Obama’s self-image in the health-care fight
President Obama has returned to one of his favorite themes in response to the partial shutdown of the federal government and the prospect that the government might have to default on some of its debts. That theme: He is a moderate, reasonable, flexible, pragmatic guy who finds himself, sadly, in constant battle with conservatives who are none of these things.
Thus his comment in an interview with John Harwood on CNBC: “John, I think it’s fair to say that, during the course of my presidency, I have bent over backwards to work with the Republican party. And have purposely kept my rhetoric down. I think I’m pretty well known for being a calm guy. Sometimes people think I’m too calm. And am I exasperated? Absolutely I’m exasperated.” He is exasperated, that is, by how impossible the Republicans have made it to deal with them.
Perhaps needless to say, almost all liberals share Obama’s outlook: Their side is eager to compromise — and he, for some of them, is if anything too eager — while conservatives are implacable to the point of insanity.
Conservatives, of course, do not view Obama as at all moderate: They view him as an extreme liberal, or worse. The gap between the liberal and the conservative view of Obama is, for liberals, further evidence of the Right’s disconnection from reality.
It is a gap with a history that long predates Obama. As far back as Woodrow Wilson, progressives have presented themselves as pragmatists just trying to move the country forward, with no particular ideological destination in mind. Progressives have presented themselves in this way even when, as in the case of Wilson, they were hostile in principle to the philosophy of government that animates the Constitution and committed to replacing it with a new one.
President Obama speaks less often in a theoretical mode than Wilson did, though, and his recent claim to have a monopoly on pragmatism has concerned partisan haggling rather than the ends of government. The two great examples adduced in defense of his claim have to do with the two biggest legislative accomplishments of his presidency: the stimulus bill and the health-care bill.
Obama himself made the case that Republicans had slapped away the hand of friendship on the stimulus. In January 2010, he told Joe Klein of Time his version of the story: “I came in expressing a strong spirit of bipartisanship, and what was clear was that even in the midst of crisis, there were those who made decisions based on a quick political calculus rather than on what the country needed. The classic example being me heading over to meet with the House Republican caucus to discuss the stimulus and finding out that [House minority leader John] Boehner had already released a statement saying, We’re going to vote against the bill before we’ve even had a chance to exchange ideas.”
That does sound pretty bad. The actual events unfolded differently. Obama spoke to the Republicans on January 27, 2009, a day after Nancy Pelosi and David Obey, then the speaker of the House and the chairman of the House Budget Committee, had introduced a stimulus bill into which the Republicans had had no input. Boehner had then said that he would oppose that bill and that he hoped Obama would replace it with something bipartisan. Boehner summarized his message to Obama to reporters: “Help us make this plan better so that it will put Americans back to work.”
Boehner’s plea went unheeded, of course, and on January 28 the House passed the Pelosi-Obey bill. Being shut out of the process contributed to the decision of every House Republican to vote against the bill. Eleven House Democrats joined the opposition. The president’s story about Republican partisanship on the stimulus, then, is more or less the opposite of the truth: Republicans asked for cooperation and received none. The Democrats had votes to spare, and what they did was their prerogative, but what they did should not be misrepresented.
The liberal narrative on Obamacare goes like this: The health-care program is a Republican plan, based on one championed by the Heritage Foundation and signed into law by Governor Mitt Romney in Massachusetts; over the years many Republican politicians had endorsed its most controversial feature, the individual mandate; and Obama tried hard to get Republicans to support the bill. Yet Republicans opposed it, and have continued to oppose it, hysterically — simply because, so we are to believe, Obama was the one proposing the plan.
There are elements of truth in this account, but they’re exaggerated. Plenty of conservative think-tankers always opposed the individual mandate. Grassroots conservatives did not oppose it before 2009, but only because it had never previously come to their attention. Few Republicans had ever thought that creating a constitutionally dubious board to manage federal health-care spending was a promising path to reduced health-care costs generally.
Influential Democrats, such as Senator Daniel Patrick Moynihan of New York, endorsed the addition of personal accounts to Social Security. Another Democrat, John Breaux of Louisiana, co-chaired a commission in the Clinton administration that endorsed premium support for Medicare. That didn’t stop Democrats from uniting against President Bush’s Social Security proposal or Paul Ryan’s Medicare plans. The Clinton administration favored a cap on Medicaid spending per capita; elected Democrats in Washington, D.C., today have shunned the idea. If we are going to fault Republicans for opposing Obamacare even though some Republicans had supported important elements of it in the past, should we not fault this Democratic backsliding on entitlements too? If we should, then two parties have shown rigidity and extremism.
Note also that on the liberal argument Obamacare was a kind of compromise because it included ideas that Republicans should have liked, even if actual Republicans did not like them. Actual Republicans were not offered much input during the legislative debate over the health-care law. Obama dumped the plan’s initial provision for a “public option,” or government-run provider of insurance, but it was resistance to that idea from Democratic senators rather than from Republicans that killed it. The president would not have had to abandon anything essential to his plan in order to add medical-malpractice reform to it. He did not, presumably because he disagreed with it or valued the support of trial lawyers more than buy-in from Republicans.
The policy Obama wanted did not admit of much compromise beyond such incidental issues. Once you ban insurers from discriminating in almost any way among people based on their health risks, you pretty much have to force healthy people to buy insurance and offer large subsidies for the purchase. But that is a highly contestable vision of what health-care reform should look like, and it is liberal dogmatism to see conservative extremism in the rejection of it.
Had Obama taken a different approach to the policy, he might have gotten more bipartisan support. He would not have had to embrace a plan cooked up by the Cato Institute to do it. Republicans, especially early in his term, were not all going to oppose any expansion of the federal government’s role in health care. Forty House Republicans and seven Senate Republicans voted to expand the children’s health-insurance program in February 2009.
The claim that Obama is moderate as well as flexible, meanwhile, cannot bear much scrutiny. His administration has been relentlessly hostile to school choice, with no allowance for the evidence that it shows promise in improving educational outcomes for some students, does not hurt any other students, and saves money as well. It has repeatedly found its legal positions losing unanimously at the Supreme Court — on property rights, on religious freedom, and on the executive branch’s power over state governments, for example. It has opposed a ban on abortion even for the purpose of sex selection.
The last Democratic administration famously undertook a number of bipartisan initiatives: welfare reform, free trade, a reduction in the capital-gains tax. This administration has taken a few smaller steps toward free trade but otherwise done nothing to match. A liberal might well defend this record by arguing that the electorate forced Democrats to govern more conservatively in the 1990s, when Clinton reigned. What cannot be successfully refuted is that on domestic issues, Obama has governed as a committed liberal without much interest in reaching out to his opponents.