You can’t save political capital. You can only spend it. Those wise words were passed along to me by a Vermont politician years ago. The meaning is simple — when people support you, when you’re popular, you can use that good will in order to accomplish things. You can’t bank current popularity for a future date. And because popularity is such a changeable attitude, you better act fast when you’re held in high regard.
Republicans have some political capital in their pockets right now. Granted, it’s not a huge surplus, but it’s enough to get some things done. Doing anything at all in the political arena carries some risk, however, so the question is: Will Republicans want to spend their small cache of political capital on a risky venture such as a health care reform proposal? Here’s why I think they must:
Americans are genuinely hurting because of the Affordable Care Act. Many Americans have either had their insurance canceled, know someone who suffered that fate, or fear changes to their plans and provider networks as the ACA’s roll-out continues. (Count me in that last category.) It isn’t unreasonable for Americans to want politicians to fix these problems. After all, politicians created them in the first place. And Americans could reasonably believe that politicians who don’t step forward to fix the mess created by the ACA — especially politicians who’ve criticized the ACA relentlessly — aren’t acting responsibly. They’d rightly think “a pox on both your houses.”
In other words, if the GOP doesn’t respond seriously and responsibly to the ACA problems because they fear political backlash or don’t want to take the risk, they become part of the problem, not the solution. The GOP could wave farewell to the small stash of political capital they now enjoy.
A Quinnipiac poll released a week ago showed Republican gains on the generic ballot…even with generally low approval ratings for the GOP. This swing was characterized by political writer Charlie Cook as one of the “most dramatic” he’s seen in 40 years. The poll also showed bad approval ratings for the president, not just in general but on specific policy issues. (For a good write-up of the poll’s findings, go here.)
Republicans also can put together a health care reform proposal that takes advantage of some shifts in public attitude that represent another kind of political capital — understanding. The most important attitude shift is this one: a majority of Americans, according to Gallup, no longer believe government has a responsibility to ensure all have health care coverage:
Throughout much of the 2000s, a solid majority of Americans believed it was government’s job to ensure all Americans have healthcare coverage, hitting a high in 2006 when 69 percent agreed while 28 percent said it was not government’s responsibility. However, after 2006, Gallup measured a steady decline among those who believed government should ensure healthcare for all.
While that number is not specifically replicated in a CBS/NYT poll released recently, a sizable minority of respondents do not believe it is government’s responsibility to provide affordable health care to all (a super majority, however, do believe government should play a role in providing health care to the elderly).
This is an important lesson that the American public has absorbed. Due to the continued bungling of the ACA website and the law’s impact on insurance plan changes and cancellations, America might be wising up to something I’ve been writing about for a while now: No one, least of all the government, can make health care “affordable.” We can strive to make it less expensive and easier to access, yes. But affordable? Not if you define that word the way most people would. For example, even cutting health care costs in half still won’t have the effect of making it affordable for many folks. A $1,000 invoice pared down to $500, in other words, is still a hardship to a struggling middle-class family.
Republicans need to take advantage of this new enlightenment. They need to tell America, no, we can’t necessarily make health care more affordable, but here’s what we can do to make it less expensive. Obviously, the GOP list would include tort reform, ways to enhance usage of health savings accounts, introduction of more free-market principles, and maybe even ways to decouple insurance from employment. That last one is probably the biggest issue for most Americans–how to get insurance if they lose the job it was tethered to.
Yes, some components of the ACA that are popular will probably need to be left in place or at least not substantially modified. Whether or not you think it’s good policy to require insurance companies to allow children to stay on their parents’ policies until the age of 26 isn’t as important as grabbing the opportunity to make responsible, substantive changes to health care that Americans are primed to understand and accept.
Republicans should grab this chance to spend political capital on health care reform. Say what you want about the Democrats’ passage of the ACA, but at least they had the courage to put political capital on the line for this issue. If the GOP doesn’t do the same, it will not only be bad politics. It will be irresponsible governing.
Libby Sternberg is a novelist.