How Obamacare Lost Its Soul

The president has replaced the moral case for reform with a transactional one. That's a mistake.
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Kevin Lamarque/Reuters

For supporters of the Affordable Care Act, President Obama’s new push to "sell" the law is a welcome sign that Healthcare.gov is on the mend, but it also risks devolving into transactionalism—a narrative of “Democrats delivering benefits on one side, and Republicans trying to deny them on the other,” as Politico puts it. To make the case, Obama needs to strike the sustained, emotional moral clarity—consistent claims that go beyond economic benefits—that helped bring him to the Washington in the first place.

The president took a valuable first step at the Center for American Progress on Wednesday, delivering a cogent, thoughtful address on declining economic mobility in America. The speech showed flashes of Campaign Trail Obama’s moral fire. He appealed to our shared obligations, citing last week’s apostolic exhortation from Pope Francis (“How can it be that it is not a news item when an elderly homeless person dies of exposure, but it is news when the stock market loses two points?”) and, on healthcare, Martin Luther King (“Of all the forms of inequality, injustice in health care is the most shocking and inhumane”). What remains to be seen is whether Obama will keep it up.

I worked for the president’s campaign in 2008, running a small field office in the heart of Ohio’s Rust Belt. One of my favorite members of our team was a high-school senior named Anoop Bal who, despite being on the varsity basketball team and student council and having to apply for college, somehow found six hours each afternoon and evening to spend organizing volunteers in his hometown of Canfield, a bucolic (if somewhat conservative) Youngstown suburb.

One the campaign’s most inspiring moments for me was paradoxically also one of its most distressing. One Sunday evening, Anoop—an observant Sikh who wears a turban—was out canvassing, only to find himself detained by police officers called by a worried neighbor. A fellow resident of the Ohio town where Anoop was born and raised had found his appearance alarming. I’d later learn that this happened multiple times.

What was inspiring was that no matter what got in Anoop’s way, he persisted in devoting every minute he had to the promise he saw in then-Sen. Obama’s campaign. And he didn’t do so out of self-interest—it was the result of emotional resonance with a cause. “I definitely identified with him on the moral and idealistic side of things,” he told me over the phone on Tuesday. “[Obama’s message] wasn’t so much of a ‘here’s this specific benefit to you’—it was on more of a moral level.”

Somewhere along the way, the political operation that recruited Anoop—and whose candidate transfixed the nation with the story of a nine-year-old girl who started eating mustard-and-relish sandwiches because her mom had cancer but no health insurance—turned to more transactional rhetoric. By mid-2009, Vice President Biden was cutting videos telling voters how “you'll be surprised at how much you'll get out of this health-insurance reform we're proposing”; then-budget chief Peter Orszag was explaining that the real reason to pursue healthcare reform was because it would help reduce the deficit. As Marshall Ganz, who helped pioneer Obama’s 2008 field-organizing model, put it in 2010, “Obama entered office wrapped in a mantle of moral leadership,” but, after taking office, “abandoned the bully pulpit of moral argument.”

In the intervening years, Obama has claimed that bully pulpit only occasionally—in Strongsville, Ohio, in the days leading up to the ACA’s passage, for example, where he connected healthcare to “what’s right and what’s wrong” by telling the story of Natoma Canfield, a woman stricken with cancer who could no longer afford her insurance premiums; at George Washington University, in April 2011, when he challenged Republicans on the morality of their vision for “changing the basic social compact in America.” These sparks of righteous fire have been encouraging, but they’ve also been disjointed—too often, the president’s light stays hidden under a bushel for long stretches, or only appears elegiacally, after national tragedies.

Now the White House is, according to Politico, “kicking off a three-week drive to refocus the public on the law’s benefits,” including decreased costs for preventative care and prescription medicines, protections for preexisting conditions, increased access to affordable plans.

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Michael Zuckerman

Michael Zuckerman is a writer based in Cambridge, Massachusetts.

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