When Barack Obama was elected president in 2008, voters were not merely choosing a candidate they found more compelling. They also were endorsing a renewal of the notion that government could be a force for good.
The flawed rollout of Obamacare, his signature legislative achievement, is testing that premise, giving Republicans a chance to re-litigate the role of government and Democrats pause that the damage could lead to congressional losses.
At stake is whether Obama loses more than the triumph of expanding health insurance by allowing Republicans to claim Ronald Reagan was right in his 1981 inaugural speech when he said: “In this present crisis, government is not the solution to our problem; government is the problem.”
“This plays right into that argument,” said Evan Bayh, a former Democratic senator from Indiana who voted for the Affordable Care Act. “So, do people think there is an appropriate role for government? Absolutely. Does the botched rollout of the ACA undermine that because it harms the government’s credibility for effectiveness? Yes it does.”
The first evidence of which side will prevail in the debate will come in the 2014 fight for control of the U.S. Senate. Republicans need a net gain of six seats to retake the chamber; all the Democratic incumbents running for re-election supported the health-care law, and the governing philosophy underlying it.
The Affordable Care Act’s start has been so shaky that Democrats are expressing concern the impact may bleed into the 2016 presidential campaign, giving Republicans a chance to reset the balance in the country in their favor and possibly undo the health-insurance program.
“It is a massive cultural inflection point right now, particularly for a group of young voters who were invited onto the political scene by President Obama,” said Representative Peter Roskam, an Illinois Republican. “And, ironically, part of what was so attractive was that this was private sector, tech-savvy, sophisticated marketing and highly interactive. All the things that made the campaign a success are in stark contrast to Obamacare,” he said.
“There’s another overlay on this and it is this notion of comprehensive anything,” Roskam said. “‘Comprehensive’ is now an adjective that is being tarnished. It’s become suspect. It’s the lack of the ability of the federal government to be comprehensive about anything.”
Since Presidents Franklin Roosevelt’s New Deal and Lyndon Johnson’s Great Society programs, the Democratic Party has been associated with using the federal government as an instrument for achieving parity and equality in American life.
Reagan altered that dynamic and began an era where Republicans emphasized markets and limited government, a message that resonated in the South and West and transformed political alliances to his party’s benefit.
It affected Democrats as well. President Bill Clinton, speaking after two partial government shutdowns in the 1990s and his own failed effort to expand health-care coverage, said in his 1996 State of the Union address that the “era of big government is over.”
Yet Clinton, driven more by political realities than a change in philosophy, added, “but we cannot go back to a time when our citizens were left to fend for themselves.”
Obama, mindful that Clinton was just the most recent Democratic president since Harry Truman to try to expand health coverage, worked to meld a public-private approach. That added layers of complication to the program, with multiple computer systems, government agencies and private companies seeking to coordinate as never before.
So far, Americans aren’t pleased. Only 40 percent of them approve of the law and 55 percent disapprove, according to a Gallup Poll published Nov. 14. In a survey released Nov. 18, a record 56 percent of adults said it wasn’t the federal government’s responsibility to make sure all Americans have health insurance. In 2006, 69 percent said it was the government’s obligation.
In 2008, exit polls showed 51 percent of voters wanted the government to do more -- and Obama won 76 percent of that group -- while 43 percent said government was doing too much. In 2012, those numbers were reversed.
“What people wanted is practical solutions to problems in their everyday lives,” said Bayh, who decided not to seek re-election in 2010. “What people were most concerned about in the first quarter of 2009 was the economy. Yet that isn’t what was put at the head of the policy agenda. My own party emphasized social equality more than economic growth.”
Obama’s pollster, Joel Benenson, released a report to Democrats on Nov. 19 urging them to focus on jobs and the economy. He said his survey showed voters were dispirited by the government shutdown in October and the focus on the flaws of Obamacare.
His poll found that 39 percent of all voters, and 23 percent of independents, agreed with the statement, “The way to get our country back on track is to get government out of the way and unleash the power of businesses and markets to create jobs by lowering taxes and eliminating needless regulations.”
Fifty-nine percent of all voters, and 65 percent of independents, agreed with the alternate choice that “the way to get our country back on track is to get the public and private sector working together to invest in manufacturing, technology, small businesses and education to create jobs our country needs and train our children to succeed in the new economy.”
Democrats “have not done a very good job” of emphasizing that the law benefits working families most, Dukakis said. “There are a lot of middle class folks with no health insurance or very poor health insurance.”
“If you ask Republicans whether working Americans should have decent affordable health care, they would say yes,” he said.
Dukakis, who now teaches at Northeastern University in Boston, said the Massachusetts health-care system, the model for Obamacare, is “working beautifully” after dealing with startup problems, and the national system can, too.
Representative Sander Levin, a Michigan Democrat, said Republicans will fail if they try to exploit the flawed rollout, citing their unsuccessful efforts to privatize Social Security and the popularity of federal programs such as Medicare and the interstate highway system.
“The scale of Social Security is immense,” Levin said. “The scale of Medicare is immense. The federal highway program is immense. Ironically, the ACA is built on the use of the private health-care structure and it’s turning out to be really complicated. The notion of building health-care reform on the private health-care system with an individual mandate goes back to the Republican approach,” he said.
“To say it’s a government takeover, that’s not true,” Levin said. “It was a blend of public and private involvement.”
The halting beginning of such a broad-scale program has prompted criticism of Obama as a manager in addition to the carping from Republicans about government bungling.
“Obama ran the most effectively organized campaign in modern political history, but he didn’t bring any of that capacity into government,” said Paul Light, a professor of public service and governance at New York University.
“Effective managers don’t just make empty promises and then move on,” Light said. “That’s why Obama is drifting downward. He’s made promises on this.”
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