The Rift That Could Kill Health Care

The divide between liberals and centrists in the Democratic Party is nothing new. Matthew Dallek on the liberal déjà vu threatening health-care reform.

Democratic differences are endangering Democratic control of Congress, while blame for the collapse of health-care reform has been laid at President Obama’s doorstep. Pundits charge that Obama ceded control of his agenda to a dysfunctional Congress, futilely attempted to negotiate a bipartisan agreement in the Senate, and should have better communicated the benefits of reform to all Americans. These criticisms of his tactics aren't entirely off-base, and Democratic defeats from Virginia to Massachusetts have turned the president into a convenient target for his critics. However, the reality is actually more complicated than the conventional wisdom has suggested.

Such divisions are partially traceable to internal bickering over the party’s vision and direction during the 1980s debates.

Reform's spectacular collapse is attributable to a long-suffering Democratic Party with a decades-long tradition of ideological battle over major legislative initiatives. During the 2008 primary season, commentators repeatedly said Democrats had apparently fractured over gender, race, and class issues. But the centrist-liberal splits that emerged in the health-care debate are actually more salient divisions than this trio of issues.

John Avlon: The Coming Liberal Suicide Such divisions are partially traceable to internal bickering over the party’s vision and direction during the 1980s debates. Senator Ted Kennedy challenged incumbent Jimmy Carter in the 1980 presidential primary, with the issue of “national health insurance” fueling Kennedy’s run, according to biographer (and Daily Beast contributor) Adam Clymer.

Belittling Carter’s refusal to advocate for a health-care overhaul (the “unfinished business…of the Democratic Party”), Kennedy’s campaign highlighted the intra-party split, pitting liberals supportive of national health insurance against centrists opposed to such a bold reform at the national level. He said that access to health care was a “right”—not a “privilege.” After Michael Dukakis’ bitter 1988 defeat at the hands of George H.W. Bush, Kennedy insisted that Dukakis' ideological reticence of being labeled a “liberal” caused him to lose an “eminently winnable” election.

Another moment that set the tone for the 2009 debate was the founding of the Democratic Leadership Council in 1985. The DLC advocated tax cuts for America’s middle-class, championed welfare reform, and denounced the proliferation of liberal interest-group politics. DLC executive director Al From argued that “fundamental changes in the [Democratic] message” were urgently needed after party losses in the 1988 presidential election, and DLC president Bill Clinton told centrist Democrats that their party should offer Americans “a new choice” that “provides them responsive government.”

Such sentiments didn't end with the waning influence of the DLC in more recent times. Indeed, centrists often expressed unease with the size and scope of Obama's government-led health-care reform plan. Lest they be branded as big-government liberals, centrists, for the most part, fought against the public option, sang the praises of free markets in general, and opposed expanding Medicare to insure more Americans.

Long-simmering differences over abortion rights further cleaved the Democratic Party in Obama’s America. At the 1992 Democratic convention, Pennsylvania Governor Robert Casey was denied a speaking role because he was a foe of abortion rights and wanted to deliver an anti-abortion speech. Seeking to cast himself as a “New Democrat” who would uphold traditional values, Clinton declared that abortion should be “safe, legal, and rare” in the United States.

Last year, when Michigan Representative Bart Stupak won a provision restricting federal funding of abortion in the House’s health-care legislation, liberals threatened that they would walk away from reform unless the provision was scrapped. Stupak balked at a separate compromise on abortion rights that Senate Democrats had brokered, and these as-yet-unresolved differences help explain why health-care reform didn't pass in 2009.

Then there was the question of how to pay for the health-care reform package. The mid-1980s-era “tax and spend” label–a kiss of death to Walter Mondale’s 1984 White House run–haunted Democrats in the fractious 2009 debates.

While liberals wanted to charge a health-care surtax on wealthy individuals, centrists insisted that taxing “Cadillac” health-insurance plans was more desirable. While each approach has its own merits on policy grounds, it's also the case that fear—for example, that Republicans would have their revenge on centrists who voted for tax hikes and endorsed a broad government expansion—factored into the splintering of the Democratic Party in the 2009 health-care debate.

Each side absorbed different lessons from Reagan’s presidency. Each side cast Obama’s election in a different light. These differing interpretations made forging compromise on health-care legislation more challenging than anticipated.

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As Obama said in his State of the Union address, Democrats in Congress retain large majorities despite the loss of Kennedy's Massachusetts Senate seat. Unstated was that the ideological splits within the Democratic Party are sufficiently large—and that the prospects for enacting major reform have dimmed considerably since the heady days of Obama's inauguration in January 2009. If Democrats want to hold on to their majorities in Congress and achieve Kennedy’s dream of universal coverage, they should heed Obama’s call to govern responsibly, and bridge their differences.

Matthew Dallek, acting director of the U.C. Davis Washington Program, is the author of The Right Moment: Ronald Reagan's First Victory and the Decisive Turning Point in American Politics.