It’s hard to imagine anything less political than Americans’ everyday interactions with our health care system. Illness and accident don’t distinguish between Democrat and Republican. Neither do rising premiums, pre-existing conditions, or the fear that our loved ones might find themselves without insurance. Like it or not, our basic need for health care is something that unites us.
Which makes it all the more ironic — and disheartening — that in Washington no issue has proven more divisive. One of us served in the Clinton White House, the other as a House Republican campaign chairman. We’re no strangers to fierce argument over health care reform. Yet what was once a debate has become a total stalemate, and in the first 10 months of the Trump administration, things have gone from bad to worse. For all the discord in D.C., another major overhaul of our health care system has never seemed less likely.
But that doesn’t mean we should stop trying to improve the system we have. On the contrary, there are straightforward, bipartisan actions Congress could take that would further lower the uninsured rate and curb rising costs without adding to the deficit.
These steps wouldn’t be a big “win” for either party. They would, however, make an enormous difference in Americans’ lives. Congress should seize the moment.
First, Congress should consider a Senate bill proposed by Republican Lamar Alexander of Tennessee and Democrat Patty Murray of Washington state. The Alexander-Murray template would restore subsidies, expand outreach efforts for the health insurance marketplaces, and give states more flexibility to implement their health care goals while continuing to protect Americans with pre-existing conditions. “In my view, this agreement avoids chaos,” Alexander said. “And I don’t know a Democrat or a Republican who benefits from chaos.”
He’s right, of course. The House and Senate should pass Alexander-Murray and send it to the president’s desk. And by signing it into law, President Trump would burnish his deal-making credentials, secure an impressive year-one victory that boosts his poll numbers, and put his own stamp on the American health care system.
Second, Congress should consider additional, bipartisan plans to make meaningful improvements to the healthcare system. One such plan was recently proposed by the House Problem Solvers Caucus, a group of 43 Democrats and Republicans committed to working together even in this polarized political age. Their ideas — such as a “stability fund” to help states care for high-cost patients, or defining full time work as 40 hours per week instead of 30 — are not designed to rally either party’s base. Not every member of the caucus agrees with every element of the plan. But that is the nature of compromise. And while they don't always get much attention, other compromises are quietly being struck throughout the House and Senate. Congress should embrace these good-faith efforts to make our health care system better for everybody.
Finally, going forward, Congress must return to regular order — holding hearings, considering amendments, allowing debate and making a genuine effort to secure the votes of legislators from both parties. We each know from experience that crafting bills this way is time-consuming, tedious and often frustrating. Yet we also know that the resulting legislation is better, and more lasting, than anything negotiated behind closed doors. Moreover, listening to each other, rather than talking over each other, is likely to yield longer lasting, more stable results.
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No less important, a transparent, fair legislative process is needed if we are to preserve Americans’ faith in our democracy. Sen. John McCain, R-Ariz, with whom we have each disagreed on different issues, said before rejecting a health care repeal attempt last summer: “We’ve been spinning our wheels on too many important issues because we keep trying to find a way to win without help from across the aisle.”
It’s a message we all should take to heart. It’s good politics, too. A win-win scenario, with shared victors, is more likely to lead to members’ re-elections than the current highly polarized, dysfunctional process.
Health care policy will never be entirely immune from politics. Yet hopefully we can agree it’s a good thing when the percentage of Americans without insurance falls rather than rises. Hopefully we can agree that the Affordable Care Act needs improvement. By passing Alexander-Murray, embracing compromise throughout the House and Senate, and returning to regular order, members of Congress can make the system we have better. They can make Americans healthier. They can meaningfully improve the lives of people across their districts, their states, and the country as a whole.
That sounds like a win to us.
Mack McLarty, vice chairman of No Labels, was Bill Clinton’s first White House chief of staff. Former Virginia Rep. Tom Davis, co-founder of No Labels, is a former chairman of the National Republican Congressional Committee and the House Committee on Oversight and Government Reform.