a failing that several former Republican officials later recognized with regret. That bit us in the ass when it came to repeal and replace. One reason for this laziness was a simple lack of interest.
For decades, Republicans had seemed interested in health-care policy only when responding to Democratic policies required it.
Once the ACA became law, basically everything bad that happened in health care was attributed to it. For example, rising prices for prescription drugs has been a problem for years. But the ACA did not seek to address that, except for one provision that sought to facilitate generic copies of some of the most expensive biologic medications.
Also, before the ACA, some insurers stopped offering plans in the individual market, while others raised premiums dramatically and often would not cover care at high-cost providers like teaching hospitals. The ACA did create some losers.
Among those hardest hit are people who earn just slightly too much to qualify for federal premium subsidies, particularly early retirees and people in their 50s and early 60s who are self-employed. Both were rejected by more conservative Democrats in the Senate. That meant people with incomes under the poverty line but still too high to qualify for Medicaid in their states have no affordable program available.
However, even some of those consumers have seen benefits from the law, although they might not realize it, like required rebates from insurers who charge too much for administrative costs. But it is human nature for people who feel wronged to complain loudly, while people who are satisfied merely go on with their lives. We're three-and-a-half years into an administration defined by constantly dividing the country between those who support the current president and everyone else, who are often denigrated as haters and losers and "enemies of the people.
That was the context for Republicans taking offense at Obama for daring to suggest that "we can do better. The eulogy never mentioned present-day Republicans. It included no reference to President Trump by name.
Yet the reaction on the right to Obama was furious — just as it was during the entirety of his two-term presidency. The contrast with how much of the right responds to Bernie Sanders is instructive. By every measure, Sanders is more ideologically radical than Obama and therefore much further away from the Republican Party on policy. Yet he doesn't inspire rage on the right like Obama does or as the triangulating Bill Clinton did before him.
Now, during the Democratic primary this was undoubtedly in part a result of a political calculation that Sanders getting the nomination would be good for the GOP in the general election. The right would surely have hit him relentlessly if he'd ended up becoming the Democratic nominee.
And they would have done so even though Sanders' singular focus on economic issues makes him more difficult to engage in the culture-war terms favored by the right. In Trump's hands during a general-election contest, the term "socialism" would have gone far beyond economics to take on all kinds of cultural resonance.
Yet the difference remains: Sanders doesn't provoke rage like Obama does. While some might point to race, I doubt those made apoplectic by a Black politician would be comparatively forgiving to a septuagenarian Jewish social democrat with a thick Brooklyn accent.
Something else is going on, and I think it's that the right accepts that Sanders just pushes his factional agenda from the socialist left and doesn't presume to speak from outside of or above the partisan fray.
Obama, by contrast, doesn't know how to speak in any other rhetorical register than above and beyond the partisan fray. He invariably sounds reasonable, his tone fair-minded, objective. Republicans are overall more supportive of drone strikes than Democrats but also on the president who is promoting the policy. This poses a serious concern for our ability to effectively communicate and reach consensus with one another about political issues.
How can we forthrightly debate the merits of a presidential action when its support is, to some degree, a function of the person who occupies the Oval office? If we want to find common ground, it is important to recognize tribalism, how we ourselves may be affected by it, and consider how it may shape the attitudes of our public. Michael Bernstein, Ph.
These respondents were labeled either Republican or Democratic voters in the analysis. There were 10 experiments in total. Prompts for all experiments were assessed on a scale of strongly disagree 1 to strongly agree 5 where 3 indicates a neutral opinion. We consider responses of 4 or 5 to indicate support or agreement. Live Now. Cato at Liberty. Blog Home RSS. Email Signup Sign up to have blog posts delivered straight to your inbox!
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