Few legislative efforts over the last 25 years compare with the grueling, monthslong battle to turn the Patient Protection and Affordable Care Act into law.
Even now, nine years later, the health care plan dubbed Obamacare stands as a testament to the fierce political divisions in the United States and the bare-knuckled gamesmanship needed to transform sweeping ambition into federal policy.
Which is to say, advocates of the Green New Deal had better buckle up.
Several veterans of the 2009-10 health care debate talked to E&E News and offered their perspective on what strategies Green New Deal activists might duplicate, which ones they should avoid and what challenges will be new to this fight.
A common thread was the opinion that the Green New Deal is miles away from becoming law and that its transformative vision of tackling climate change with a government-led jobs program is even more radical than President Obama’s aim to reform U.S. health care.
Even so, they said there were useful lessons to learn from the Affordable Care Act. Assembling a broad coalition is important. So is finding a backdoor to fix hiccups — major or otherwise — in what’s sure to be a sprawling piece of legislation.
Here are their five takeaways.
Neutralize industry opposition
At the start of the health care fight, Obamacare architects faced challenges from across the political spectrum. There were moderates who feared costly, disruptive changes; liberals who demanded more benefits; and Republicans who just wanted to stop Obama.
Looming over them all was industry. Insurance, pharmaceuticals and others in the sector had disintegrated President Clinton’s health plan. They could sink this legislation, too — or, maybe, they could become an asset.
The White House and congressional Democrats worked to bring insurance companies more customers, and they minimized cost-reduction provisions.
“There weren’t too many vested interests that took it on the chin,” said Jonathan Gruber, an Obama administration adviser who helped shape the ACA as well as its Massachusetts precursor.
“The only true losers in the Affordable Care Act were very rich people who had to pay higher taxes and healthy people already buying individual insurance. … Put together, those groups were tiny,” he said.
Democrats had dissuaded industry from allying with Republicans, denying the minority a potentially critical weapon in the health care fight.
The Green New Deal faces a steeper challenge, and some energy companies will fight it hard. But others might have a price at which their tolerance can be bought, especially if it offers them a path forward in a low-carbon economy, Obamacare designers said.
Lobbyists have less power than 10 years ago, thanks to small donors and grassroots activists, so there’s probably less political risk to lawmakers excluding them from crafting the Green New Deal’s major planks, said Andy Slavitt, who was Obama’s administrator of the Centers for Medicare and Medicaid Services.
Rather than sideline industry completely, he suggested Green New Deal backers engage industry on technical matters that affect implementation, while resisting pressure to reshape the package around industry preferences.
“You do end up needing the people who are affected to be part of the implementation process,” Slavitt said. “Even once you’ve made up your mind from a policy standpoint, you have to listen to what practical implementation issues there are.”
That included rural hospitals for the ACA, he said, and it might include rural energy issues for the Green New Deal, given the Senate’s rural tilt.
Control the narrative
One early challenge for the Obama administration was dealing with the false claim that its health care plan would lead to “death panels.”
While untrue, the assertion by former Alaska Gov. Sarah Palin (R) tapped into widespread fears about further government involvement in medicine, and the term was heavily used on the cable news circuit.
Jacki Schechner, who served as national communications director for the progressive coalition Health Care for America…
