The latest, last-ditch effort by Senate Republicans to overturn the Affordable Care Act — the so-called “skinny repeal” — gives Democrats a golden opportunity to begin redefining their party as a reliable champion of the bread-and-butter economic issues that working-class voters care about.
Republican attempts to dismantle Obamacare have ground to a near halt as the nation absorbs the implications of undoing the current law’s dense web of federal subsidies of medical services that insurers are legally required to cover. According to the nonpartisan Congressional Budget Office, ripping away the subsidies and loosening mandatory requirements could add 16 million people to the rolls of the uninsured.
But Republican leaders are determined to press ahead, using a strategy that treats repeal efforts as a budgetary matter, which, under Senate rules, requires passage by a simple 50-vote majority rather than an all-but-impossible 60 votes.
The GOP leaders hope to narrowly pass repeal in the Senate without any help from Democrats, and then hammer out a final law with their counterparts in the House. But to execute that budgetary maneuver, the Senate must go through a so-called vote-a-rama, a period during which Democrats can introduce dozens or even hundreds of individual amendments and force Republicans to vote on them.
If done properly, the vote-a-rama could be the place where Democrats reconnect with the middle-class voters who deserted the party in droves last year. At a time when 52% of Americans think the Democrats don’t stand for anything except opposition to the Trump administration, a string of carefully crafted statements of principle and intent can showcase core values like fairness, compassion and practical aid for the poor and the unlucky.
The core Republican effort to roll back Obamacare’s expansion of Medicaid services is a good place to begin. Under various versions of the GOP’s plans, states would endure an average 19% reduction in Medicaid funding.
These same states are grappling with a dire need to treat opioid addiction and seniors with Alzheimer’s. The estimated 15 million Americans caring for someone with Alzheimer’s are families that Democrats should be targeting to explain what will happen if the primary source of federal funding for nursing homes and other end-of-life care gets reduced or eliminated.
It’s not enough for Democrats to simply point to the horrors of shrinking Medicaid. They should introduce amendments to expand Medicaid even further, especially provisions that shore up the finances of community health centers in medically underserved areas.
It’s important that the substance of Democratic proposals not be reduced to a blocking effort. Far better is it to brand the fight as the continuation of a party tradition — helping families avoid medical and financial catastrophe.
Just as Democratic President Franklin Roosevelt created Social Security and Democrat Lyndon Johnson signed Medicare into law, Democrats should argue that the Affordable Care Act — especially the expansion of Medicaid — is another core pillar of support for working families, something the party can credibly stand for and fight for as the 2018 midterm elections approach.
