ObamaCare and America's youth -- why lessons of 2014 will last a lifetime

Monday is the day open enrollment closes for the majority of the American public and the Obama administration is counting on young people – Millennials – to carry them across the finish line.

Suddenly, the president seems to be everywhere he might find young people.

Earlier this month, he took time to be a guest on the Funny or Die show “Between Two Ferns” and called into Ryan Seacrest's radio program.

Meanwhile, First Lady Michelle Obama appeared in the “Your Mom Cares” video along with other celebrity moms, urging young people to sign up for ObamaCare.


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One motivation for all this outreach is economic. ObamaCare will work better if young people sign up, because they are relatively healthy. The Obama team wanted youth to vote in 2008 and 2012 and now hopes they will make a financial decision to join the health exchanges.

But the White House would also like young people to support ObamaCare as a policy. That would help the president’s sagging poll numbers, which may be a drag on his party this November. And it would address the really serious and long-term political question, which is what lessons Millennials draw from this era in our history.

As someone who directs and studies the political and civic participation of our nation’s youth, I find that the political orientation of each generation tends to be set in young adulthood.

The generation that came of age under Franklin D. Roosevelt decided that Herbert Hoover’s minimal government had failed and that federal programs could help them. They formed the New Deal Coalition for half a century and still fight for Social Security today.

The generation that reached voting age with Ronald Reagan remains skeptical of government and relatively libertarian.

Thus the stakes are very high: the next fifty years of American politics and policy will be strongly influenced by the conclusions that the Millennials derive from the present moment.

In 2008, polls showed them strongly supportive of government action to address issues like health and education. Analyzing polling data going all the way back to the 1960s, we find that Millennials were the most pro-government generation on record, as of 2008.

But it is clear that their enthusiasm has been shaken since then.

Politics has been an ugly business. Even though many youth would blame Congress more than the president for the bitter stalemate in Washington, it’s still hard to be enthusiastic about a federal program if you despise the institutions that oversee it.

Quite a few Millennials peeled off from the Obama coalition because they stood to the left of the president on the health care bill itself (preferring a single payer system or at least the “public option”), not to mention issues like Afghanistan and the NSA surveillance debate. These young people are not likely to vote Republican unless they are drawn to GOP candidates who stake out strongly civil libertarian positions on issues like surveillance. But their enthusiasm for mainstream Democrats is very much in question.

I have never seen persuasive evidence that media outreach and celebrity appeals can change fundamental opinions about policy and politics. Obama’s visit to “Between Two Ferns” will not be the turning point in the administration’s efforts.

So what should they do to get young people involved in health reform?

First, they could try to alter the design of ObamaCare to encourage more engagement. Critics say that the Affordable Health Care Act “socializes” medicine, but in fact, individuals must buy their own health insurance plans from private vendors on an exchange, albeit with a subsidy if they qualify.

You are supposed to sit alone at your computer screen deciding which option is best for you and your family.

The bill could have been written so that various kinds of organizations and groups could participate together. For instance, unions and churches could have been allowed to enroll, and people could have been given opportunities to found new groups that would sign up together. Then young people would have had the chance to help build organizations.

It is not necessarily too late to change ObamaCare in this direction. In fact, the Affordable Health Care provides $11 billion for community health centers that are governed by local residents. A broad coalition called Health Access California has signed up millions for ObamaCare and also worked on other aspects of public health since 1987. Health Access California was not created by the law but has used it effectively. Few know about these efforts.

If the participatory aspects of the law were strengthened and publicized, many young people would take part and see themselves as agents of change. Our research consistently finds that when Millennials are offered opportunities to address public issues, they step up.

Second, the administration could engage young people to advocate for health care reform. We estimate that in 2008, more than 4 percent of all young adults volunteered for a political campaign--the highest number ever recorded, and higher than the rate for older people that same year.

Some worked for John McCain or for state and local candidates, but the lion’s share volunteered for Obama. They represented a potential mass movement to support health care reform in Congress and to sign people up for the new program once it was enacted.

But since then, the administration has taken only token efforts to engage these young people. Young voters basically ended up on the email list of Organizing for America, which morphed into Organizing for Action. Neither organization has been a movement or even a space for discussion.

The 2008 Obama campaign was creative and courageous about engaging young supporters. Youth were encouraged to develop their own messages and build local organizations in support of the candidate.

Since then, neither the Obama administration nor the Democratic Party has innovated very impressively or shared much power with their grassroots allies. They have created some public online forums, but their main idea right now seems to be sending the president onto comedy shows, much as Bill Clinton played his sax on the "Aresenio Hall Show" in 1992.

Over the next year or so, young Americans may draw several alternative lessons from ObamaCare. The conclusions they reach will affect their view of politics for decades to come.

First, they may decide that health reform was a failure, even a fiasco, and draw the general lesson that the government is incompetent or untrustworthy. That would move them to the right. Republicans have every reason to drive this lesson home.

Second, youth may decide that ObamaCare worked.

Despite all the fireworks, it was actually a rather modest tweak in the private health insurance market, a set of rules and incentives that will shift some people’s behavior. They may conclude that expert-driven reforms can benefit society and that Republicans have just stood in the way of progress. That would keep youth on the center-left.

Third, they might possibly decide that we (not just the government or a few experts) have improved our health care system. If young people become heavily involved in community health centers and efforts like Health Access California, they would see themselves directly improving the nation’s health. They would say that it wasn’t Barack Obama but the American people who broadened health coverage and began to cut costs.

That conclusion would generate a new spirit of responsibility and creativity that would not belong narrowly to the right or the left.

But to get it started would take a lot more than bantering with Zach Galifianakis.