By Michael Gerson
Monday, September 19, 2016
In the event of a victory by Donald Trump in November,
political analysis will take on a forensic cast. How did establishment politics
— first in the GOP primaries, then in a national electorate — come to die?
Privately, Democrats would regret their selection of one
of the most joyless, least visionary presidential candidates in recent memory.
Publicly, they would blame trends that incubated within the Republican
coalition, particularly a nativism incited by conservative media and carried by
a candidate — alternately cynical and frightening — who is unbound by truth,
consistency or decency.
And, by God, they would be right in much of this
critique. But this is adequate to explain only how Trump seized a powerful
plurality of Republican primary voters. Stipulating a Trump victory, Democrats
could not dismiss the winning coalition as an ocean of deplorables. If Hillary
Clinton loses, it will be because she was the résumé candidate in an
anti-establishment wave election. It will be because she argued that the United
States, with incremental corrections, is on the right track set by Barack
Obama, while more than 60 percent of Americans believe the country is off
course, and have thought so for years.
If Trump succeeds in essentially turning out the midterm
electorate in a presidential year — whiter, older, angrier — the main
motivating issue may be the restriction of immigration. But the general
atmosphere of contempt for government that helps Trump — of disdain for the
weakness and incompetence of the political class — is due to the Affordable
Care Act.
More than six years after becoming law, the proudest
accomplishment of the Obama years is a political burden for Democrats. A recent
Gallup poll found that a majority of Americans disapprove of Obamacare. The
larger concern for Clinton and her party comes deeper in the numbers. Only 18
percent of Americans believe the Affordable Care Act has helped their families;
80 percent say it is has hurt or had no effect. A higher proportion of
Americans believe the federal government was behind the 9/11 attacks than
believe it has helped them through Obamacare.
The Affordable Care Act has come to embody and summarize
declining trust in political institutions. The law was passed in a partisan
march, without a single Republican vote. The system’s federal website was
launched with a series of glitches and failures that still make
“healthcare.gov” a byword for public incompetence in the computer age. Only
17 state-based exchanges (16 states and the District of Columbia) were created.
Of that number, four (Hawaii, New Mexico, Nevada and Oregon) have failed, and
Kentucky’s will be dismantled/shuttered next year. According to a recent report
by the House Energy and Commerce Committee, the Oregon exchange received $305
million in federal funds but never created a functional website or enrolled a
single person in private insurance online.
Premium costs in the exchanges increased about 12 percent
nationwide from 2015 to 2016. Current rates are being finalized, but it looks
as if the increase from 2016 to 2017 will be double that. “This suggests that
the system is not finding its balance or approaching stability but actually
getting more unstable,” says Yuval Levin of National Affairs. “People just
aren’t finding the insurance offerings in the exchanges attractive, and the law
leaves insurers very few options for improving them. The insurers are
increasingly fleeing — a third of counties in the U.S. will have only one
option in the exchanges next year. And there isn’t much the administration can
do about it.”
Because of a poisoned legislative atmosphere, there is no
prospect of legislative fixes to an unstable and perhaps unsustainable system
of health exchanges. So President Obama is left to call a “Millennial Outreach
and Engagement Summit” later this month, urging the kids to buy health
insurance and right Obamacare’s listing demographic ship. It is less a solution
than a concession of helplessness.
Trump calls attention to these failures, while offering
(as usual) an apparently random collection of half-baked policies and baseless
pledges (“everybody’s got to be covered”) as an alternative. There is no reason
to trust Trump on the health issue; but there is plenty of reason to distrust
Democratic leadership. No issue — none — has gone further to convey the
impression of public incompetence that feeds Trumpism.
If Trump wins, there will be a host of reasons, but one
will be this dramatic failure of liberal governance.
No comments:
Post a Comment