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The Obamacare repeal battle showed the power and limits of grassroots organizing

Five lessons the Obamacare repeal fight taught resistance organizers.

Activists Protest Against GOP's Trumpcare Bill Photo by Justin Sullivan/Getty Images

Jennifer Flynn Walker and Paul Davis are close friends, left-wing organizers who worked together as activists during the HIV/AIDS crisis of the 1990s and have trained hundreds of other activists since.

They’ve also both dedicated much of their past seven months to fighting Republicans’ efforts to repeal and replace Obamacare. But ask them what to make of the fight and you’ll hear wildly different answers.

“People power actually won,” said Flynn Walker of the Center for Popular Democracy. She said Obamacare repeal’s failure revealed the power of activism and grassroots mobilization to sink unpopular legislation. “It was the voices of the people who won this campaign.”

But Davis, now an activist with Housing Works, suggested the opposite — that the campaign revealed the limits of what grassroots activism can accomplish against a Republican Congress. “The true lesson here is in the power of vapid cruelty — the [GOP’s] profound commitment to needless cruelty with no rationale or reason,” he said.

By the end of their arduous campaign against the health care bill, left-wing organizers were simultaneously exhausted, exhilarated, and somewhat conflicted over how to interpret the results of their biggest fight in years. The bill was, in the end, defeated. But Senate Republicans came within just one vote of passing the “skinny repeal” bill, suggesting that all the activists’ efforts may have proven insufficient to protect the insurance of 16 million Americans had Sen. John McCain (R-AZ) not defied all expectations at the last minute.

Despite local and national civil disobedience campaigns, the Republican Party walked right up to the brink of passing a bill that sometimes polled below 20 percent. A bill so wildly unpopular, facing massive national outcry, could be expected to die on arrival. But 49 Senate Republicans voted for it anyway.

Since the bill’s collapse, I’ve interviewed about 10 activists on the front lines of the health care fight to find out what they learned from spending more than half a year trying to kill Trumpcare. They shared five lessons from the fight — including about the strength, and the apparent limits, of the grassroots activism many have dedicated their lives to building.

1) Resistance bandwidth is limited and must be concentrated

Several times during the Senate health care fight, Sen. Chris Murphy (D-CT) tweeted a message urging the public to concentrate on the health bill rather than a Russia-related story.

Sen. Ron Wyden (D-OR) similarly announced that he’d answer every reporter’s question about Russia by first talking about health care. “When reporters ask me a question about Russia, I now say, ‘I’m happy to talk about it, but you’re going to have to listen to me talk about the health care challenge ahead first,’” Wyden said.

In June, Murphy went on MSNBC and said Democrats had allowed themselves to become “distracted” by Russia. “The fact that we have spent so much time talking about Russia, you know, has been a distraction from what should be the clear contrast between Democrats and the Trump agenda,” he said.

In retrospect, this lesson may seem obvious — by the end of the health care fight, congressional Democrats and activists grew accustomed to trying to ignore the fog of scandal emanating from the White House to focus on health care.

But that wasn’t always the case. “The need for relentless pressure despite mind-blowing distractions is now clear,” said Ben Wikler, the Washington director of “But at the beginning of this, it wasn’t obvious at all. As the public and as activists, we weren’t used to these political explosions popping constantly from the White House. We really had to train ourselves to ignore them and keep our eye on the ball.”

In other words, activists learned that the Trump show may be flashy and impossible to ignore — but, faced with pending legislation, it’s vital to focus at the legislative mechanics.

2) Keeping media attention is a tall task in the Trump administration’s chaos — and Senate Democrats can help

One of the toughest periods for the resistance to the health care bill came during the first two weeks of June, when Capitol Hill was consumed by FBI Director James Comey’s testimony before Congress. Health care fell off the national radar.

During these two weeks, Senate Majority Leader Mitch McConnell was making progress on writing and corralling the votes for a bill, despite its implications for the health insurance of millions of Americans.

But because McConnell was writing the bill in secret, resistance leaders admitted struggling to get the press to pay attention. The number of calls over the bill to congressional staff offices had slowed to a trickle. On a phone call on June 13, Wikler called the slowdown in activism “unacceptable.”

Then something happened that put the health bill back on the front pages: Senate Democrats went nuclear.

Sen. Kirsten Gillibrand (D-NY) holds a rally on the Capitol steps opposing the GOP health bill.
Vox / Jeff Stein

On June 19, the week after Comey’s testimony, Democrats announced that they would withhold consent on legislative business, shutting down the normal operations of the Senate. They also started invoking the two-hour rule, which cut short the time Senate Republican committees had for their hearings.

The media followed the drama. Major news outlets like CNN, the New York Times, and Fox News gave prominent coverage to Senate Democrats’ extraordinary protest. That fueled a positive feedback loop, where coverage of the fight helped activists mobilize more resistance against the health care bill, which led to more media coverage about the bill, which in turn led to more activism, according to Wikler.

“If you want to draw public attention, you have to put up a big, visible fight,” Wikler said in another interview this week. “There was a period when health care appeared to be banished from the front pages; that only changed when Democrats said they’d shut down regular operations of the Senate.”

He added: “If Republicans are trying to keep quiet, Democrats need to step outside business as usual to make sure the media won’t look away from it.”

3) The most progressive policies can be the hardest to repeal

Republicans in the Senate came within just one vote of passing a health care bill — called “skinny repeal” — that would have stripped away the Affordable Care Act’s most centrist policies, like the individual mandate and the Obamacare exchanges.

Meanwhile, Republican senators struggled the most to repeal the parts of Obamacare that reflected its most left-leaning policies, like the expansion of Medicaid and regulations governing insurance companies. The health bills McConnell proposed that would have gutted Medicaid — the Better Care Reconciliation Act (BCRA) and the Obamacare Repeal Reconciliation Act (ORRA) — failed by nine votes and seven votes, respectively, amid stated concerns from Republican senators about the Medicaid cuts.

“There’s a great irony here,” said Sen. Jeff Merkley (D-OR) in an interview shortly before the “skinny repeal” vote.

He noted that the members of the GOP appeared to have the easiest time defanging the most market-oriented parts of Obamacare. They struggled, he added, to touch the parts of Obamacare that involved the largest expansions of the welfare state.

How McConnell sold the bill to its members was also instructive. In the runup to the health vote, he privately told GOP senators that even if they voted for Medicaid cuts, the bill would never become law, revealing its political potency.

This is a lesson resistance leaders shared as well — that Medicaid, not the market-centered exchanges, was what Republicans struggled the most to attack.

“The most progressive policies proved the most popular and the most politically impregnable,” Wikler said. “That is a clear lesson from this fight.”

Added Rep. Raúl Grijalva (D-AZ), a progressive House member: “The public support for the expansion is huge; that program has solidified itself, like Medicaid and Social Security, as a third rail. Those were bold initiatives. While what hurt Obamacare were the exchanges and the mandate — and the huge role insurance companies had in crafting them. And those were conservative ideas.”

4) Activists had to rewrite their playbook because of the GOP’s wildly unusual process to try to pass the bill

In February, as House Speaker Paul Ryan worked on his Obamacare repeal bill, Kelley Robinson realized she had a problem.

Robinson, the national organizing director of Planned Parenthood, wanted to send the organization’s legions of followers to House Republican town halls. But vanishingly few House Republicans, she discovered, actually had town halls planned.

So activists instead got creative. “Members said they were not holding town halls, and we said, ‘We'll do search parties to find them wherever they are,’” Robinson recalled. “We had hundreds of these ‘search parties.’”

Activists took similar steps throughout the country. Senators ran into constituents at Independence Day parades who urged them to reject the GOP health bill. Liberals held an “empty chair town hall” for Sen. Marco Rubio (R-FL). Dozens more “empty chair” town halls would be held in states around the country, according to the Town Hall Project.

There was no escape in Washington. On Capitol Hill, activists with the disability rights group ADAPT crashed the offices of Senate Majority Leader Mitch McConnell, screaming and getting dragged out of his office by police. Planned Parenthood activists staged mock “waiting rooms” in senators’ Washington offices, bringing in magazines and coffee tables to mimic doctors’ offices.

“Folks were looking for ways to tell their stories, and we had to figure out new and unique ways to get the message out,” Robinson said. “We showed them, hey, we’ll be willing to wait and hold you accountable at the end of the day.”

5) Activism has its limits. That doesn’t mean it was irrelevant.

Activists convinced that their organizing stalled Obamacare repeal don’t just point to the fact that the skinny repeal bill failed on the Senate floor.

Additionally, they note that McConnell and Ryan had initially planned to repeal Obamacare by February — before House members confronted a wave of town hall protests against health care cuts. They also argue that acts of civil disobedience, like those by ADAPT, forced the media to talk about the bill’s impacts, which in turn made it more unpopular with the country as a whole. Two Republican senators admitted to me that the resistance was making the bill more difficult to pass.

Beyond that, other activists have said that their work indirectly led to the bill’s defeat, even if McCain didn’t directly cite them as the reason he voted no. Topher Spiro, a prominent Obamacare defender at the Center for American Progress, said the activism and public outcry forced McConnell to try to ram a secret bill through the Senate without hearings or debate — a process that in turn hamstrung Senate Republicans.

The wild and unprecedented legislative process hurtled to a conclusion that flew against all of McConnell’s previous promises for running the body. Senators only had a few hours to read the text of the “skinny repeal” bill before voting on it.

“It's now clear that causing a delay in timing worked. For one thing, it forced McConnell to use a rushed, secretive process — which itself became a liability for McCain,” Spiro said.

Still, it’s hard for some organizers to shake the conclusion that the health care fight proved the Republican Congress’s indifference to grassroots activism.

ADAPT activists spent close to 60 hours sleeping in Sen. Cory Gardner’s (R-CO) office to decry the bill. A tour bus from Ohio brought dozens of protesters to confront Ohio Sen. Rob Portman in Washington. Activists chartered planes to fly anti-Trumpcare messages in Sen. Shelley Moore Capito’s (R-WV) district, and showed up at her house.

All those senators voted for the bill.

“The senators and Senate staffers barely feigned interest that their policies were literally going to kill people in front of them — that’s not a very good lesson, but it’s unavoidable,” said Davis, of Housing Works. “One of the primary things we discovered is that very few members of the Republican Party feel accountable to anyone other than a particular set of Republicans.”