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The ACA Repeal: Our Lives Are at Stake, So What Now?

This is a time for heroic communities to prove we have the power to save one another.

As you have probably heard by now, the House has voted 217-213 in favor of repealing the Affordable Care Act (ACA). The American Health Care Act (AHCA), or Trumpcare, as many have dubbed it, is one step closer to becoming law, and many of us are duly terrified. The battle now moves to the Senate, and those who argued that the Trump administration had proven too inept to fear have had their out-of-touch arrogance exposed. In truth, the “normalization” we were all afraid of came in the form of notions that Trump was too much of a buffoon to hurt us — a contention that never made sense, given how much power the Republicans currently wield.

Shaken by these developments, many people are asking, “What do we do now?”

First, Some Facts

If the AHCA actually reduces the budget, it can pass with 51 votes. No one knows yet how this bill will affect the budget because the GOP rushed it through without hard numbers. If it does not reduce the budget, it will require 60 votes, and the GOP is not likely to snare that many votes in the Senate. That means that if the bill doesn’t reduce the budget, it will have to be rewritten, and make no mistake, stalling matters.

We’ve Got Power

In this dark moment, it’s easy to feel powerless, but we have a lot going for us in this fight, and we have a lot of leverage. We just need to be strategic about using it. A number of Republican senators are vulnerable, because a lot of people in their states have benefitted from the ACA. A lot of those same people hate Obamacare in theory, but the cold, hard reality of losing health care could provoke a different response.

The Republicans who flipped in the House were no doubt assured by President Trump and Speaker Paul Ryan that their names won’t be remembered by the upset masses. They have likely been told that it’s the Senate that will be deemed responsible for the final outcome. Some of these people may actually get off the hook that way — but senators have no such division between themselves and the end game. Any negative outcome in this fight will fall at their feet, and they must be made to understand that if they vote yes, there will be a reckoning.

The Democrats Will Not Save Us

Let me repeat: The Democrats will not save us. Their chanting of “nah nah nah nah, hey hey, goodbye,” as Trumpcare passed the House is a solid reminder of how detached and out of touch these people are with the consequences of such moments.

The implication of their song was that some Republicans who voted yes will be voted out in the next election, which is hopefully true, but their behavior provides an excellent lesson in the importance of tone and context. As people like me, with multiple chronic health conditions, whose loved ones’ lives are hanging in the balance, watched this vote in horror, establishment Dems on the House floor gave us all a reminder that they don’t live in these moments with the rest of us. This is all gamesmanship to them.

They were singing as people shook with fear, because of the dawn of a new political advantage. Remember that, and do not repeat this behavior in your own organizing. There is a time to be flippant, but there are also times to be solemn, thoughtful and, if you’re so inclined, even prayerful.

As you protest and take other actions, choose the tone of those actions in advance and have the discipline to maintain it.

Remember, no Democratic official will be our lifeline. We are the emergency response, and with 24 million people’s health care on the line, we are literally fighting for our survival, and the survival of our communities. To confront this crisis, we must become a crisis, so invest your efforts in direct action, not Democrats.

What Does Outreach Look Like?

I don’t expect marginalized people to plead with people who elected Trump. They are not likely to listen to us anyway. White allies and accomplices, you are needed in this outreach. I am not discounting the power or voices of marginalized people — we have as much, if not more, to lose than anyone in this mess, and we have powerful voices to leverage — but there are many fronts in this fight. Whether we are educating our communities, hounding senators or telling our stories to the public in op-eds, protests or through artistic expression, we will all have to decide what venue, and what audience, will help us gain the most ground. So take one for the team.

We often think of outreach in terms of a spectrum of allies. We begin by trying to convince those whose views are closest to our own, and work our way towards those who may passively agree, then toward those who are neutral, before potentially persuading our passive opposition, but this scenario is different. Yes, we need to activate everyone who might be inclined to listen, but the Republican base is also a resource here, because when a person feels personally threatened, a lot of policy positions become negotiable, even if underlying beliefs do not.

If you’re thinking, “But the Republican base has consistently acted against its own interest,” you’re right. It has. In the case of Trumpism, it has done so because the rise of fascism and white nationalism in the US affords the GOP’s base an opportunity to freely express their sense of supremacy, and see it codified in law. Throughout history, people have frequently acted against their own interest for the sake of leadership that validates their delusions of superiority. But the current situation provides us with very concrete consequences and imagery with which to confront people.

Remember, all campaigns and actions are stories, and we are all storytellers. The imagery of your story matters as much as being able to detail your characters — who are the heroes, who are the villains? What future are you foreshadowing? Map out your story points and make sure your narrative is written in thoughtful opposition to theirs.

Strategically, Republicans are the issue here, so it’s Republicans who must have the fear of collective action driven into their heads. Tell a story that terrifies them, a narrative that will follow them wherever they go, that they may actually never escape.

All Republican senators are legitimate targets, but moderate Republicans and Republicans in largely Democratic states are probably the most viable. States that have expanded health care — like Kentucky, West Virginia and Alaska — will be crucial. Those people need to hear clear messaging about what they stand to lose.

Read, Read and Read Some More

Understand what you are advocating for and against. Be able to explain what you wish were better about the ACA, but also be ready to explain why it cannot be repealed and replaced with Trump’s plan. Figure out who your friends are, locally, and whether there are any local groups you can invest your efforts in. If there isn’t a group that fits your views, or that is active in your area, that’s OK. Rally who you can, even if it’s just you and your close friends, and start making lists and plans.

Do your homework, pick your targets and apply pressure. Mass marches and rapid responses are important, but don’t limit your efforts to taking to the streets to voice your rage. To win, we must act strategically and with great intention. Swift action is called for, but if we’re not hitting the right targets, our efforts will yield us nothing. Map out who is vulnerable, then hit them with whatever you can.

Do What You Can

Educate your targets’ constituents about what the repeal will mean for their communities. Be sure to drive home what’s at stake, for them, if this happens, because their self-interest may be your only leverage.

Plan and schedule war-dialing sessions: Jam the phone lines of targeted legislators so that they can’t do anything but take messages about this issue. Create Facebook event pages, macro images and copy/paste posts to encourage participation.

Meet with your targets. Write to them. Disrupt their events. Stage direct actions to challenge them. Make sure they know this is only the beginning, and that if we have to bury our parents, neighbors or children because of them, we will bury their careers along with them. Hold mock funerals for those who will be lost if this bill becomes law outside their offices. Hold mock funerals for their careers at their events, and on their lawns. Make sure they know that pop-up memorial services will haunt both their personal and professional lives if they sign off on any version of this bill.

It’s also important to haunt the vulnerable members of the House who voted for the repeal. This will give senators who are on the fence a glimpse of what they could be in for. Review the names of vulnerable Republican Congress members who voted in favor of the repeal, and drag those names through the mud. Make memes about their complicity, remind people of their names, bombard them on social media, and derail their events (while prioritizing action against senators, since they haven’t voted yet). The consequences of signing off on so much suffering must be presented in no uncertain terms, and it’s always better to show than tell.

Lastly, don’t let anyone dismiss your fears by saying that the bill won’t be as awful by the time it passes the Senate. There are no acceptable losses here. No one’s survival is negotiable, and no version of this bill will leave us all intact. Our solidarity must be rock solid, deeming no one expendable, and beating a path toward a system that truly leaves no one behind.

This is not a drill, and Trump’s buffoonery will not save us. This is a time for heroic communities to prove we have the power to save one another, and I, for one, believe that we do.

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