Yesterday’s blog was about how uncertain a leader’s legacy, depending largely, though not entirely, on the leader’s successor. As of last night, it seems the cornerstone of Barack Obama’s legacy, the Affordable Care Act (ACA), will remain in place. Despite having control of the House, the Senate, and the White House, the Republicans were unable to repeal “Obamacare,” not to speak of replace it.
This raises the question of why? Given how strong their position, why were Republicans unable to do what they had repeatedly and relentlessly sworn to do for two years?
The ACA proved difficult and, likely, ultimately, impossible to dislodge for many reasons that include but are not limited to: 1) lack of transparency associated with the repeal and replace process; 2) widespread public disapproval of the replacement bill; and 3) difficulty in retracting any public benefit once it’s been granted.
I would argue though that there’s a single overweening explanation for why the ACA still stands – President Trump. Trump eagerly and effectively undid a slew of other Obama initiatives. The ACA, in contrast, he mouthed off about – but that was pretty much it. All Trump did to kill Obamacare was to announce that he was waiting, “pen in hand,” to sign the repeal and replacement legislation that Mitch McConnell was supposed magically to navigate through congress.
Everything we know about what it takes to enact major legislation of this sort tells us that presidential leadership – presidential wheeling and dealing, presidential back-slapping and hand-holding, presidential pleading, promising and threatening – is essential. Critical to the success of a controversial and complex legislative initiative, especially one on healthcare. Without relentless presidential involvement, repealing and replacing the Affordable Care Act was, in other words, never in the cards.
Truth is that large parts of Obama’s legacy were undone because his successor was determined to undo them. Truth is that the ACA remains the law of the land because if his successor was determined to repeal and replace it, there was scant evidence to this effect.