Skip to main content
Part of complete coverage from

Obamacare and the failure of half-baked liberalism

By Julian Zelizer, CNN Contributor
updated 7:08 AM EST, Mon November 11, 2013
STORY HIGHLIGHTS
  • Julian Zelizer says rollout of Obama's health care plan has been filled with problems
  • He says the Affordable Care Act was product of timid liberalism, a trend in past decades
  • Zelizer: Liberals have shied away from arguing strongly for government solutions
  • Programs such as Obamacare are complex, require cooperation of states, private industry, he says

Editor's note: Julian Zelizer is a professor of history and public affairs at Princeton University. He is the author of "Jimmy Carter" and "Governing America."

(CNN) -- The rollout of the Affordable Care Act has been filled with problems and controversy. Facing entrenched opposition from a Republican Party that has been determined to subvert the program from the moment it passed, President Barack Obama has frustrated supporters by continuing to offer the GOP plenty of ammunition for their attacks.

The website for purchasing health care has been an embarrassment.

The contradictions between Obama's promises about everyone being able to keep their existing coverage and the reality that millions of Americans would not be able to do so has raised memories of President George H.W. Bush's famous "Read My Lips" pledge.

Health and Human Services Secretary Kathleen Sebelius has admitted that the enrollment numbers will fall well short of what was expected.

While it is true that the challenges facing the program have received much more attention than the successes, the problems are impossible to ignore. There are many reasons for Obamacare's troubles, ranging from the failure of White House officials to adequately prepare for the launch of the website to the successful Republican efforts to undermine its operations, including the refusal of many governors to establish exchanges in their own states.

Julian Zelizer
Julian Zelizer

But a large part of the problem was the underlying ideological outlook that shaped the original proposal. The ACA was a product of a kind of half-baked liberalism that has been popular among many Democrats for several decades.

Since the 1990s, many Democrats have settled for jerry-built proposals that shy away from direct and aggressive federal intervention. Many Democrats have concluded that in the current era, the only domestic programs that stand a chance of passing Congress are those that rely on the participation of market-based actors, limited federal funding and heavy federal-state collaboration in the administrative process.

Conservatives have been very effective at defining the national agenda throughout these years, defending the argument that government is the problem, as Ronald Reagan famously said, and nurturing a political coalition that has continually pushed liberals into the corner.

In response, many Democrats concluded that the best strategy was to veer toward the center. They have pushed programs that create incentives for Americans to do certain things within the private market, rather than just offering those services themselves directly through the government.

While many domestic programs in the United States included this kind of mix throughout the 20th century, in recent decades Democrats have embraced this approach even more aggressively for fear that anything more sweeping would die in Congress.

While there are good political reasons behind this approach, it has also come at a huge long-term cost to the strength of the programs, and Obama is now paying the price.

Foremost, these mixed public-private programs have trouble building strong public support. Their complexity makes it difficult for politicians to excite the public and explain the benefits to constituents. Often the benefits are hard to discern for most Americans who see a patchwork of regulatory policies.

The complexity allows opponents to characterize the programs in unfavorable terms, even spreading false information without strong pushback. President Bill Clinton learned this in 1993 when his market-based proposal for health care was turned by Republicans into a state-centered monstrosity and went down to defeat.

The contrast with Social Security is striking.

Under President Franklin Roosevelt's program, created in 1935, the federal government directly sends paychecks to the elderly. Americans have always understood the benefits they receive. The clarity of the funding, with a payroll tax paying for benefits, has also been important in creating a sense of ownership among workers that has pushed them to support the program for decades.

The other problem with half-baked liberalism is that it provides many points for opponents to weaken measures after they have passed. The implementation process becomes a nightmare.

We have seen this with the Dodd-Frank legislation that established a relatively weak regulatory infrastructure filled with loopholes that has allowed the financial services sector to continue to engage in highly risky behavior.

Another example is the fact that Obama's economic stimulus program in 2009 did not include the kinds of public works jobs that defined the success of the New Deal for many Americans.

Mixed public-private programs often fail to address the underlying forces causing a problem, while giving private industry a chance to reap profits off the policy. This is what critics said of the Empowerment Zones of the 1990s, a style of urban policy that had limited effect on revitalizing impoverished urban areas.

The ACA has been no different. The legislation required states to set up federal exchanges and mandated that the federal government would create an exchange of its own for individuals living in states that lacked their own system.

This design allowed Republican governors to block the creation of state exchanges and intensify the pressure on the federal government to handle the program. Congress didn't devote to ACA the funding that was needed to handle this task.

ACA also relies on the expansion of Medicaid to provide coverage to the uninsured. But the legislation left itself open to legal challenge and the Supreme Court allowed states to opt out of this expansion. The result is that in many states, the future of the uninsured remains up for grabs.

Rather than providing insurance directly through a public option, the legislation instead relied on a mandate to force qualified individuals to purchase private coverage through exchanges. The risk is that premiums continue to stay high and that access to the programs continues to remain problematic, all of which will make ACA look like less of an improvement than many hoped for.

The design of the program will also likely strengthen the government-health care complex that has grown since the creation of Medicare. The president has been notably quiet in criticizing the insurance companies in recent weeks.

As Politico reported, one White House official said, "Their interests are aligned with our interests in terms of wanting to enroll targeted populations. It is not that we will agree with everything now either, but I would say for some time now there has been a collaboration because of that mutual interest." The government also tied its own hands in regulating costs by backing down from original proposals to regulate drug prices.

In a recent article in National Affairs, Johns Hopkins University political scientist Steven Teles writes about "Kludgeocracy in America," which he defines as the nation's tendency to offer complex and byzantine policy solutions to the most pressing policy problems. The solutions we offer are temporary and short-term fixes to long-term problems that leave no one satisfied and often intensify distrust of government.

According to Teles, if the government chose cleaner solutions to big challenges such as health care and education, "government would be bigger and more energetic where it clearly chose to act . . . but smaller and less intrusive outside of that sphere."

The stakes of fixing the health care mess are enormous for the President as well as for liberals who want to prove that government is capable of handling big problems.

But the policy problems should also be a wake up call for liberals that it might be worth fighting for something bigger next time around. It was not inevitable that Obama chose the path that he did.

Despite the conventional wisdom, there is plenty of evidence that liberalism remains quite strong in the body politic -- based on ongoing support for specific programs like Social Security, strong electoral performance of Democrats in 2008 and 2012 on campaigns that emphasized progressive themes and the miserable approval ratings of the GOP.

While it is true that the perfect should not be the enemy of the good in American politics, it is also true that sometimes a fight for the perfect is one worth having and could produce results that only strengthen the case for more.

Follow us on Twitter @CNNOpinion.

Join us on Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Julian Zelizer.

ADVERTISEMENT
Part of complete coverage on
updated 5:01 PM EDT, Wed October 22, 2014
Paul Callan says the grand jury is the right process to use to decide if charges should be brought against the police officer
updated 12:19 PM EDT, Thu October 23, 2014
Theresa Brown says the Ebola crisis brought nurses into the national conversation on health care. They need to stay there.
updated 6:35 PM EDT, Tue October 21, 2014
Patrick Hornbeck says don't buy the hype: The arguments the Vatican used in its interim report would have virtually guaranteed that same-sex couples remained second class citizens
updated 9:36 AM EDT, Fri October 24, 2014
Paul Begala says Iowa's U.S. Senate candidate, Joni Ernst, told NRA she has right to use gun to defend herself--even from the government. But shooting at officials is not what the Founders had in mind
updated 6:08 PM EDT, Thu October 23, 2014
John Sutter: Why are we so surprised the head of a major international corporation learned another language?
updated 5:54 PM EDT, Thu October 23, 2014
Jason Johnson says Ferguson isn't a downtrodden community rising up against the white oppressor, but it is looking for justice
updated 12:21 PM EDT, Fri October 24, 2014
Sally Kohn says a video of little girls dressed as princesses using the F-word very loudly to condemn sexism is provocative. But is it exploitative?
updated 4:06 PM EDT, Tue October 21, 2014
Timothy Stanley says Lewinsky is shamelessly playing the victim in her affair with Bill Clinton, humiliating Hillary Clinton again and aiding her critics
updated 10:14 AM EDT, Thu October 23, 2014
Imagine being rescued from modern slavery, only to be charged with a crime, writes John Sutter
updated 12:00 PM EDT, Tue October 21, 2014
Tidal flooding used to be a relatively rare occurrence along the East Coast. Not anymore, write Melanie Fitzpatrick and Erika Spanger-Siegfried.
updated 7:35 AM EDT, Tue October 21, 2014
Carol Costello says activists, writers, politicians have begun discussing their abortions. But will that new approach make a difference on an old battleground?
updated 9:12 AM EDT, Tue October 21, 2014
Sigrid Fry-Revere says the National Organ Transplant Act has caused more Americans to die waiting for an organ than died in both World Wars, Korea, Vietnam, Afghanistan and Iraq
updated 2:51 PM EDT, Tue October 21, 2014
Crystal Wright says racist remarks like those made by black Republican actress Stacey Dash do nothing to get blacks to join the GOP
updated 6:07 PM EDT, Tue October 21, 2014
Mel Robbins says by telling her story, Monica Lewinsky offers a lesson in confronting humiliating mistakes while keeping her head held high
updated 9:29 AM EDT, Mon October 20, 2014
Cornell Belcher says the story of the "tea party wave" in 2010 was bogus; it was an election determined by ebbing Democratic turnout
updated 4:12 PM EDT, Mon October 20, 2014
Les Abend says pilots want protocols, preparation and checklists for all contingencies; at the moment, controlling a deadly disease is out of their comfort zone
updated 11:36 PM EDT, Sun October 19, 2014
David Weinberger says an online controversy that snowballed from a misogynist attack by gamers into a culture war is a preview of the way news is handled in a world of hashtag-fueled scandal
updated 8:23 AM EDT, Mon October 20, 2014
Julian Zelizer says Paul Krugman makes some good points in his defense of President Obama but is premature in calling him one of the most successful presidents.
updated 10:21 PM EDT, Sun October 19, 2014
Conservatives can't bash and slash government and then suddenly act surprised if government isn't there when we need it, writes Sally Kohn
updated 8:05 AM EDT, Wed October 22, 2014
ISIS is looking to take over a good chunk of the Middle East -- if not the entire Muslim world, write Peter Bergen and Emily Schneider.
updated 9:00 AM EDT, Mon October 20, 2014
The world's response to Ebola is its own sort of tragedy, writes John Sutter
updated 4:33 PM EDT, Fri October 17, 2014
Hidden away in Russian orphanages are thousands of children with disabilities who aren't orphans, whose harmful treatment has long been hidden from public view, writes Andrea Mazzarino
updated 1:22 PM EDT, Sat October 18, 2014
When you hear "trick or treat" this year, think "nudge," writes John Bare
updated 12:42 AM EDT, Sat October 18, 2014
The more than 200 kidnapped Nigerian schoolgirls have become pawns in a larger drama, writes Richard Joseph.
updated 9:45 AM EDT, Fri October 17, 2014
Peggy Drexler said Amal Alamuddin was accused of buying into the patriarchy when she changed her name to Clooney. But that was her choice.
updated 4:43 PM EDT, Thu October 16, 2014
Ford Vox says the CDC's Thomas Frieden is a good man with a stellar resume who has shown he lacks the unique talents and vision needed to confront the Ebola crisis
updated 4:58 AM EDT, Sat October 18, 2014
How can such a numerically small force as ISIS take control of vast swathes of Syria and Iraq?
updated 9:42 AM EDT, Fri October 17, 2014
How big a threat do foreign fighters in Syria and Iraq pose to the West? It's a question that has been much on the mind of policymakers and commentators.
updated 8:21 AM EDT, Fri October 17, 2014
More than a quarter-million American women served honorably in the Iraq and Afghanistan wars. Now they are home, we have an obligation to help them transition back to civilian life.
updated 4:27 PM EDT, Thu October 16, 2014
Paul Begala says Rick Scott's deeply weird refusal to begin a debate because rival Charlie Crist had a fan under his podium spells disaster for the Florida governor--delighting Crist
updated 12:07 AM EDT, Thu October 16, 2014
The longer we wait to engage on Ebola, the more limited our options will become, says Marco Rubio.
updated 7:53 AM EDT, Wed October 15, 2014
Democratic candidates who run from President Obama in red states where he is unpopular are making a big mistake, says Donna Brazile
updated 12:29 AM EDT, Thu October 16, 2014
At some 7 billion people, the world can sometimes seem like a crowded place. But if the latest estimates are to be believed, then in less than a century it is going to feel even more so -- about 50% more crowded, says Evan Fraser
updated 12:53 PM EDT, Mon October 20, 2014
Paul Callan says the Ebola situation is pointing up the need for better leadership
updated 6:45 PM EDT, Wed October 15, 2014
Nurses are the unsung heroes of the Ebola outbreak. Yet, there are troubling signs we're failing them, says John Sutter
updated 1:00 PM EDT, Wed October 15, 2014
Dean Obeidallah says it's a mistake to give up a business name you've invested energy in, just because of a new terrorist group
updated 7:01 PM EDT, Wed October 15, 2014
Fear of Ebola is contagious, writes Mel Robbins; but it's time to put the disease in perspective
updated 1:44 PM EDT, Tue October 14, 2014
Oliver Kershaw says that if Big Tobacco is given monopoly of e-cigarette products, public health will suffer.
updated 9:35 AM EDT, Sat October 18, 2014
Stop thinking your job will make you happy.
updated 10:08 PM EDT, Tue October 14, 2014
Ruben Navarrette says it's time to deal with another scandal involving the Secret Service — one that leads directly into the White House.
updated 7:25 AM EDT, Tue October 14, 2014
Americans who choose to fight for militant groups or support them are young and likely to be active in jihadist social media, says Peter Bergen
updated 9:03 AM EDT, Mon October 13, 2014
Stephanie Coontz says 11 years ago only one state allowed same sex marriage. Soon, some 60% of Americans will live where gays can marry. How did attitudes change so quickly?
updated 4:04 PM EDT, Tue October 14, 2014
Legalizing assisted suicide seems acceptable when focusing on individuals. But such laws would put many at risk of immense harm, writes Marilyn Golden.
updated 9:07 AM EDT, Mon October 13, 2014
Julian Zelizer says the issues are huge, but both parties are wrestling with problems that alienate voters
updated 6:50 PM EDT, Mon October 13, 2014
Mel Robbins says the town's school chief was right to cancel the season, but that's just the beginning of what needs to be done
updated 11:43 AM EDT, Sat October 11, 2014
He didn't discover that the world was round, David Perry writes. So what did he do?
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT