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The unlikely source for news on the GOP’s Obamacare repeal bill: Democratic activists

“This is a ‘do everything you can’ moment.”

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Dylan Scott covers health care for Vox. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo and STAT before joining Vox in 2017.

`The Republican bid to repeal and replace Obamacare has happened largely out of sight. The House held some public hearings, but negotiated the last-minute deals that helped its bill pass in secret. The Senate skipped any pretense of an open debate.

That process has left an information vacuum — one that a pair of high-profile Obamacare defenders have been happy to step in and fill with their own inside intel, as they seek to drag the GOP’s bill down.

Everybody, including reporters, has been desperate for new morsels of information throughout the deliberately secretive process. But you also have to wonder, in this era of Fake News, how reliable the reporting of two Democrats on the inner workings of their Republican nemeses could really be.

Topher Spiro, who studies health policy for the Center for American Progress, and Andy Slavitt, who oversaw Obamacare for the Obama administration in its final years, have more than 100,000 followers between them and, at least to my eyes, they’ve become leading figures in progressive Twitter activism.

Both have a personal stake in the Obamacare fight — Spiro worked for Senate Democrats and helped draft the law and Slavitt was one of President Obama’s top health care officials. They use their Twitter feeds to disseminate policy analyses and direct their followers to the Republican lawmakers they think should be feeling the pressure.

But they’ve also — in something that feels new to me — used Twitter to spread their own intelligence about the GOP’s internal health care debate. It’s often impossible to verify, but it certainly mobilizes other progressives.

I spoke with Slavitt and Spiro recently about these issues. The transcript has been edited for clarity and length.

Dylan Scott

Both of you in different ways devoted significantly chunks of your professional life to the Affordable Care Act. What’s this process, this whole debate, been like for you guys, and has that been part of your motivation to be so outspoken?

Topher Spiro

For me, as someone who worked on drafting the law, at the time it was very abstract when you’re writing policy down on a piece of paper. What this debate has really driven home for me is the impact on real people. Through this debate, I’ve had the opportunity to interact with lots of people, many of whom whose lives were saved or whose lives are at stake.

For me, as someone who’s more of a policy wonk, it’s really changed the way I think about policy. I think a lot more now about these things really affect people in a real way. For me, it’s become much more of an emotional thing. I think that’s maybe what you see when you see me advocating.

Dylan Scott

I know Twitter is not the core of your work. Andy, you’ve been jet-setting across the country. Topher, I know you’re working on real policy analyses. But you have managed to become prolific social media presences on this issue. How do you look at Twitter in that broader tapestry of work that you’re doing on this issue?

Topher Spiro

I was never someone who was on Twitter before this debate started, so it’s really been a new thing for me. What we’ve found is that it’s been a great way to disseminate the policy analyses. Using the medium has caused me to really think hard about how I’m explaining policy analysis. It’s really forced me to think about my audience and think about how to explain some complex analysis in a really simple way that people can relate to.

It also makes me think about what kind of analysis would be useful for someone who’s out in Nevada who wants to their lobby Sen. [Dean] Heller. What we’ve done is a lot of state-level analysis and levels of impacts at the congressional district level. Twitter has helped me understand the importance of that kind of analysis and it’s been a great to disseminate the analysis.

Andy Slavitt

Let’s look at the context. We all have a bill that by all intents and purposes is going to go from beginning to end in a matter of weeks, without any public exposure. We have a story that changes every few hours, in terms of what’s in it, what’s not in it. Then we have a pretty effective spin machine, and things that come out aren’t always true.

I write a weekly column for USA Today, a lot of people read it, I put a lot of work into it. But six hours after I write that column, the world’s changed and things are moving very rapidly.

Marry that with the tens of thousands of people around the country I’ve interacted with personally. They have a hunger to know and understand. I have people who carefully make me promise to them that not only will we do everything we can to help them, but that we’ll keep them informed.

I too am new to Twitter, within the last year and a half. There’s set of unwritten rules of how to be effective at Twitter and how to make sure you communicate really well. The discipline requires you to make sure things are very simple and sometimes has a little bit of an edge to it. What that means is when the talking point machine comes out, when Paul Ryan says ‘X and Y and Z’, when policy analysts do the work and say, ‘Wait a minute, it’s not X and Y and Z at all’, then you have at least a hope of making sure that the messages get out.

Dylan Scott

I try to remind myself constantly that Twitter is not real life. Do you have a sense of what its actual impact is? I’m sure you have to worry sometimes that you’re just yelling into the hurricane.

Topher Spiro

I think the true answer is that we don’t know. For me, you have to try to hope that you’re having an impact. Otherwise, you’re taking the risk that not doing anything you know for sure you won’t have an impact.

All I can tell you is that the emergence of these groups like Indivisible that have networks spread across the country means that when Andy sends out a tweet and it gets picked up by them, information can spread like wildfire across the country. I know this because when I’m telling people to call certain senators, I would get lots of replies on Twitter from people in that very district. When you can target a small area of the country like that, it’s clear to me that we’re able to get our information out.

Andy Slavitt

This is a “do everything you can” moment. Leave it all out on the field. This is one portion of what we’re doing. I spend a lot of my day talking to hospital CEOs and lawmakers and governors and staff, so this is one element.

Topher’s right, you never really know. The people who already care deeply and believe and just need to be informed, it’ll be much more effective if they’re informed. That’s a target you can hit. You can serve a purpose, because information is so fragmented and so unclear, and there’s so much bad information. When you see some of the things that Topher puts out, it really helps get those people engaged.

I also make an explicit point of trying to talk to Trump voters. First of all, there were apparently a lot of them. Secondly, a lot of them are as deeply impacted if not more deeply impacted by this. So if you can talk to them in ways that takes the politics out, it’s very important to win them over on these issues. There, I’m a little less certain. Of course, the echo chamber problem that you have with any social media platform is real. We’ve got to make sure we do a better job communicating with people who don’t already agree with us.

Dylan Scott

That brings us to the part of this interests me the most, maybe because I’m a reporter. Something I have seen both of you do that’s stuck out to me, that feels a little new: You guys as advocates are effectively reporting inside information about what’s happening in the congressional debate.

How intentional was that or has it become? What is the rationale to go beyond not just disseminating policy details and motivating people, but to sharing inside intelligence?

Topher Spiro

This is one of the most secretive processes we’ve seen for legislation of this scale. It’s really unprecedented. We wouldn’t have to be doing what we’re doing in terms of disseminating intel, if we have a more open and transparent process, if we had a draft discussion bill, if we had public hearings on a draft discussion bill, if we had expert testimony. A lot of what we’re doing is out of necessity.

The people we interact with on Twitter, especially people who care about this issue the most, there’s a real hunger for any information, any developments. I feel a duty to disseminate any information that I have. So I’m really doing the opposite of Republicans, which is sharing any information that I have and making it public.

Part of it is when we hear alarming updates, alarming information about the prospects of the bill, we have to raise the alarm with the grassroots community. So that they know now is the time to exert pressure. That’s especially important this time around. I think during the debate on the House bill, there was this big lull in the middle and people maybe got a little complacent. We can’t let that happen again.

Andy Slavitt

I think you have to understand that there’s not a clean line between things that are value-added or new versus things that have already been reported. You’re drawing a line where you see things that have been reported, versus things that have not been reported, and that’s a distinction that doesn’t really mean much to most Americans. Most Americans don’t read Vox or the Washington Post or the New York Times.

Things that feel very old to you, because you’ve known about them for two days, it may be another week before they get released into the public consciousness. I think the lines aren’t very clean between what’s been reported or what hasn’t.

Dylan Scott

Given the advocacy role of both of you, and adding that I think a lot of people would be skeptical that a progressive advocate knows what Senate Republicans are thinking about, why should we trust this to be reliable information?

Topher Spiro

The simple answer is that you don’t have to trust us. People can do whatever they want with the information. We’re not representing that we are the media or a source of news, and I think people probably understand that. We’re just sharing information that we have and people can do what they want with it.

I think our track record is pretty good. We’ve put out some information that is then later confirmed by traditional news outlets. We talk to the same kinds of people that you talk to. We talk to lobbyists who talk to other lobbyists. As you know, a lot of people in this town talk. A lot of Democrats talk to Republicans.

I’m not saying we’re infallible. We do the best that we can given the circumstances. But if we hear some information, we think it’s credible, my view is that we have to share it.

Dylan Scott

It also occurs to me that we’re dealing with a crisis of trust in publicly available information. Has it entered into your calculations that there might be any risks in conveying this kind of information yourselves, as people with a perceived bias?

Andy Slavitt

I don’t think people are confused about my opinion. I don’t think people are confused about David Brooks’s opinion when he writes on the opinion pages. I’m making an argument. I don’t pretend to be a reporter.

By the same token, when I know things for certain or believe I do, I state it that way. When I hear things and don’t know if they’re true, I say “if true,” because I want to be as true to what I understand and believe as possible. But no one assumes I don’t have an opinion.

I do believe that at the end of the day, if we don’t have bipartisan support for health care, we’ve gone backward as a country in ways that I think are very destructive. But I believe that the path to bipartisanship means killing rancid, awful, inappropriate, partisan products like the ones coming out now that hurt people. I’m very clear on the fact that I think this hurts people.

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