Will the passage of healthcare reform provide a boost to Obama’s popularity and the chances of holding on to a Democratic majority in the fall? The question preys on the minds of many progressives, even those who find the White House lacking in zeal for causes on the left. The alternative would mean polarization, at best. At worst, it could be a return to the dark days of Republican rule from which we have escaped all too recently. To be sure, the failure to pass the healthcare bill would have been a catastrophe. The measure was a significant test for the base of the Democratic Party. Could a leadership that stumbled badly on the banks, mortgage cramdowns and credit card regulation actually provide something of tangible benefit to the working people of this nation?
Before this victory, Obama’s position was not unlike that of Roosevelt as he approached his first midterm in 1934. FDR stabilized the banking system through a more conservative series of reforms (the banking holiday, the Emergency Banking Act and Glass-Steagall) than many had hoped for; he succeeded in passing legislation that was supposed to address the recession systematically (the Agricultural Adjustment Act and National Industrial Recovery Act roughly paralleling the stimulus bill in terms of what they were supposed to accomplish). But these policy victories notwithstanding, FDR hadn’t addressed the needs of the more than 10 million unemployed. His answer to this critique came in the fall of 1933 with the creation of the Civil Works Administration, which under the leadership of Harry Hopkins succeeded in directly employing 4.3 million people between Thanksgiving of 1933 and 1934. While the CWA was only a temporary program, it sent a message to workers who had voted for a New Deal in 1932 that the president was trying to make a difference for them.
Heading into the midterm elections of 2010, Obama has something concrete to show for his leadership, and that cannot be discounted. What matters more than anything at this juncture is how quickly the concrete benefits of healthcare reform start to flow to the millions of Americans in desperate need of help. Many of the bill’s most important provisions do not kick in for many years, but others—the elimination of pre-existing conditions, the ability to enroll dependent children up to the age of 26—will be in effect by September, and they speak to the needs of middle-class voters, who have to be kept in the political fold. Whether this will be enough is hard to say.
Social Security was passed in 1935, but the benefits it promised did not start to flow until 1940 for the small first group of retirees. It was not until the ’50s that something approximating universal coverage became a reality, and even today nonworkers are not covered in their own right. African-Americans were robbed of Social Security benefits, even if they had worked all their lives, because the exclusions that were built into the original legislation to placate Southern politicians who threatened to veto the whole package were not reversed for decades. As it happens, Social Security was fairly popular from its inception, largely because it was sold as a contributory insurance policy rather than a "handout" or act of charity toward the elderly poor and because it offered something for (almost) everyone. But it took time before it was fixed in the social policy firmament to the point where its opponents were silenced. Some of them are still with us, as the proposals for privatization demonstrated not long ago.
Once American families begin to depend on the safety net—whether for retirement, higher education or healthcare—the popularity of these provisions becomes very hard to diminish, even by those committed to unraveling them. This is, no doubt, why opponents of healthcare reform are so eager to snarl it up in the courts or rally the base for repeal. They too are students of history. They know that if American families start to rely on these new forms of health insurance, to factor them into their household ledgers, the reforms will become entrenched to the point of no return.