Health Care “Opt Out” Baits a Trap for US Republicans
By Al Giordano
Prior to October 20, just a week ago, the “conventional wisdom” among Washington DC-centric pundits and bloggers was that the so-called “public option” on the upcoming national health care bill was dead in the water.
Since October 20, the same voices have shifted to a presumption that the public option – in which the US government would create its own health program (much like it already has for members of Congress) to compete with private insurance companies, bring their prices down, and offer another option to citizens – is now a done deal and the remaining question is what kind of public option will be approved by Congress.
What changed on October 20 to so radically shift the beltway CW?
315,023 phone calls – deployed by Organizing for America, President Obama’s grassroots political arm – that flooded the US Capitol switchboard in a single day: that, and that alone, is what shifted the ground beneath the health care debate. Those that participated in organizing that warning shot know it even while many who did not lift a finger for it look for other explanations for this positive shift in the discourse.
Opponents have framed the public option as a stealth first step to a national “single payer” plan of universal national health care administrated by the government, and they may well be proved right about that in years to come. Meanwhile, the fact that the President, years ago as an Illinois state senator, supported a single payer solution, has been bandied about by some proponents this year as evidence that he either sold out “the base” (what some white college educated progressives call, um, some white college educated progressives) or that his attention to practical realities somehow indicate that he lacks a political backbone.
It’s been an entire summer of silliness from both of those camps; from the “Obama is a socialist” club to “Obama is another Bush” chorus, the infantile nature of so much of US politics has been on full display with the health care debate as its fulcrum.
Although during this same Summer of Shove of 2009, the President was repeatedly clear on his desire for a public option in the health care law that has eluded every administration since that of Harry Truman in the 1940s and 50s, he was accused again and again of not really wanting it or seeking it. Daily Kos blogger Brooklynbadboy offers an entertaining inventory of pundits and bloggers who “declared the public option dead.”
Among them are those like the whiny voice of blogger Jane Hamsher - still bitter that Obama beat her candidate Clinton in the primaries - who on August 17 declared, “Many people are rightly upset that the White House is sending stronger and stronger signals that they are willing to jettison a public option. What was once the defining feature of the Obama health care plan has now been dismissed with a bipartisan flourish.” Then on September 10 repeated, “the White House has been trying to get out from under th e burden of supporting the public option for weeks.” Then on September 18 re-repeated, “President Obama has been desperate to ditch the public option for weeks.”
Such prattling has been duly featured at the Huffington Post along with daily “reports” (read: rumors based mainly on the statements of unnamed sources inside the beltway, but played as hard news) to feed the HuffPo editorial line, which goes like this: Obama doesn’t want a public option on health care and so “the base” (white college educated progressives, especially of the blogging tendency) has to “make him do it.”
That narrative has been a good example of the typical self-aggrandizing attempt by a certain tendency to insist that the story is about them (most of whom already do have health insurance, by the way, and don’t mix very much with we hoi polloi that do not).
I’ll offer an alternative view, informed by my study of Obama’s political modus operandi and my bias and experience that community organizing usually proves a thousand times more effective on any matter than poutrage blogging or its corresponding activist circle jerk: Almost none of those complaining voices participated in Organizing for America’s October 20 day of action that had set a goal of 100,000 phone calls to Congress demanding health care and exceeded that goal three times over. If any of the poutrage bloggers even mentioned it, much less promoted it or urged readers to join in that show of grassroots muscle, I didn’t notice, and probably you didn’t either.
The poutrage bloggers are evidently hostile to the entire idea of community organizing; that ordinary people can make extraordinary things happen by reaching outside of the beltway, recruiting each other, and deploying such human forces strategically and surgically to impose public opinion onto Washington from outside of it. History now reflects that those 300,000 plus phone calls to Congress on October 20 marked the turning point in the quest for a public option on a Capitol Hill where some key Senators had to be dragged kicking and screaming into getting out of its way. Suddenly, Senate Majority Leader Harry Reid – who only began publicly touting the public option after his and other senators’ phone lines were lit up – is being proclaimed by some as the hero of the story who somehow got out in front of the White House in its favor.
Suddenly Reid – the schlamozel of so much poutrage blogging before - is their standard bearer, only because he serves their narrative that seeks to reserve credit for themselves for the coming public option health care program, and glances jealously at the President and his allied Organizing for America, who they see as competition over credit for organizing the the members of the poutrage club did not do.
Which brings us to the next media sensation in the debate as health care legislation rounds third base and heads toward the home plate: What is looking increasingly like an “opt out” provision in the bill which would gain the remaining stragglers among Democratic US Senators who have been hostile to the public option all summer long. It is a compromise – as legislation always involves – that would allow individual states (presumably via state legislatures, although the final bill hasn’t been written yet) to “opt out” of the public option on health care.
“Opting out” is perhaps not the right term for what would happen if, say, Oklahoma’s - or another state's - legislature and governor availed themselves of that provision. What they would really be doing, in effect, is prohibiting their own citizens from benefiting from the national public health care program, imposing only private insurance company options upon those citizens.
What nobody has mentioned so far – so let me please do so – is the political trap an “opt out” provision would set for health care opponents, particularly those in the Republican Party.
Let’s imagine that after more than 60 years of failure, Congress finally, this fall, approves a health care bill and that it has a public option but also with the “opt out” provision for states. Americans throughout the land – particularly the tens of millions without any health insurance at all and the many more who are unhappy with their private sector health plans – will feel a great wave of relief and hope for improvement of their own families’ daily lives.
Any state legislature and governor that then decides to “opt out” – thus denying their own citizens the option to sign up for national government sponsored health insurance – will then have provoked a lasting political storm upon themselves. It will become very personal, as people realize that Governor Smith or State Senator Jones directly denied their children what other Americans have won.
In the 26 states – 24 of them west of the Mississippi – that have statewide referenda processes, any state that opted out would be subject to public referendum campaigns aimed at reversing the opt-out. These would be a community organizer’s dream and an anti-public option politician’s nightmare. Even in those states without referendum processes, the public ire would be focused on those state legislators and governors that denied their own citizens access to what citizens in other states will have: a federal health insurance option to compete with those offered by the big insurance companies.
All political hell would break loose in any state where the legislature and governor opted out of national public health care, because they won’t really be opting out, but, rather, would be slamming a door on their own constituents. In those states, entrenched legislators once thought to be permanent in their seats would become electorally vulnerable. In the 2010 and 2012 elections many will be unseated by challengers who vow to return the stolen public health care option to the people. Such a dynamic would surely fall more heavily on Republicans, but also on some conservative Democrats as well.
The “opt out” clause, on a policy level, is a distasteful compromise, but on the level of electoral politics it is pure political gold, especially for pro-public health care Democrats. It could lead Republican legislatures and governors in key states to be replaced by Democratic majorities. It would become the battle cry to register millions of non-voters from the most marginalized sectors of society – those without any health insurance at all, first and foremost – to inundate the polling places in years to come.
In sum, as the various compromise options on getting a public health care option through the US Senate go, the "opt out" public option is the one that most sets a trap for opponents for years to come. It is a dare, really: Go ahead and try to deny your own state’s citizens what millions of Americans have now won for their families and themselves. You’ll be sorry if you do.
It is a long distance runner’s strategy, made possible on a single day – October 20 – by the unsung organizers that flooded the Capitol switchboard. And should that be the result of the final legislation that comes through Congress, it will set in motion a chain reaction of political firestorms that offer state-by-state organizing opportunities to continue to change the political map in the United States for the better, and bring the entire country, step-by-step, closer to a future single payer health care plan.
Update: And right on cue, another embittered Clinton '08 supporter (indeed, the rocket scientist staffer behind the then-Senator's lackluster "online" campaign, outgunned and outmaneuvered at every step by Obama's), Peter Daou, unwittingly reveals that, yes, it's all about who gets credit! Ha ha. His spiel is titled, "Don't Bother Waiting for Bloggers to Get Credit for the Public Option." Hey Peter, don't break your typing arm by trying to pat yourself on the back. And notice that he doesn't even mention the 315,023 phone calls generated to Congress a week ago? He could have just as well typed, "LA LA LA LA LA I'M NOT LISTENING!"
Update II: Andrew Sullivan, on the other hand, sees and hears the same train comin' down the track.