The controversial Obamacare repeal-and-replace bill, the American Health Care Act (AHCA), has passed the House of Representatives and now resides in the U.S. Senate. The House bill, widely derided as a piece of draconian conservatism that would cause millions of Americans to lose their health insurance, was expected to be rejected in its current form by the Senate. Now the Senate has released its version of the bill, and a vote is imminent. If the AHCA passes the Senate, it will become law.
Currently, five Republican Senators have indicated that they will refuse to vote in favor of the AHCA. While this is a very good sign for Democrats, it appears that the White House will pull out all the stops to get the five recalcitrant conservatives to change their minds. If Donald Trump can whittle the five negative votes down to two, he can break the 50-50 tie in the Senate with vice president Pence as the tie-breaker.
Democrats have to keep at least three Republicans on their side, and are desperately seeking ways to apply pressure. Unfortunately for liberals, it appears that Obamacare supporters have yet to discover a good attack strategy to cripple the public image of the AHCA. In 2009 and 2010, Republicans managed to tarnish Obamacare with the viral term “death panels,” creating the mental image of rooms full of dispassionate bureaucrats deciding to withhold treatment from loved ones.
The angry response to the AHCA has been widespread, but has not landed a “zinger” that cuts to the core of America’s political culture. A viral epithet is needed to tarnish the AHCA to such an extent that at least three Republican Senators come to view the bill as political kryptonite. Many people believe that the AHCA is bad public policy, but the electorate does not rally around policy analysis – people need catchphrases and soundbites.
In a bit of irony, it appears that Democrats’ best bet for a viral epithet involves one of the very charges leveled against Obamacare by Republicans themselves. Several years ago, the GOP criticized Obamacare for being opaque and created behind “closed doors.” Today, the GOP has been lambasted for creating both AHCA bills, House and Senate versions, in secret. Famously, U.S. Senator Rand Paul (R-KY) went across the Capitol to the House of Representatives and demanded to see the AHCA bill that was being crafted in secret.
Such party infighting has been common this year, with Republicans in both the House and the Senate complaining that they have no idea what will be in the healthcare bill until its unveiling mere days before the expected vote.
As a result of all this secrecy, Democrats may use the phrase “behind closed doors” as a cudgel with which to batter the AHCA ahead of the Senate vote, which is expected to occur before Congress’ July 4 recess. The insinuation will be that GOP leadership knew that the AHCA bill would be unacceptable to voters, and even many members of the Republican Party, and thus kept it under wraps to avoid dissent. By hastily unveiling the bill at the last second and loudly demanding that party members vote for it, the GOP is arguably subverting democracy and relying on brute intimidation.
Avoiding wonkish arguments, such as pointing out the Congressional Budget Office’s prediction that millions of citizens would lose health insurance coverage under the AHCA, liberals may have better luck painting the GOP as cowardly and undemocratic. By attacking the process of creating a bill in secret and then trying to ram it through a vote, the Democratic Party can attack conservatives on a broad front. Moderate and independent voters who are satisfied with their health insurance and not afraid of losing it may wonder what else the GOP might try to undemocratically ram through Congress if given the chance.
With President Trump having pledged to “drain the swamp” during his campaign, accusations of closed-door meetings and intimidation tactics on Capitol Hill may erode his image among supporters. Even those who have little sympathy for citizens who might lose their health insurance may think twice about supporting an administration that hypocritically promised transparency before crafting bills in secrecy. “Behind closed doors” can also be used as a potent attack due to Trump’s CEO image, with Dems likening the president and his allies to corporate cronies who push costs onto workers in – you guessed it – closed-door meetings.
However, the strategy may backfire: Democrats, after all, pushed through Obamacare without a single Republican vote and were criticized heavily for crafting the bill in secret. The big difference, which may save the Democrats this year, is that Obamacare was intended to expand healthcare coverage, not reduce it. Both Democrats and Republicans behaved badly when crafting healthcare reform, but the Democrats’ goal was arguably nobler. Republicans have argued that the AHCA will reduce health insurance premiums, but provided little support for that assertion other than general praise for “market forces.” Given Americans’ widespread dissatisfaction with healthcare, it is unlikely that many voters are confident that the AHCA will improve their bottom lines.
