Republicans Will Be Blamed if Democrats Block ACA Replacement by Michael Sances
Reacting to the Congressional Budget Office’s prediction that 24 million Americans will lose insurance under his American Health Care Act, House Speaker Paul Ryan insisted that the AHCA is just the first step in a three-pronged approach.
According to Ryan, prong two is working with Health and Human Services Secretary Tom Price to modify existing regulations, and prong three is drafting and passing additional health-care reform legislation. The end result, he predicted, would be even greater affordability and accessibility than has existed under Obamacare.
How will the Republicans pass these promised legislative reforms under prong three?
For bills that are not budget-related, 60 votes – and thus at least 8 Democratic votes – are needed in the Senate. Passing this threshold, and thus crossing the chasm from prong two to three, is highly unlikely.
In this way, Ryan is pursuing what the Robert Peart and Thomas Kaplan of The New York Times calls a “high-risk” strategy: gut the ACA and leave 24 million people uninsured (prong 1), and then dare the Democrats to not go along with the Republicans’ plan to re-insure some of those people (prong 3).
Whose fault will it be if no real replacement is passed?
Ryan appears to be betting that voters will blame the Democrats. That may seem plausible: while we can debate how we got to 24 million (if the AHCA passes) uninsured, a voter might reason, the Democrats had a chance to make it a little better, and said no.
Yet voters do not appear to reason this way. Instead, they mostly act as if the party in control of the White House is responsible for everything. The general rule of midterm elections is that the president’s party loses seats. But when the economy does well, the president’s party loses less seats; when it does poorly, the president’s party loses more seats.
Why is the economy so important in elections?
Voters, lacking reliable information about what the president and lawmakers have actually been up to in terms of policy, use the economy as a shortcut: if the economy is good, something must be working well in terms of the current president’s policy; if it is performing poorly, it must be time for a change. Thus a voter who loses insurance and does not have it restored will blame the Republican Party, as they currently control Washington.
One might object that voters only use the economy because they do not receive clear information as to what lawmakers have been up to. In the case of the ACA and its promised repeal; however, information should be abundant.
Surely voters will be able to assign blame for the repeal to Republicans, but also blame to the Democrats for not helping ameliorate the aftermath?
It turns out that voters have trouble assigning blame for events even when policy information is relatively abundant. For instance, voters punish the incumbent president for events that have nothing to do with policy, such as natural disasters, shark attacks, and sporting matches. It is abundantly clear in each of these cases that the president’s policies have nothing to do with voters misfortunes, and yet presidents are still blamed.
Voters also appear to reward state lawmakers for the policy decisions of the president, even though it should be clear to voters that state lawmakers bear no responsibility for the president’s actions.
Finally, my own research suggests that voters even blame the president for tax increases that voters themselves approve. It is hard to imagine a situation where responsibility for voters well-being is more clear-cut, and yet voters still appear to blame the president.
In short, when life is made better, for whatever reason, voters reward the president by giving him or her more power. When life is bad, they take power away.
Such a strategy on the part of voters is not necessarily bad or the result of laziness. Assigning responsibility is hard, even when the facts are right in front of you.
What does all this mean for whether the Democrats cooperate with the effort to replace the ACA?
Knowing that bad times mean more votes for them, the out-party has a strong political incentive to obstruct. By a somewhat perverse logic, if life is made worse for 24 million Americans, life is made better for the Democrats who will gain seats at Republicans’ expense. Yet if the Democrats agree to help out those 24 million uninsured, they must know that they will be simultaneously reducing their winnings in 2018.
Michael Sances is Assistant Professor of Political Science at The University of Memphis.