Since the 2016 election, much ink has been spilled trying to pinpoint the cause of the collapse of the Democratic Party, both in Congress and state legislatures, during Barack Obama’s presidency. Among the most important was the deep antipathy to the Affordable Care Act (ACA), or Obamacare. The Democrats passed it on a very unusual party-line vote and the implementation of the act has failed to live up to Obama’s promises.
The Republicans have campaigned for most of a decade on repealing and replacing Obamacare—in fact, the House has voted more than 60 times to repeal or alter Obamacare. But each of those attempts came when Obama was in the White House, ready to veto any legislation that passed the House and Senate. Now that Obama is out of the White House, and Republicans have more influence in Congress than any time since 1928—plus an ally in President Trump—one might expect them to easily repeal and replace Obama’s signature healthcare bill.
To highlight a few Republican objections to the ACA: the legislation is now projected to cost $1 trillion more than Obama initially promised (twice as much), while providing coverage to just 40 percent of the promised number of Americans; the average family’s premiums have gone up 40 percent in just two years (and that is before projected hikes of 25 percent in 2017); and many Americans have lost their plans and their doctors. Moreover, the cost of Obamacare tells only part of the story. It does not say anything about the problems of granting the federal government control over 1/6 of the national economy, supported by 2,400 pages of legislation and four times that number of federal regulations, which can change at the president’s whim.
However, Republicans appear to be almost paralyzed by indecision and disagreement. Some Republican legislators want to simply repeal the law and go back to the status-quo before 2009, whereas others want to repeal and replace the law with some sort of policy that preserves its more popular provisions, like protection from being denied coverage for preexisting conditions, and still others want to “fix” Obamacare. After seemingly waiting for over a month for President Trump’s instructions, they have finally released a plan. However, that plan fails to repeal or replace Obamacare, and appears to have been drafted less to create good policy than to avoid a filibuster.
The problem, as Charles Krauthammer has noted, “is that Congress has become so dependent on following the lead of a president in general … now that it’s in control, it can’t get its act together, unless you get strong presidential leadership.” In short, the president has gradually taken over many of the day-to-day duties of Congress. But according to the Constitution, Congress is supposed to initiate policy change by debating and passing legislation.
Indeed, America’s Founders would have been quite surprised and disappointed to see Congress waiting for the president and crafting legislation designed more to maneuver around Senate obstacles than to make good policy. They believed that the greatest danger in a republic was a concentration of the legislative and executive power in the hands of one branch. Their solution, as James Madison noted in Federalist 51, was that “the greatest security against a gradual concentration of the several powers in the same department consists in giving to those who administer each department the necessary constitutional means, and personal motives, to resist encroachments of others … Ambition must be made to counteract ambition.” Under the Constitution, Congress has the means to pass legislation to reform healthcare on its own. What it needs is the personal motivation to act without waiting for the president.
Here is the problem: It is far easier for individual members of Congress to complain about Obamacare than it is to do something about it. And if they do act to change Obamacare, some fear they will be blamed for the consequences of that change. It is more convenient to pass the buck. However, they cannot pass the buck forever. They have campaigned on this issue more than any other for almost a decade. It is incumbent upon them to keep their promises to the American people.
It is also important for the American people to recognize that this problem of congressional inaction goes beyond the issue of healthcare or the Republican Party. Both parties have become too reliant on the president as a source of virtually all power to change the law, partly because the public has come to see that as the role of the president. But Congress’s function should not be to merely rubber-stamp the president’s agenda. The president’s job is to execute laws. He cannot also be the most important actor in the creation of new laws. The Republicans thus have a chance not just to fix America’s healthcare, but begin to repair its constitutional fabric. Will they?