The health care debate has revealed a political system unmoored and in crisis.
Part of it is the recklessness of the legislation under consideration. Putting all policy arguments aside, no one — including congressional Republicans — believes these bills to be carefully drafted. House Republicans passed the American Health Care Act before seeing a final Congressional Budget Office score — they didn’t want to know what it did, and they didn’t want anyone else to know either. Senate Republicans moved to debate their bill on the floor before they knew what their bill was.
Republicans are making life-or-death policy for millions of Americans with less care, consideration, and planning than most households put into purchasing a dishwasher.
But the deeper problem — the one that will continue to corrode the system long after this debate resolves — is the role that deception has played throughout the process.
This has been a policymaking process built, from the beginning, atop lies. Lies about what the bills do and don’t do. Lies about what is wrong with Obamacare and lies about what the GOP’s legislation would do to fix it. Lies about what Republicans are trying to achieve and lies about which problems they seek to solve.
This isn’t just a moral offense, though it is that. It is a profound challenge to the policymaking process.
For the most part, the political system — from voting to journalism to policymaking to congressional debate to interest group organizing — is built around the idea that the signals sent by the central players are meaningful, even if the rhetoric is often slippery. That’s how policymakers coordinate with each other. That’s why journalists report what politicians say in speeches. That is why activists organize based on what policymakers propose. That’s why voters tune in to presidential debates and party conventions.
This is not to be naive. Politicians fib, prevaricate, misdirect. They exaggerate and make untenable promises, like Mitt Romney’s mathematically impossible vow to make deep, deep cuts to tax rates without losing a dollar in revenue or raising the burden on the middle class, or Barack Obama’s insistence that the Affordable Care Act would not cancel a single American’s health insurance plan.
Still, the lying tends to be marginal, not central. If you listened to Romney, you would conclude that he wanted to cut taxes; if you listened to Obama, you would conclude that he wanted a new program to expand health insurance coverage. Politicians can typically be counted on to try to fulfill their campaign promises. They tend to try to do what they said they would do, if only to signal to their allies how to fall in line, and to ensure their voters know which side they’re on.
That has not been the case here.
A debate where words have no meaning
Mitch McConnell is perhaps the most cynical politician in Washington. Alec MacGillis’s biography of him is literally, and correctly, called The Cynic. Still, reading McConnell’s 2014 speech on “Restoring the Senate” is breathtaking today.
The speech was, in essence, a manifesto for how McConnell promised to lead if he gained control of the chamber. It reads today as a dark, postmodern joke:
When Democrats couldn’t convince any of us that [the Affordable Care Act] was worth supporting as written, they decided to do it on their own and pass it on a party line vote. And now we’re seeing the result. The chaos this law has visited on our country isn’t just deeply tragic, it was entirely predictable. And that will always be the case if you approach legislation without regard for the views of the other side. Without some meaningful buy-in, you guarantee a food fight. You guarantee instability and strife. It may very well have been the case that on Obamacare, the will of the country was not to pass the bill at all. That’s what I would have concluded if Republicans couldn’t get a single Democrat vote for legislation of this magnitude. I’d have thought, maybe this isn’t such a great idea.
Then McConnell got yet more specific:
Here’s what I would propose to do about it.
First, one of the traditional hallmarks of the Senate is a vigorous committee process. It’s also one of the main things we’ve lost. There was a time not that long ago when chairmen and ranking members had major influence and used their positions to develop national policy on everything from farm policy to nuclear arms. These men and women enriched the entire Senate through their focus and expertise. ... With few exceptions, that’s gone. It’s a big loss to the institution, but most importantly, it’s a big loss for the American people, who expect us to lead.
And here’s something else we gained from a robust committee process: over the years, committees have served as a school of bipartisanship. It just makes sense. By the time a bill got through a committee, you could expect it to come out in a form that was broadly acceptable to both sides. Nobody got everything, but more often than not everybody got something. And the product was stable, because there was buy-in and a sense of ownership on both sides.
The committee process is a shadow of what it’s been. Major legislation is now routinely drafted not in committee but in the Majority Leader’s conference room and then dropped on the floor with little or no opportunity for members to participate in the amendment process, virtually guaranteeing a fight.
There’s a lot of empty talk around here about the corrosive influence of partisanship. Well, if you really want to do something about it, you should support a more robust committee process. That’s the best way to end the permanent shirts against skins contest the Senate’s become. Bills should go through committee. And if Republicans are fortunate enough to gain the majority next year, they would.
There was no signal at all in McConnell’s words. He wasn’t laying out an ideal he would strive toward even if he failed to reach it, or a strategy he would follow until it became clear he had no alternative but to abandon course. The speech was pure deception. Coverage of it simply misinformed readers. As soon as McConnell attained power, he governed in precisely the opposite way to how he promised to govern.
It’s not just McConnell. Consider President Donald Trump’s promises on health care, made mere days after he won the presidential election:
President-elect Donald Trump said in a weekend interview that he is nearing completion of a plan to replace President Obama’s signature health-care law with the goal of “insurance for everybody,” while also vowing to force drug companies to negotiate directly with the government on prices in Medicare and Medicaid. ... Trump said his plan for replacing most aspects of Obama’s health-care law is all but finished. Although he was coy about its details — “lower numbers, much lower deductibles” — he said he is ready to unveil it alongside Ryan and Senate Majority Leader Mitch McConnell (R-Ky.).
Or take this tweet:
I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me.— Donald J. Trump (@realDonaldTrump) May 7, 2015
Every single one of these promises was a lie. Trump did not write or release a bill. The bills he endorsed do not provide insurance for everybody, or for more people, or even for as many people as have it today. All of the bills he endorsed are built around much, much higher deductibles, as well as massive Medicaid cuts. Trump’s words — which were reported widely, including at Vox — offered no guide to the policies he would ultimately make; they served only to mislead anyone who heard them.
From day one, the argument all Republicans could agree on was that their replacement bill was needed because Obamacare’s individual markets were collapsing — too few young and healthy people were buying insurance, and a fix was needed. This was false as a broad claim but true in some markets.
But now Senate Republicans look to be ending their process with a bill that mainly repeals the individual mandate, and thus sends far more markets into collapse. And so the one vaguely real problem they identified and repeatedly promised to solve they are now making much, much, much worse.
This is not normal. It is crazy-making. It’s a debate where words have no meaning, promises have no value, noise carries no signal. A functional policymaking process cannot survive in this environment for long.
If this becomes the new normal in policymaking, it will be disastrous
John McCain’s emotional speech before the Senate on Tuesday was a remarkable moment in American politics — but less for what he said than for what he did immediately afterward.
McCain’s speech was a paean to the traditions of the Senate. It was met with a standing ovation from his colleagues and widespread adulation from the press. “An angry prophet,” said the Washington Post.
Of the Senate’s vaunted view of itself as the world’s greatest deliberative body, McCain said, “I'm not sure we can claim that distinction with a straight face today.” Today’s Senate, he continued, is “more partisan, more tribal, more of the time than any other time I remember.” It was a speech laced with shame for what he and his colleagues have done to the body they serve.
When he turned to the business at hand — the repeal of Obamacare — McCain was unsparing. "We've tried to do this by coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them it's better than nothing, asking us to swallow our doubts and force it past a unified opposition,” he said. “I don't think that is going to work in the end. And it probably shouldn't.”
There was a better way, McCain said:
Let the Health, Education, Labor, and Pensions Committee under Chairman Alexander and Ranking Member Murray hold hearings, try to report a bill out of committee with contributions from both sides. Then bring it to the floor for amendment and debate, and see if we can pass something that will be imperfect, full of compromises, and not very pleasing to implacable partisans on either side, but that might provide workable solutions to problems Americans are struggling with today.
As McCain spoke, two Republican senators opposed moving forward with McConnell’s health care process. One more and the process was dead. McCain had the decisive vote — to say nothing of the moral and emotional authority of his dramatic post-surgery return to the Senate. He could have forced McConnell to run health care through the committee process. Everything McCain lamented of the Senate he had the power, in that moment, to improve.
But McCain instead voted to continue the rushed, partisan process he said probably wouldn’t work, and probably shouldn’t work. He had the power to create the change he hoped to see in the institution he loves. Instead, he embodied and deepened its dysfunction.
It is not just McCain. For years, the senators I interview on both sides of the aisle have privately expressed their despair, their disappointment, their humiliation. Few legislators today take pride in their work or believe the era in which they serve will be remembered with admiration and honor. In these discussions, I always ask the same questions. Why not buck leadership? Why not act in the way you think is honorable, if you think the institution is rotting around you? Why not band together with your similarly angry colleagues and refuse to let anything pass unless changes are made?
I have never gotten a good answer.
Skepticism is healthy in politics. But this era requires more than skepticism. This is a total collapse of the credibility of all the key policymakers in the American government. Our political system is built on the assumption that words have some meaning, that the statements policymakers make have some rough correlation to the actions they will take. But here, in the era of bullshit politics, they don’t. If this becomes the new normal in policymaking, it will be disastrous.