Every Monday at 1 p.m., Slate is hosting In the Know, an election talk show, on YouTube and Facebook Live. This week, Slow Burn host Noreen Malone talked to Valerie Jarrett, a senior adviser to President Barack Obama, about what lessons Joe Biden can learn from the administration about health care, economic recovery, and working with a Republican-controlled Congress. You can read an excerpt of their conversation, which has been edited and condensed for clarity, below.
Noreen Malone: What are some strategies that the Obama administration learned for dealing with [a Republican-led Congress] that might potentially be of use to a Biden administration?
Valerie Jarrett: I think the biggest strategy is that you have to stay in close touch with the American people and encourage them to put pressure on our elected representatives. I can give you a very painful example of where that did not work for us is around the issue of reducing gun violence. We tried mightily in the wake of Sandy Hook to get the Republicans in Congress to take even the most sensible steps to keep guns out of the hands of people who are a threat to themselves or to somebody else, and to close the background check loophole. Now, if you look at polling, 90 percent of the American people agreed with that. But we tried to move so quickly, before the press and the public moved away, that there wasn’t enough time for the American people to put pressure on their elected representatives. And so I think that the best strategy going forward is to recognize you can’t just look at polling and see where the pulse of the people might be. The people have to put pressure on their elected representatives, and that’s the only way they move forward.
Right now, one of the debates is over the Affordable Care Act. And the Supreme Court, we know, is going to hear the case. Coming up this will be the third attempt that the Republicans have made to repeal the health care plan that enables people to get health insurance affordably. But the only reason why it was not successfully repealed once President Trump took office and the Republicans had control of the House and the Senate is because people showed up at town halls. And they objected to taking away their protections for preexisting conditions, or insurance that they finally had for the first time, or women having preventative care, young people staying on their parents’ plans until they were 26. All of this came up at the public hearings that Republicans had when they went back to their districts or their states. That’s how you keep the pressure up and make change happen.
Let’s assume that the most important thing we can do in the health care realm, to help the economy and also the American health care system, is to stop the coronavirus. Let’s also assume in this scenario that there’s a plan for that, and that it will happen. But you still have, as you said, a Supreme Court that could overturn the ACA. You still have the problem of rural hospitals going out of business, of more people uninsured than there were four years ago. What is the first concrete step that you think a Biden executive branch should take? And then what is the first concrete step that you think Congress should take?
As Vice President Biden has said, he would bring Dr. Fauci, a world-renowned expert in infectious diseases, back inside the tent to guide an evidence-based strategy. We know from the evidence we have so far that masks are very important, so we need to encourage people to wear masks. Vice President Biden made very clear that he would send up to Congress a bill to make sure that we are able to produce the equipment we need to keep our health care workers safe, to make sure that we do the testing that needs to be done in our country, to improve the testing, the speed with which the results are delivered. And that we need to make sure that the vaccine, once it is developed and we’re sure in a transparent and open way that it is safe, that it is fairly and widely distributed expeditiously. I think Vice President Biden would focus on those pillars first.
But beyond COVID, what can Congress and the executive branch do to protect or expand health care in this country and the ACA in particular?
Well, if there is time left, I think that Vice President Biden would withdraw from the lawsuit currently before the Supreme Court. He would also want to make sure that he sends up to the Hill a package to strengthen the Affordable Care Act by introducing a public option. You mentioned health insurance in rural communities is too high. The private market alone, if there isn’t competition, will drive up costs, which is why Vice President Biden thinks we should give the American people a choice. You can insure through the public option, or you can participate through the exchanges, and you can get a competitive price. And then of course we would market the enrollment. The Trump administration has not aggressively marketed the enrollment in the ACA, which is part of why you’ve seen some drop-off. We also need to make sure that every state expands the Medicaid provision, so that more people who are the working poor have access to health insurance as well.
So, look, there are plenty of benefits to the Affordable Care Act, but I know Vice President Biden is interested in making it even stronger. And he’s hoping that the Republicans will come to the table, put politics aside, and focus on the American people, who we know right now are suffering. If you think about preexisting conditions, if that’s in peril, which it is, in the case before the Supreme Court, everybody who’s had COVID-19, now you’ve got a preexisting condition, potentially. Your insurance companies can jack up your rates, or they can drop you completely. If we don’t have provisions such as are in the Affordable Care Act.
You were one of the co-chairs of the transition team last time, correct? Beyond everything else with the Trump administration, it is sort of a case study in mismanagement, right? In how not to run an office, in my opinion. You have some experience running offices. If you were to get in there, what would you prioritize in terms of, like, staffing and alliances? I’m not necessarily talking about policy areas to focus on. Just sheer, like, let’s turn this business around, if we’re thinking of the executive branch as a business.
Well, you’re only as strong as your weakest link, so selecting a Cabinet and White House team that shares the values of Vice President Biden and Sen. Harris and prioritizing what you’re going to get done. They need to reinstitute the disciplined way in which we operated our policy councils. We had a National Security Council, an Economic Council, a Domestic Policy Council, and policy issues came up through that organizational structure, working with the Cabinet and the various agencies. And it went through a rigorous process before it ever got to the president’s desk. I’m sure Vice President Biden will put those checks and balances back in place, beginning with his transition. You want to make sure that you come out of the gates quickly and have some wins right off the bat, whether it’s health care, combating COVID-19, rebuilding our economy, building it back better than it was before. That’s a priority for Vice President Biden.
We know we’re going to need another stimulus package. And we are seeing the delays and the stock market dropping today as a result of the inability of the Republicans to get their act together and pass a stimulus. The House passed one back in May, and we’ve been waiting all this time. We’re having hearings on a Supreme Court nominee but not passing relief. It would be helpful to the American people, and to state and local government. I know how important that is to Vice President Biden, because he oversaw the Recovery Act back in 2009, the $800-plus billion that we got out the door so quickly to help jump-start the economy the last time that we were in a recession. I think you’re going to see a lot of activity, both in terms of personnel, moving forward with priorities that he can do through executive order, reversing many of the executive orders that President Trump put in place, and also asking the members on the Hill to pass legislation to ensure that we restore both our lives and our livelihoods.
Do you think too much of what the Obama administration accomplished was done through executive order? You’re talking about now being able to undo what one president did. Obviously, that is something that Donald Trump was able to do with some of Barack Obama’s achievements.
It’s a really good question. And I think our approach was always try to get the kind of change that would be sustainable. That’s why we spent so much time getting the Affordable Care Act actually passed and enacted into law. There are other examples. The repeal of “don’t ask, don’t tell.” It was very important to us to ensure that people could openly serve, if they were gay, in the military without worrying about being discharged, as they’re prepared to make the ultimate sacrifice for our country. Now there were those who at the time said, well, “President Obama should just do it by executive order.” Well, the law didn’t provide for that. But also, importantly, we didn’t want his successor to just repeal it.
It’s why we worked so hard to get comprehensive immigration reform through as a law. And it wasn’t until it was clear it would not move forward that President Obama did sign an executive order giving protection to the Dreamers. But as we’ve seen over the last nearly four years, they are in limbo and the stronger position would have been if it had been a law. I think the first, best thing is to try to get laws passed. Because you recognize that executive orders can be reversed by your successor. But if it’s clear that you have a Congress that isn’t going to work with you, it’s better than nothing at all. And that’s what we did.
This transcript was adapted from In the Know, Slate’s live election show that broadcasts every Monday at 1 p.m. Eastern on YouTube and Facebook. Watch the full conversation here:
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