Megan McArdle argues that it would have been better for everyone, including Democrats, had Hillary Clinton won the Democratic nomination in 2008. Why? Because she would have bailed on comprehensive health care reform. Let’s start with the easier, normative question first:
I’m actually going to disagree a bit here. I think that Hillary Clinton would have been more cautious when dealing with Republicans, and therefore ultimately more successful in some ways. At the very least, she would not be facing the same level of vehement opposition in Congress.
I think liberals really do not understand emotionally the extent to which the Tea Party was created by the Affordable Care Act and the feeling that its government was simply steamrolling it. From the Tea Party’s perspective, you had an unpopular program that should have died in the same way, and for the same reasons, that Social Security privatization did: because sensible politicians saw that, no matter how ardently they and their base might desire it, this was out of step with what the majority of the country wanted (and no, you cannot rescue the polls by claiming that the only problem with the law was that it wasn’t liberal enough; when you dig down into what people mean when they say that, the idea that there was ever a majority or a plurality that was secretly in favor of Obamacare collapses).
A few points:
- The idea that abandoning health care reform would have significantly moderated conservative opposition is highly implausible. The Tea Party would have just focused on the stimulus plan rather than the ACA. Congressional Republicans had already decided to uniformly oppose Obama’s major initiatives before the ACA. The ACA wasn’t the reason for the mania ostensibly about the deficit that led to the various crises created by congressional Republicans.
- In addition, while it I suppose it’s possible that Obama would have maintained higher approval ratings had he never even tried health care reform, it’s extremely implausible that trying and failing to pass comprehensive health care reform would have been a net political positive. Republicans would still be mobilizing against the greatest threat to freedom in known human history, while most Democrats would (correctly) feel betrayed. Incidentally, this is where the analogy to Bush’s Social Security privatization scheme collapses. Ending Social Security as a public program was a purely an elite-driven enterprise; most Republican voters don’t even favor benefit cuts, let alone privatization. But comprehensive health care reform has been a major liberal priority for many decades.
- And even if you assume an attenuation of conservative mobilization that isn’t balanced out by liberal demobilization, again, so what? There was no way the Democrats were hanging on to the House of Representatives in 2010. You would have to be dreaming in technicolor to think that contemporary House Republicans were going to pass major progressive legislation. Obama won re-election and held the Senate despite the unpopularity of the ACA. So what would materially change had the ACA not been passed? The Democrats would have a few more House backbenchers? There’s no positive legislative achievement trivial enough to be worth trading for that.
- On the public opinion question, it’s worth noting that repealing the ACA is even less popular than the ACA. Combined with the fact that the individual components of the ACA are generally more popular than the whole, we shouldn’t assume that its unpopularity is permanent.
- And, finally, even if you think the political cost is greater than I do, ultimately the point of winning elections is to do things. The argument that Obama should have abandoned comprehensive health care reform in favor of…something else is analogous to the argument that it would be better for the reproductive rights of women to be held hostage for political purposes than to protect them. There’s not much value in maintaining power for its own sake, and while you can sometimes attenuate opposition by not winning that’s not much of an argument to therefore never win.
McArdle’s argument that Democrats should have wanted Obama to abandon health care reform fails for the same reason her Halbig trooferism fails: it fails to comprehend how much the issue means to most Democrats.
Now, let’s turn to the more difficult empirical part of the counterfactual:
I think that Hillary Clinton would have pulled back when Rahm Emanuel (or his counterfactual Clinton administration counterpart) told her that this was a political loser and she should drop it. I’ve written before about how my Twitter feed filled up with comparisons to 1932 the night that Obama took the presidency, and it’s quite clear to me that the Obama administration shared what you might call delusions of FDR. It thought that it was in a transformative, historical moment where the normal rules of political caution didn’t apply. The administration was wrong, and the country paid for that.
Of course, in my counterfactual, Hillary also probably wouldn’t have proposed ambitious health-care reform; she’d have done something more modest, like a Medicaid expansion. Progressives might well say that they’d rather have the first two years of the Obama administration, followed by gridlock, than steadier but more modest achievements by a Hillary Clinton administration.
Even leaving aside the fact that there was going to be gridlock after 2010 no matter what, I’m very confident that the second counterfactual is wrong. Any Democrat who took office in 2009 was going to propose the consensus health care reform of the primaries. To argue that Hillary Clinton wouldn’t have proposed her signature domestic policy proposal when Barack Obama proposed it (in a form closer to hers than his) is implausible in the extreme. I also note that the behavior of Republican statehouses makes it pretty clear that Tea Partiers would not have perceived a major expansion of America’s largely single payer health care system for the poor as “modest” — that’s a job for progressives who are too good for your mere politics! — a rather major problem for her other core argument.
The only serious question is whether Clinton would have bailed after Scott Brown’s victory. In a general sense, there’s some reason to believe that Clinton would have been receptive to the Rahm narrative. While Clinton’s primary supporters see her as someone who would be tougher on Republicans, I see someone who was paying Mark Penn millions of dollars, suggesting that she hadn’t fully abandoned the tendency to political risk-aversion that major Democrats learned in the 80s.
That said, on this specific issue I think it’s enormously unlikely that she would have jumped ship when the going got tough. Do you think that Clinton would want to be remembered as someone who twice screwed up comprehensive health care reform? I think that’s enormously unlikely. It’s possible, I suppose, that she could have tried and failed, but again I doubt it; she would know better than anyone that the “just shove it down Congress’s throat” strategy preferred by the ACA’s left critics is a massive fail.
So not only do I not buy that it would have been good for Democrats had Clinton won and abandoned health care reform, I see no reason to believe that she would have.