Jacob Hacker on Obamacare’s Rocky Rollout and Our Frail Democracy

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Jacob Hacker, director of Yale’s Institution for Social and Policy Studies, is one of the most astute political analysts around. His 2010 book, Winner Take All Politics, co-authored with Berkeley’s Paul Pierson, is one of the best chronicles of how rising economic inequality leads to greater political inequality in a vicious cycle, as those who have amassed vast fortunes use them to buy political clout, which in turn enables them to set the rules of the game in such a way that they can enrich themselves further. The book would become an inspiration for Moyers & Company’s first three episodes.

In 2006, he first teamed up with Pierson to write Off Center: The Republican Revolution and the Erosion of American Democracy, which detailed the rightward-lurch of the GOP three years before the advent of the tea party.

Two years later, Hacker proposed a health care reform scheme that would have expanded Medicare while retaining the existing system of employer-based insurance – he basically championed the “public option” before the legislative debate over the Affordable Care Act had begun.

Now, with the bungled rollout of Obamacare leading the evening newscasts and just a week after Senate Democrats changed the filibuster rules to combat unprecedented obstruction in the upper chamber, Moyers & Company caught up with Hacker to get his take on recent events.

Joshua Holland: In Off Center, you detailed how a relatively small group of conservative ideologues were able to push the political center rightward. One of the ways that happened was that they rejected some of the longstanding norms that made our admittedly clunky democracy – with all of its checks and balances and minority vetoes — work, or at least work to a certain degree. Can you connect that to Harry Reid’s decision to finally eliminate the filibuster on judicial nominations and presidential appointments?

Jacob Hacker: I think it’s a very big deal. The fact is, as we wrote in Off Center, our political system has been affected very badly by the highly unequal polarization of the two parties. When we talk about polarization, we often think it’s like a barbell with equal weight on both sides, but in fact the right side is much heavier than the left side and that off center drift has created huge incentives for the conservative side to push the bounds of acceptable political behavior.

There’s an arms race quality to it. Once one side has breached a norm, then the other side feels pressured to do so as well. Both sides are playing this game, but the side that’s really pushing the ball down the court, if you will, is the Republican side.

So the filibuster had become, essentially, a de facto rule of 60. Until last week, everything but the budget was essentially subject to a 60-vote threshold and in a body that is already quite malapportioned. And that’s a remarkably anti-majoritarian system.

So we’ve moved in the direction of greater democracy. I think it’s one small step for Democrats, and one giant leap for democracy.

Holland: Half of all the executive branch nominees that have been filibustered in the history of this country have been filibustered under Obama. So those who say that both sides do it are not looking at the historical facts. Both sides don’t do it to an equal degree.

Hacker: Right, absolutely not. And just to clarify that, what I’m saying is that all of the breaches have been by Republicans but Democrats have felt very strong pressure to match that. This happens with campaign finance too, right? Super PACs are essentially a conservative invention, but the Democrats are now feeling a lot of pressure to adopt the same strategy, and you can recognize the unequal polarization of the parties and at the same time recognize that what we’re seeing is a race to the bottom and it’s tearing down our democracy.

Holland: Carl Levin, one of the three Democrats who voted against the so-called nuclear option, warned that Democrats would rue the day when they are back in the minority and are unable to block the most extreme nominees. Is that somewhat of a hollow risk, simply because Republicans have already decided to pursue a maximalist strategy at all times?

Also: is this the beginning of the end of the filibuster for legislation as well? Once you ding that structure, is it inevitable that it will fall?

Hacker: I think in the long term, the filibuster will go down. There are a lot of people, myself included, who would argue that this is just good for our democracy, regardless of which side of the partisan aisle it helps, and that’s a principled position, I think, for a fair number of Democrats. They were willing to accept the risk that they would have these same tactics used against them.

The first thing to go is going to be the ability to filibuster Supreme Court nominees. It’s such a rare event in any case, if a minority party were to try it, it would be gone. And so that’s dead. The next question is whether or not legislation outside the budget — the budget, again, is not subject to the filibuster — would go to majority rule, and I think that would require a very specific set of circumstances.

Holland: I certainly remember with painful clarity good bills being passed in the House, only to die in the Senate during first term. I think they racked up 200 of them, or something like that.

Hacker: Oh yeah, the Senate is where good ideas go to die. There’s this saying that’s attributed to George Washington, but I don’t actually think he said it, that the Senate is like the saucer that will cool the coffee. But I think what we have now is frozen coffee. It’s just become an institution that operates fundamentally differently from how it operated in the past. Younger Americans don’t realize that there was once a time when filibusters were rare and used mostly for things on which a small minority felt intensely, mostly as a way to publicize their opposition.

[The late US Senator from South Carolina] Strom Thurmond, for example, famously waged the longest filibuster to try to stop the Civil Rights Act. So the big change was that it became routine – that happened in the 1980s and accelerated in the ’90s, and now we’re starting to see a move back towards what’s been the historical norm, which is that the Senate is a reasonably majoritarian institution.

Holland: Now, let’s shift focus here a little bit and talk about the other huge political story of the day, which is the maddeningly bad rollout of Obamacare.

Hacker: This has been a huge, huge fiasco, and I think people should recognize that. Those who are supportive of the law, like me, should acknowledge it, but we should also step back and put this into some perspective.

And the two things I would just want to remind people of are first, that this bill is not going to be repealed or seriously amended until Obama is out of office. So it could very well hurt the Democrats substantially in the short- to medium-term, including in the midterm elections, which were looking pretty good for Democrats after the debt ceiling craziness hurt Republicans last month. That, in turn, may do a lot of other things that aren’t good for our republic, but it’s not going to cripple the Affordable Care Act, and so it’s going to have a chance to hit the ground. It’s waddling or crawling now, but it’s going to get a chance to hit the ground with a little bit more speed going forward.

The second is that I can’t think of a law in the post-Reconstruction era that has been as vigorously contested by the other party after passage. So while I do think people should understand that the administration has completely fumbled the ball here, what makes it so dangerous is they’re fumbling the ball while the opposition is closing in on them with a huge bunch of linebackers.

There’s a move underway to try to block enrollment in the law, to discredit it, to defund it, to do anything they can. And if you think about some counterpart periods — for example, you didn’t have massive Democratic attempts to try to block the implementation of the Medicare prescription drug bill passed under Bush, partly because Democrats were favorable towards that.

There were a whole bunch of initiatives that were passed under the Bush administration that had tepid or nonexistent Democratic support and there was nary a whisper about trying to hurt their chances of going into effect. And I think there’s a history of sort of politics stopping when a law is signed. That doesn’t mean people don’t fight it in the courts, and it doesn’t mean that they don’t try to repeal things when they get back in office, but it does mean that taking a law that’s on the books and doing everything within your power to thwart it — I think that’s just been unprecedented in recent memory.

Holland: Especially from a minority. It’s one thing to win an election and say, “We’re going to repeal that thing that we didn’t like.” This is completely different.

Hacker: Oh, absolutely. But let’s not kid ourselves. I mean this rollout is really bad. It’s hurt the perceptions of the law, which were never that great to begin with. The law has always been an abstract symbol rather than a concrete reality in people’s lives, and the longer it takes for it to actually go into effect and start providing help to people, the less chance there is of its image improving in the medium term.

And I would just say one last thing about this, which is that there’s a fundamental mistake that was made by the administration, which I think is lurking over this. People do understand when somebody says something that turns out not to be true, and the president’s promise that you’d be able to keep the healthcare you have was not a promise that he should have made. There were a lot of good ways you could say, “We are going to do everything within our power to ease disruption without making that promise.” The president and his allies were rightly pointing out that insurers were dropping policies right and left and that there was a ten percentage point decline in the share of people getting health insurance through their employers in the years leading up to the passage of the Affordable Care Act.

So I think the President made an error, and there’s a lot research among political scientists which shows that it’s these simple things like, “Read my lips, no new taxes,” or “I pledge never to raise taxes,” for — the taxpayer pledge that Grover Norquist has everyone sign – those things are just so easy for people to grasp, and the complexity of these policies—and this is a very complex policy—makes people fall back on that. So I’m worried that that’s going to be a bit of an albatross around the Democrats’ neck for a while.

Holland: Let’s talk about complexity a little bit. Since the rise of Clintonism, a lot of liberals have tried to deliver public goods in a way that doesn’t look like it represents “big government” programs. So, for example, we give people child tax credits and tax credits to help with retirement savings and college costs. Suzanne Mettler wrote the great book called The Submerged State, and she pointed out that these kinds of benefits leave people with less appreciation for what the public sector does and an inflated sense of what the market can provide.

Now, you’re one of many people who are sometimes called an “architect of Obamacare.” I should make clear that the Hacker plan was very different in the details, but ultimately, it was similar in terms of the overall structure…

Hacker: Yes, I think that there was broad agreement among those seeking reform that it was not politically feasible, and perhaps not even desirable, to displace many of the existing sources of coverage, but rather to try to build on the current system in a way that would move towards a more integrated, efficient and encompassing system that covered everyone and better controlled costs.

Holland: But let me ask you this: It’s five years later. You’ve watched this thing play out in the real world, and one of Obamacare’s biggest challenges is its inherent complexity…

Hacker: Yes, I used to call it a Rube Goldberg contraption, and I’m a supporter! I guess I would say two things here. The first is this idea that the US relies heavily on the private sector and on indirect means of providing benefits is very true. I actually wrote a book in 2002 about this called The Divided Welfare State.

The point is — and this has been confirmed by really good research by the Organization for Economic Cooperation and Development – the United States spends as much, if not more than other countries on social benefits. We just do it much more through mandated and induced private sector spending — from private pensions, which now are just basically private investment accounts in the form of 401(k)s — to private health benefits that are subsidized to the tune of $250-$300 billion a year through tax breaks.

This does have really big implications for the politics of social policy in the United States. If you get your benefits primarily through private means, you’re very unlikely to see the ways in which the public sector is involved. I don’t think that’s as true for the Affordable Care Act in its structure, because of course you are getting these benefits, even if they’re private, through these exchanges. But I think it reminds us why it would have been preferable to have the so-called public option which I developed.

The public option, which is the idea of having a public insurance plan alongside the private plans, would have made these systems look at lot like Medicare today. That is, most people are enrolled in a standard public plan, but people can choose private plans that have various features, and about a fifth of Medicare beneficiaries do so.

What we have here is a situation in which the whole thing is dependent on getting all these private plans to participate, as well as regulating them, and we haven’t even gotten to those problems yet, because we can’t get people enrolled.

The other thing is – and I’ve seen no discussion of this — the biggest problem with the Affordable Care Act is that it lacks an effective means of automatically enrolling people. If you think about why Social Security is so effective – and why Medicare is so effective – it’s that essentially everyone is brought into it at a certain point in their lives. Medicare is quasi-voluntary for Part B, but you would have to be crazy not to sign up.

The research shows that if you have an opt-out, rather than opt-in, you get much higher rates of enrollment. That would have solved the big problem that I see, which is that we’re going to have a lot of people falling through the cracks in the early years, and you can’t control costs going forward if there are people moving in and out of the system and you don’t have wide coverage.

Holland: I just wonder if at this point the Republican party has gone so far off center — to use the title of your 2006 book — that maybe it’s time for liberals to return to the kind of unapologetic support for government intervention that marked the New Deal era and the Great Society. Because if a market-based public/private expansion of health coverage that the Heritage Foundation was championing just 20 years ago is going to be greeted with an opposition that calls it a government takeover of healthcare and says it’s the road to socialism anyway, I don’t know that we have that much to gain by loading up the submerged state.

Hacker: Well, yes, exactly. You’re not going to win over today’s Republicans. They’re like Lucy with the football. Every time the Democrats — the Charlie Brown Democrats — run towards the football, they keep moving it to the right.

Al Gore had a joke that the right hand didn’t know what the far right hand was doing, but at this point there is no right hand. It’s all the far right hand. And the handful of Republican moderates who are left are so frightened about tea party challenges that they are hiding out in undisclosed locations and siding with conservative Republicans on virtually everything that matters.

So you’re absolutely right that that’s the fundamental problem. But I don’t think that Democrats and progressives are trying to win over Republicans anymore. They’re trying to win over the American people, and I don’t think we can pretend that there hasn’t been a 30-year attack on government.

The Obamacare rollout does not help. It reinforces some of the biggest misconceptions about government. You know, there are programs like Social Security that everyone understands to be really well managed. And nobody says, “Oh, that military that is defending our nation are a bunch of faceless bureaucrats who don’t know what they’re doing.” The point is that we see government in concrete terms. Abstractly, we hate it, but when we look at specific programs like Social Security, which is the largest domestic program, we love it.

So what is it that progressives need to do? I think that there’s got to be some attention to the larger problem of the lack of faith in government, rather than the selling of specific policies. Just go back to what I consider to be that really ill-fated statement of the President. His promise was basically, “Only good things can come of this bill. You will never see your healthcare change for the worse.” Whereas I think there could have been a much stronger, and easier way to explain what was going on, which is to say, “Look, the system is crumbling. Private insurance is much less available than it was 10 years ago. It’s going to be much less available 10 years from now. What we need to do is try to figure out a new, solid foundation for that system, and how we’re going to do it is we’re going to bring a little bit togetherness into the system, right? We’re going to see ourselves as linked together a bit by our shared need for healthcare, or the shared risks that we face.”

And that is what government is about. Government is about doing things that we can’t do alone, and it’s about doing it through a system that we believe is at least partially responsive to the broad will of the American people.

My view is that we will have greater faith in government when we have greater faith in American democracy. So to return full circle to the beginning of our discussion, I think the biggest reason that people are distrustful of their political institutions is they’re feeling that they’re not being well represented. And it’s ironic that both sides of the political spectrum feel that way, but maybe they’re not wrong. I mean, look at the dominance of money in American politics, the extent to which it seems like nothing can get done in Washington. That is something that hurts all Americans. It doesn’t just hurt Democrats. It hurts them more than it hurts Republicans, but it doesn’t just hurt Democrats — it hurts us all, because we are, after all, a great democratic experiment. We are the only country, in my view, that can lead on some of the greatest challenges we face globally, including climate change. But we basically look a bit like a banana republic right now, and until we start to look more like that shining city on the hill that the Puritans spoke about, we’re going to have a hard time getting other people to follow our beacon.

Joshua Holland was a senior digital producer for BillMoyers.com and now writes for The Nation. He’s the author of The Fifteen Biggest Lies About the Economy (and Everything Else the Right Doesn’t Want You to Know about Taxes, Jobs and Corporate America) (Wiley: 2010), and host of Politics and Reality Radio. Follow him on Twitter: @JoshuaHol.
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