Although the Affordable Care Act has transformational potential, the guts of the legislation contain as much Bill Clinton as Lyndon Johnson. A two-page bill could have extended Medicare and provided universal coverage, but by relying so heavily on the private market, and straining to avoid the taint of Big Government, the Affordable Care Act is the Russian novel of social policy, now totaling 20,202 pages. Loopholes and exemptions abound. As Ezra Klein has grimly warned, “Far from introducing innovation and efficiency into the system, the decision to build a complex, 50-state public-private hybrid has introduced towering complexity into the project, and seems, potentially, to be beyond the government’s capacity to do well.”…
But even in the absence of immediate results, liberals were once able to tolerate a bungled policy—so long as it was done in the name of accumulating governmental know-how. Louis Brandeis urged testing programs in “laboratories of democracy.” Franklin Roosevelt bragged about his “bold, persistent experimentation.” Fortunately for the New Deal, Twitter didn’t broadcast every farmer’s sad encounter with the Agriculture Adjustment Act. But the culture of modern Washington, with its hyperventilating media and legislative saboteurs, takes pornographic pleasure in magnifying failures—which in turn erodes the public’s willingness to give liberalism another shot.
This means the earliest days of a policy’s existence have acquired even greater significance. Just as Clinton had to tweak the traditional liberal formula to advance progressive aims, so will whoever follows Obama. Her challenge will be to ensure that her biggest legislative achievements—curbing carbon emissions perhaps, or expanding the Affordable Care Act—are impeccably implemented with the precision that her ancestors celebrated. She must contend with the new expectations that technology has set, with all of those devices that arrive in our hands seemingly glitch free. That’s what the Obama administration somehow failed to grasp and what liberalism requires if it ever wants to replicate its greatest victories.
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