June 20, 2018
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Minority Report

Passing a comprehensive health care plan that provides coverage for most of the 47 million uninsured Americans, while also reducing and containing costs throughout the system, is one of President Obama’s central policy goals. It also is one of the most challenging to pass.

The president will have to work hard to get the support of all 60 Democrats in the Senate, not to mention Republicans in the House and Senate. If Democrats with conservative constituencies wary of government-run insurance programs, such as in western states, fail to support the final plan, it may be doomed. If this is the case, Republicans will not affect the bill. But if it becomes clear that just barely enough Democratic support exists to pass a plan, Republicans can play the spoiler role. If they do, and the bill passes on party line votes, the GOP will have shirked an important responsibility.

Though the Constitution did not anticipate political parties, they have become an essential part of our democracy. When one party controls the White House and both houses of Congress — as was the case during the first six years of the George W. Bush administration, and is the case now — bad policy can result.

If Republicans are wise, they can play a key part in shaping the final health care bill. They cannot overplay their hand and demand, for example, that no public option be part of the final product. Instead, they can identify two or three components of the bill that they want to change, and work to get those concessions. They might suggest, for example, a phase-in of the public option. Or they might point to a different tax source to fund the public option than that identified by Democrats.

The president and congressional Democrats would do well to listen, if Republicans adopt a sincere tone in trying to improve the bill. Democrats should not concede the heart and soul of the plan, but remain open-minded about possible improvements. Even if these concessions don’t win big blocs of Republican votes, allowing the plan to be modified makes sense for Democrats, because it results in Republican investment in its success.

It will be hard for Republicans to adopt this role. Working to tweak a plan whose existence clashes with one’s core principles is not easy. But rather than wash their hands of it and hope it fails, Republicans win favor from an electorate that now views them as obstructionists if they act to improve it. This is what Americans expect from elected officials.

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