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An Unnecessary Primary Panic?

Sen. Elizabeth Warren, D-Mass. speaks with Sen. Bernie Sanders, D-Vt. at the Senate Health, Education, Labor, and Pensions Committee hearing with governors to discuses ways to stabilize health insurance markets​, on Capitol Hill in Washington, Thursday, Sept. 7, 2017. ( AP Photo/Jose Luis Magana)

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Sen. Elizabeth Warren, D-Mass. speaks with Sen. Bernie Sanders, D-Vt. at the Senate Health, Education, Labor, and Pensions Committee hearing with governors to discuses ways to stabilize health insurance markets​, on Capitol Hill in Washington, Thursday, Sept. 7, 2017. ( AP Photo/Jose Luis Magana)

Almost 12 years ago, when Barack Obama was still an underdog in the Democratic presidential primary, he distinguished himself from his rivals on the central issue of the race by tacking to their right.

The question at hand was how the candidates intended to reform the health care system to cover uninsured, working-age people. Hillary Clinton and John Edwards, who had won acclaim from the activist and policy communities for the reach of their plans, had adopted the unpopular view that these uninsured people should be required to purchase plans (regulated and subsidized plans, but for-profit plans, nonetheless) from private companies like Aetna.

Such a mandate, they argued, would both guarantee that their plans would create universal coverage, and also protect the private insurance market from what’s known as “adverse selection,” where, in absence of a mandate, healthy people would choose to go uninsured, leaving an expensive and unstable system in place for higher-risk beneficiaries.

Obama seized the safe ground by omitting this provision from his plan—“A mandate means that, in some fashion, everybody will be forced to buy health insurance,” he said at a primary debate in January 2008. This framing annoyed Clinton and Edwards, who rightly maintained that omitting a coverage requirement would, at the very least, guarantee that many millions of people remained uninsured. “I am not running for president to put Band-Aids on our problems,” Clinton replied. “I want to get to universal health care for every single American.”

For mostly unrelated reasons, Obama won this primary and went on to face John McCain in the general election. Because the candidate who ran in the Democratic primary against the individual mandate vanquished his pro-mandate opponents, you might imagine that Republicans were scrupulously honest about what had happened, and refrained from insisting Obama’s plan would mandate the purchase of private health insurance.

In fact, that’s not what happened. “Senator Obama says, if you don’t get the health care policy that I think you should have, then you’re going to get fined,” McCain charged at the second presidential debate, as if he were running against Clinton or Edwards. The allegation did little if anything to help McCain’s cause. He went on to lose in a landslide, and Obama, as many predicted he would, bent to expert and industry pressure, and agreed to sign legislation that included an individual mandate. Then he won re-election.

This is all ancient history now, and as it turned out, the mandate proved to be less critical to either the stability of Obamacare or its universality than basically everyone had anticipated. But what was striking at the time is how liberal commentators, exhausted after eight years of the Bush administration, and hellbent on victory, responded to Obama for taking a cautious approach: they insisted that Clinton and Edwards were right, damn the polls, and criticized Obama for undermining both them and the cause of comprehensive health-care reform, for political expedience. 

They were right to advocate for the approach they believed was correct, even if the mandate was politically treacherous, and from the vantage point of 2019, the case for polls-be-damned politics has gotten stronger. In 2016, Democrats nominated Clinton, again the candidate of moderation relative to Bernie Sanders. Republicans nominated Donald Trump, who ran on a mishmash of obvious but politically incautious lies—he promised to repeal Obamacare, give everyone government-sponsored health care, ban Muslims from entering the U.S., and punish women for obtaining abortions.

It worked out OK for him.

Most Democrats aren’t incorrigible liars like Trump, but some of them have taken from the experience of 2016 that political conventional wisdom is more conventional than wise. At last week’s two-part debate, four candidates acknowledged they would eliminate the existing private health insurance market and move nearly everyone in the country on to Medicare; most candidates adopted the righteous but politically damaging view that undocumented immigrants are human beings and should have the same access to health care as citizens; many say crossing the border without authorization should no longer be a criminal offense unto itself—that unauthorized immigrants should be deported, not prosecuted and imprisoned.

Democrats should have a good-faith debate about the substantive merits of these ideas, but it’s notable that the liberal commentariat has grown uninterested in the merits of, say, Medicare for All vs. Medicare for those who want it, and has fallen back on the view that leading Democratic candidates have taken huge, unnecessary risks by endorsing unpopular or easily demagogued policy ideas.

“Early in the first Democratic presidential debate, all the candidates were asked who would abolish private health insurance,” wrote New York magazines Jonathan Chait. “Only two raised their hands: Bill de Blasio, who is not going to be the party’s nominee, and Elizabeth Warren, who might be. Should that possibility come to pass, her frank answer could prove deeply harmful and perhaps deadly…. She may have just filmed the most effective attack ad against herself.”

This is reminiscent of, though different in important ways from, one of the most comic lines of the debate, when John Hickenlooper, the former governor of Colorado, warned Democrats that “if we don’t clearly define that we are not socialists, the Republicans are going to come at us every way they can and—and call us socialists.” It is true that if Democrats nominate Sanders next year, Republicans will be on less-dishonest ground when they call Democrats socialists, because he, alone in the field, identifies as a democratic socialist. But what made Hickenlooper’s warning absurd is they are going to call Democrats socialists no matter who wins.

They have been accusing Democrats, falsely, of supporting open borders for years, and will continue to do so, even though decriminalizing unauthorized entry is not open borders. They are also going to accuse Democrats of seeking to abolish private insurance no matter who wins. This is not a guess, it’s a commitment Senate Majority Leader Mitch McConnell made when he said “Even the [candidates] who declare themselves moderates will say, with regard to health care, that they want the public option. There won’t be any private health insurance if you have the public option because the government will always sell you the insurance cheaper. So, no matter how they choose to characterize themselves, you can bet that whether it’s Joe Biden, Bernie Sanders, or somebody else, the nominee for president on the Democratic side is going to be on a path to try to turn America into a socialist country.”

It is true as a general matter that candidates for office should propose broadly popular ideas, and make those, rather than their bold- or just-but-contentious ideas, the heart of their campaigns. But it’s worth being specific about what risk, exactly, Warren and others have just incurred. They have not exposed themselves to new lines of attack, as some would have it. If she wins the nomination, what Warren may have done is marginally facilitate the effectiveness of a Republican attack that was coming anyway, by making it tendentious-but-defensible, instead of an outright lie. 

How much that would matter in the general election is much more a question of guesswork than of science. Would she be hurt by holding an easily demagogued view more than she’d gain from establishing herself as a principled candidate? Would she take the attacks lying down, or have adept responses to them? Will any of that matter if Russian spies steal and publish her emails, or Attorney General William Barr gins up a criminal investigation of her?

If attack ads that use candidates’ own words against them are all powerful, then I like the Democrats’ odds. Whether the inevitable Republican attacks on the Democratic nominee are true or false, Trump is on camera promising to finish the job of repealing Obamacare. He’s on camera calling one of his rape victims too ugly to rape. He’s also on camera bragging about committing sexual assault with impunity, but that footage surfaced before the last election, and he won.

The point isn’t that candidate statements and issue positions have no impact on vote totals (Trump lost the popular vote!) but that sorting out what their impact will be in advance is hard, and secondary or tertiary to larger choices candidates make, along with forces outside of their control. The case for political caution is thus weaker and narrower than it’s presented, either by liberal pundits, or the timorous Democratic establishment, or the crush of NeverTrump Republicans warning Democrats that Trump will win re-election unless they appease NeverTrump Republicans.

It is that, because the stakes of the election are so high, candidates should only adopt positions that poll well in every framing, in order to undermine Republicans when they flood the campaign with propaganda about Democratic radicalism. The counterarguments are that Democrats risk demobilizing activists by responding to a crisis like Trump with half-measures, and that an incumbent as weak as him presents an opportunity for Democrats to run and win on a far-reaching agenda.

This is a debate worth having, particularly over picayune issues that poll particularly badly. But it’s not one that can be resolved empirically. Democratic voters will ultimately decide which theory of the case the party will test next year, and because none of us can dictate to them with any confidence which candidates and which ideas are most electable, they should be encouraged to vote for the candidates and ideas they like the most, and candidates should be encouraged to run on ideas they believe in, and can speak about persuasively, with conviction.

As the race progresses, we’ll have a much clearer sense of whether Democratic voters and members the general public are really unfavorably disposed to the field’s left-most candidates, and whether Democrats will once again select a nominee who doesn’t take the left-most position on health care. That’s a reasonable way way to resolve concerns about electability. Encouraging candidates and voters to let fear of Republican demagoguery shape their values and ambitions is not, because the demagoguery is coming no matter what.