Dems: You need to be FOR healthcare reform

Dear Congressional Democrats,

When it comes to healthcare reform, please stand up and be FOR something.  Otherwise, you are losing at least one-half of the battle, and might end up losing the entire battle.

Let me explain.

As I see it, there are two halves of this battle.  One is the perception that the Affordable Care Act is failing.  “A disaster!” as described by many Republicans.  Perception is the mother of reality.  In some areas, premium increases are unacceptably high.  In other areas, competition is lacking.  While this may be partly due to White House actions to deliberately undermine the system, the perception that the ACA has severe flaws is widespread.  You are losing that half of the battle.

The other half is the Republicans’ proposed “solution.”  At first glance, you are winning there, as the American Health Care Act passed by the House is awful and hugely unpopular.  But opposing the House bill and calling out its meanness ultimately failed to defeat it, so maybe you aren’t really winning after all.  In the Senate, the unprecedented secrecy about legislation that would overhaul one-sixth of the U.S. economy is appalling.  But the leadership has been consistent on this:  they truly don’t care what’s in the final bill; they only care about having something, anything, that will pass with 50 or more votes that qualifies as sticking a finger in the eye of Obamacare.

Lock-step opposition may be effective up to a point, but that strategy failed in the House, and failed in the Senate with respect to various cabinet nominees and the Neil Gorsuch confirmation.  Because the Republican leadership deeply cares about tax cuts, doesn’t care one iota about healthcare policy, and has the legislative skills to navigate the rules for getting a bill passed, you are probably going to lose this half of the battle as well.

The solution?  Instead of being against, against, against all the time, be FOR something too.  Put together a Democratic alternative healthcare bill.  There are a number of ways to strengthen the Affordable Care Act by making markets more competitive, further reducing the number of uninsured, and bringing down the underlying costs of drugs, medical devices, hospital stays and doctor visits.

Then hold mock hearings.  If you cannot have official Senate hearings, have unofficial off-site hearings on the Democratic bill.  Invite experts to testify and ask them questions about the consequences of the AHCA as well.  Hammer home the differences between the Republican approach that will increase the number of uninsured and provide a tax windfall for the wealthiest versus a plan that acknowledges and would fix numerous imperfections in the ACA and further reduce the number of uninsured.

And make a big media spectacle out of being FOR something that will benefit millions of Americans.

By proposing the kind of legislation that would make real improvements, with real discussion and debate, you would be acting like you deserve to be the majority party.  The voters might agree.  You can start winning the perception battle by showing how to stabilize and strengthen the ACA.  And you outright win the policy battle with a plan that further reduces the number of uninsured Americans.