PHILADELPHIA — After six years of dozens of Obamacare repeal votes, campaign ads in which GOP candidates literally blow the law into smithereens, and a consistent political tenor that has treated the Affordable Care Act as if it was the most divisive piece of legislation passed in American history, Hillary Clinton believes she can bring Republicans to the table to make it better, rather than destroy it.
Or at least, that’s what her advisers say, many of them appearing on panels and mingling at events during the Democratic National Convention attended by lobbyists, advocates and other professionals with vested interests in the law.
Improving health care access for Americans is not just a major part of Clinton’s platform. It’s a critical aspect of her political biography, from her work on rural health in Arkansas to the embarrassing defeat of ‘HillaryCare’ when she was first lady. Now, if elected, she will come into office after an era that brought both monumental reform and epic GOP resistance. Her allies say she not only has a plan to improve the Affordable Care Act, but also the political tools to fix it.
“We can’t just be satisfied with the status quo. We need to build a new Affordable Care Act and there are challenges in the health care system that we need to address,” said Center for American Progress president Neera Tanden, an alum of the Obama and Bill Clinton administrations who is close with Hillary Clinton. She was speaking Wednesday at a health care panel hosted by Americans United For Change.
To a certain extent, Clinton allies see her ability to work with Republicans on tweaks to the law as being deeply entrenched in the larger political fundamentals her election would shift.
A Clinton victory will mean that twice, presidential-election-year voters have rejected GOP vows to repeal. For another four years, maybe another eight, any Republican-driven attempts to dismantle it will be met with her veto, and the law will become even more ingrained in the U.S. health care system. Meanwhile, GOP lawmakers will continue to hear from their constituents about the health care challenges — opioid addiction, prescription drug costs, overall affordability — that could be addressed in a bipartisan fashion that builds upon the Affordable Care Act’s existing infrastructure.
“We’ve all been in this world in which we’ve been in the pitchfork battle of the ACA, it’s hard to imagine any Kumbaya moments of the future regarding the ACA. But I think we may be in a very different place,” Tanden said.
Alums of the current administration’s health care efforts also acknowledged that Republicans might be more willing to accept olive branches of compromise from a president not named Barack Obama – who has faced unprecedented obstruction – on things like Medicaid expansion, which 19 red states have resisted.
“There are states that were never going to do it while he was president. So I think that we all know that after this election, after Hillary Clinton is elected, something will break the fever and they’ll realize that it is in their best interest to go and ahead expand,” said Nancy-Ann DeParle, who directed the White House’s Office of Health Reform from 2009-10, at the Americans United For Change panel.
But Clinton advisers see something specific about the politician herself, and the general election battle she will be fighting in the next few months, that will make bipartisan cooperation on incremental changes more possible. They said that because Obamacare hasn’t been a central issue in Donald Trump’s campaign, it is a heading towards a depoliticization.
“In this national election, at this moment, health care is not the number 1, number 2, number 3. And usually when health care is, it tends to divide people rather than unite people,” Chris Jennings, a Hillary Clinton health care adviser, told TPM Tuesday after a Real Clear Politics luncheon on the topic. He said he expected that debates on immigration and infrastructure will be the focus of national attention at the outset of a Hillary Clinton presidential term.
“Health care, hopefully, because it is not necessarily in the headlights, will have less heat imposed upon it and we can have some legitimate, thoughtful conversations on delivery reform, on how we restructure the ACA over a period of time and how we can provide flexibility in appropriate ways to the states,” Jennings said.
Her allies also pointed to her time in the Senate as proof that she has the skills to bring Republicans to the table.
“I could give you the names of people, of senators, of Republican senators today who say, ‘Regardless of what I think of her positions on the issues, the one thing I will say, is that she was incredibly good at working with people across the aisle,’” said former Sen. Tom Daschle (D-SD) at the Americans United For Change event.
But, ACA supporters caution, just because they believe Republicans will be willing to move forward on Obamacare if Clinton wins, its fate would be exactly the opposite if she was defeated by Trump. In that scenario, Republicans would be dead set on repealing it.
“The whole issue with Republican base voters was, you aren’t keeping your promises. You said, if we vote in a Republican Senate, you will be able to do this,” Jennings said. “And now they have a Republican president who is going to repeal and replace? My view is that is politically not viable that they don’t do something.”