Vyacheslav Molotov, Stalin’s foreign minister, once remarked while on a trip to Berlin in the early days of the Cold War, “The trouble with free elections is that you never know how they will turn out.”
On the morning of November 9th, Molotov’s grandson, Vyacheslav Nikonov, a member of the Russian Duma’s foreign-affairs committee, announced to the parliament, “Three minutes ago, Hillary Clinton conceded defeat in the American Presidential elections. And just this second Donald Trump began his speech as President-elect.” The Duma members cheered and applauded.
In the days to come, there were more declarations of acid satisfaction among the Russian élite. Dmitri Kiselyov, the host of “News of the Week,” a popular current-affairs show on state-controlled television, gloated over Trump’s victory and Barack Obama’s inability to prevent it. Obama, he said, was a “eunuch.” Trump was an “alpha male”—and one who showed mercy to his vanquished rival. “Trump could have put the blonde in prison, as he’d threatened in the televised debates,” Kiselyov said on his show. “On the other hand, it’s nothing new. Trump has left blond women satisfied all his life.” Kiselyov further praised Trump because the concepts of democracy and human rights “are not in his lexicon.” In India, Turkey, Europe, and now the United States, he declared, “the liberal idea is in ruins.”
Vladimir Putin did not showboat, but he, too, made his satisfaction plain. His spokesman, Dmitri Peskov, told reporters that the similarity between Trump and Putin’s “conceptual approach to foreign policy” was “phenomenal.” Trump’s victory was the basis for Russia’s “moderate optimism”; now both sides could discuss how “to clear out the Augean stables in our bilateral relations.”
All of this is all the more alarming to recall now, in the light of the latest news: according to U.S. intelligence reports, Putin “ordered an influence campaign” to undermine Clinton and work with “a clear preference” to enhance Trump’s prospects. A classified version of this intelligence has now been delivered to both the President and the President-elect. Briefed in New York on Friday by the heads of the C.I.A., F.B.I., and N.S.A., Trump, who earlier in the day called the focus on Russian hacking “a political witch hunt,” finally allowed, if obliquely, that the Russians—and not the Chinese, not “somebody sitting on their bed that weighs four hundred pounds”—might have hacked the e-mail accounts of the Democratic National Committee and Clinton’s campaign chairman, John Podesta. A declassified report concluded that Putin ordered a campaign of covert operations, from defamatory “fake news” articles about Clinton to the hack itself. Even as Trump seemed to shift his view of the source of the D.N.C. hack, he did not concede that the operation had helped his campaign. The declassified report, however, said that the C.I.A., F.B.I., and N.S.A. had uniformly “high confidence” that Putin ordered the operation in order to “undermine public faith in the US democratic process, denigrate Secretary Clinton, and harm her electability and potential presidency.” The N.S.A. had only “moderate confidence” on some details, while the C.I.A. and F.B.I. had “high confidence.” The differences, while vague, seem to be over the degree of Putin’s personal role. The declassified version of the report was unrevealing about how the agencies had come to their conclusions or collected their information.
One should continue to demand even more information from the U.S. government, and one can readily concede that Trump won his Electoral College victory for a variety of reasons, including the disaffection of the white working class in states like Michigan, Pennsylvania, and Ohio; the F.B.I. director’s two letters, late in the campaign, about Clinton’s e-mail server; and Clinton’s deficiencies and tactical errors as a candidate.
And yet how is it possible, if these intelligence reports are true, to count the 2016 Presidential election as unsullied? We are two weeks away from Trump’s Inauguration, and American intelligence agencies, flawed as they are, have declared, publicly and clearly, that they have convincing evidence that Russia, at its President’s direction, interfered in a Presidential election. Congress clearly has a job to do, but it is not alone. No matter how much it may offend Trump’s ego or his sense of self-possession, it will be his responsibility, his duty as President, to order the agencies at his command to dig even deeper, to provide as full a reckoning as possible. Will he resist Congress on this issue? Is he capable of questioning, in a sense, his own election? If he decides to refuse this duty, to just “move on,” as he likes to say, one will have to ask why.
Putin’s resentment of Clinton was always manifest; it is almost as severe as Trump’s. Putin saw the Clinton Administration of the nineties as having taken advantage of Russian weakness after the fall of the Soviet Union, twenty-five years ago. He viewed Hillary Clinton as a foreign-policy hawk who wanted regime change from Baghdad to Kiev to Moscow. In 2011, Putin, who lives in fear of spontaneous uprisings, events like the Arab Spring and the “color revolutions” in Ukraine and Georgia, accused Clinton of giving “a signal” to urge thousands of Russians to come out on the streets of Moscow to protest parliamentary-election “irregularities” and Putin’s intention to return once more to the Kremlin as President.
In the past few weeks, I’ve had conversations with Russian political experts, and all of them agreed that Putin was certainly pleased, at least initially, with Trump’s victory—and that satisfaction is reflected, too, on countless news and talk shows on television. These analysts added that Putin is undoubtedly cheered that Rex Tillerson, Trump’s appointment to head the State Department, was likely to leave behind American “sanctimony” about human rights and democracy and, following the pattern of his career at ExxonMobil, to concentrate on purely “transactional politics.” Some, however, wondered if Putin will remain enchanted with Trump once he encounters Trump’s inconsistencies, his alarming penchant for surprise pronouncements via Twitter.
Like many nationalist politicians in Europe, Trump has made plain his admiration for Putin, complimenting the Russian leader’s “great control over his country,” while at the same time failing to address the reality that Putin’s regime has instituted wholesale censorship of television, increased repressive measures on ordinary citizens, and unleashed his forces in Ukraine and Syria. (Putin, of course, discounts criticism of his policies as Western hypocrisy and points to everything from the invasion of Iraq, which he opposed, to the eastward expansion of NATO, which he sees as an aggressive act.)
Trump’s argument throughout the campaign, the reason for his compliments for Putin, he has said, is related to his stated desire to ease tensions between Russia and the United States and avoid the ultimate disaster, a nuclear confrontation. But what concerns many seasoned American analysts, politicians, and diplomats is that Trump is deluding himself about Putin’s intentions and refuses to see the nature of Russia’s nationalist, autocratic regime clearly. Trump has spoken critically of NATO and in support of European nationalist initiatives like Brexit to such a degree that, according to one Obama Administration official, “our allies are absolutely terrified and completely bewildered.”
Strobe Talbott, who was Bill Clinton’s closest adviser on Russia, told me recently that the hack of the D.N.C. and Putin’s other moves in Europe—including the annexation of Crimea, the Russian military presence in eastern Ukraine, and the financial support of nationalists like Marine Le Pen, of France—were part of a larger strategy intended to weaken the E.U. and NATO.
“I try to be careful about superlatives,” Talbott said, “but I cannot think, going back to the Soviet Union or since, that there’s been a Moscow-Kremlin-instigated gambit that was so spectacularly successful as what they have done with our democracy. All of those assets that they tried to use on us over the years were far less by comparison; this was like winning seventeen jackpots all at once.”
If you confine yourself to the Congressional Record, you would assume that Republicans methodically followed their game plan to dismantle Obamacare in the first week of the new session. The Senate passed the first phase of their repeal bill under a process called reconciliation, a budget procedure that requires only a simple majority in the Senate, without opportunity for filibuster. The Senate should wrap up in the coming weeks with a “vote-a-rama” (where Senators vote on all amendments consecutively for hours on end) and a final vote, and the finished product will move to the House, for likely passage days after Donald Trump’s inauguration.
But Republicans spent more time firming up the process of repeal than on the substance of the bill, which thus far includes no detail on what will be repealed or when, or what will eventually replace the current system. It’s like they practiced how to walk down the aisle over and over without knowing whether they will say “I do.”
This absence of detail has created a vacuum, filled with fear and infighting and jockeying for position. Hard-liners and moderates are consumed with the timeline for delay. But Tom Cotton became the first senator to publicly oppose repeal without a replacement, echoing the sentiments of others in private. Meanwhile, polling for “repeal and delay” is horrendous. And any replacement will have to contend with furious lobbying from insurers and major medical groups.
Furthermore, familiar politics are already tripping up the process. Republicans really want to eliminate Obamacare’s taxes on high-income households, insurance companies, and medical-device manufacturers; repeal should actually be seen as a tax-cut bill in the short-term. But Rand Paul’s concerns about the deficit led him to oppose the bill, and while he has failed to rally conservatives to his side thus far, money for a replacement will likely have to come from somewhere to appease the budget hawks. Separately, in a funhouse-mirror echo of the Stupak amendment, House Republicans want to include defunding of Planned Parenthood in the repeal, like the dry-run repeal bill did last year. But Susan Collins and Lisa Murkowski have threatened to fight such a measure, making Senate passage less likely. And that’s just the beginning of the knock-down, drag-out fights to come over every line of a replacement bill.
What this shows is that Obamacare really did alter the social contract in America. For all its faults—and they are considerable—Obamacare created an expectation of a definitive federal role in health-care markets. It’s untenable to simply return to a pre-2010 status quo; nobody outside of Iowa lunatic Steve King is calling for that. The public now expects that the government must provide assistance in making health-care markets work, in a way that they didn’t expect a decade ago. The public sees Obamacare as a benchmark, and any service below it will not be tolerated.
And Republicans are actively aiming low. While making public promises that nobody will lose their coverage from repeal, they have conceded that they cannot cover as many Americans as Obamacare with anything they would approve, preferring to use the term “universal access.” The one thing Republicans cannot overturn in reconciliation is the pre-existing condition exclusion, but they can allow insurers to price the stickiest applicants out of the market. This will necessarily create incentives to cherry-pick customers, and leave millions on the sidelines. The types of executive actions Trump could take for an “orderly resolution” of Obamacare all militate toward denying coverage by reducing mandatory insurance benefits and restricting rules on sign-ups.
This wasn’t really a problem in 2004 or 2006. George W. Bush didn’t have a standard to live up to on health care. He simply implemented versions of long-held Republican ideas like tort reform, health savings accounts, and state funding for high-risk pools—the exact same ideas being bandied about today, incidentally. They didn’t succeed in bringing down the uninsured rate or lowering costs. But it didn’t matter. There was no comparison point.
Now Obamacare has become that comparison point. For all the Republican talk of it being a failed experiment in government-run health care, it actually succeeded in institutionalizing a federal role for more than just children, the poor, and the elderly. This is why Bill Kristol famously wrote that memo in the 1990s urging Republicans to fight tooth and nail against Bill Clinton’s health-care reform, because it “would guarantee and likely make permanent an unprecedented federal intrusion into and disruption of the American economy.” Though Obamacare has never achieved the high approval ratings that would seemingly usher in such a guarantee, it did solidify the concept that federal intrusion is necessary. We’re not likely to go back.
Is Obamacare the perfect manifestation of that federal role? No. The subsidies are inadequate and the deductibles are too high, and the combination of consolidation in insurance markets and companies leaving the exchanges has removed the choice and competition thought to be the linchpin to bring down costs. Medicaid expansion has worked well where it has been taken up, but the exchanges are running on fumes. Nobody in the Democratic presidential primary argued for keeping the system the same; the choice was between minor or radical overhaul. Allowing customers to buy into Medicare, using all-payer rate setting to control provider costs, and federalizing Medicaid should be ideas returning to the table if and when Republican policies prove inadequate.
The debate over health care for the next decade will feature both sides trying to live up to a promise made with the American people in 2008. There are a panoply of ideas on how to extend insurance coverage to make it both affordable and useful. The party in power is scrambling to come up with ideas they can live with. The party out of power is fighting among themselves over which ideas will work best. But the biggest political risk lies in going backwards. That’s a new reality in health care that can be exploited.