Obama's Healthcare Achievements
Eric Alterman is thoughtful and eloquent as he describes progressive disappointments with Obama's first eighteen months in the presidency and probes the huge obstacles to progressive change built into our divided and institutionally cumbersome system of governance. I don't disagree with many specific points he makes. But the bottom line he draws could not be more wrongheaded. Against huge counterwinds, President Obama and his unwieldy party have managed to enact major reforms: they took higher education loans away from bankers and enhanced funding for lower- and middle-income students; they created a regulatory framework that will start to rein in Wall Street financial shenanigans; they have used regulations where legislation was impossible to further workers' rights and prod environmental improvements; and they achieved comprehensive healthcare reforms that are the most far-reaching and economically redistributive social accomplishments since the New Deal.
Health Care Reform and American Politics: What Everyone Needs to Know, a book I wrote with Lawrence Jacobs at the University of Minnesota being released this fall, explains not only how the laws passed but what they contain and will mean for Americans and the US economy if they are successfully implemented in the coming years. Like many progressives, I wanted a robust public option. But that possibility was gone even in the legislation that passed the House in 2009—legislation that included an option that would have helped fewer than 5 percent of Americans. What progressive movements achieved instead was political space—to open the door for House liberals to drive better bargains at the end with the Senate and the White House. The Affordable Care legislation that finally passed in 2010 was, as David Leonhardt of the New York Times has explained, a major counteraction to the rising inequality of recent decades. The right wing is freaked out about this healthcare reform for good reason: it sets the nation on a more democratically inclusive path and uses government regulations and revenues—real money raised from levies on the well-to-do—to help the less privileged.
The coming elections matter, because if right-wing Republicans triumph, landmark achievements for millions of ordinary Americans can be gutted or rolled back. The last thing progressives should be doing is concentrating on all that has not happened in 2009 and 2010, when a huge, redistributive and profoundly democratic healthcare reform did pass—and needs to be defended and implemented. If it can be put into full effect, this reform alone will make a more decent and egalitarian society. The political effects will come when, in due course, younger, less privileged Americans realize what they have gained and vote to defend and extend those gains. That is how progressive change worked with Social Security: it took time to be implemented and modified in progressive ways, and then became a bulwark of our democracy, because less-well-to-do senior citizens vote to defend Social Security.
Since the 1960s, progressives in the United States have often been more interested in racial, gender, foreign policy, cultural and environmental issues, and not so concerned about socioeconomic redistribution. So it is perhaps understandable that for many upper-middle-class progressives, who cluster on the East and West Coasts, the past two years just look like failure. Obama could not get many of their favored policies through Congress, even if he shouted day and night. And the White House certainly had to make choices about what to emphasize in the brief time it likely had to make headway. The administration chose comprehensive healthcare reform and a few other measures with profound economic import—and those will make an enduring difference for millions of ordinary Americans.
The chief Obama failing, in my view, has been economic. His fledgling presidency was upended, in a way, by a financial meltdown—one of many disasters he has inherited from the terrible Bush years. It may have been inevitable that most Americans would conflate the bipartisan, Bush-initiated Wall Street bailouts with the American Recovery and Reinvestment Act. And it certainly was Obama's misfortune to take office just as the economy was plunging downward, rather than, as FDR did in 1933, after the economy had reached a nadir of sorts. But I do believe that Obama could have done a bolder and more comprehensible job of explaining to Americans what the government needs to do to create enough jobs in this decade. He did not offer that bold explanation, and now it may be too late.
Obama and the Democrats face tough elections in 2010 and 2012. They should get the support from progressives that they deserve. We should all cheer up, mobilize voters, send checks and write favorable op-eds. If disaster is averted this fall, then it will be time to pressure from the left again.