Win by breaking things

Democrats should be reckless.  It is a path to victory.  Or maybe they can win by retreating a little.

Political scientist Seth Masket notes that Republicans have been winning big recently because they have a structural advantage over Democrats.  It isn't gerrymandered congressional districts and it isn't that their policies are more popular.  It is that they don't mind the idea of government chaos but Democrats do.

Weakness:  Democrats want government to work.

Therefore, in the hardball of politics Republicans have been willing to shut down the government  and simply refused to consider the appointment of Garland to replace a vacancy with eleven months left on Obama's term, in effect setting up the precedent that the Senate might never fill a Supreme Court vacancy.  Masket's proposed solution is for Democrats to mimic Republicans.  Obstruct everything.  

It worked politically for Republicans--witness their success at the state and federal level in 2010, 2012, 2014, and 2016--plus it sends a message back that obstruction works both ways and it is in the Republican interest to cooperate with Democrats. Click to read the article

There is another approach.  Democrats can recognize reality: Republicans control the House, Senate and White House.  They won elections by opposing Obamacare.  They have the majorities and the power to remake healthcare in America.  It is undeniable that the ACA is complicated, incomplete, and in some cases unaffordable for the people it is intended to help.   Obamacare is unpopular.  Some people argue it currently polls pretty well, but in fact it was poll tested in real live elections, which is why Republican have the greatest majorities in the House in a century.  

Pre-election position: confirm nobody

Democrats can be intransigent on nomination of Supreme Court justice, doing exactly to Neil Gorsuch what Republicans did to Merrick Garland. The base will demand that and enjoy seeing it.

But on healthcare they can simply let Republicans have their way. [I realize this is shocking to some, but hear me out.]   It will be a disaster for Republicans, both as a policy matter and a political one.  It is cruel to some but it will not be as cruel as the situation was just eight years ago.  Republicans will attempt to ameliorate  some of the pain with some provision for people with pre-existing conditions.  (All sorts of middle income Republicans working in the gig economy who lack an employer health plan were simply unable to buy insurance and therefore risked 100% of their family's assets if someone got cancer.  Republicans emphasize with those people.)

The pre-ACA situation was not an utter disaster for the poor.  They could not pay and they had no more money to lose.  They got what they needed: free health care.    The real pain was for exactly the people who were the voting bloc that elected Trump: the working poor, people how sometimes had homes and retirement accounts to lose when they got sick.  The doctors, hospitals, and drug companies took everything they had, then the working poor went bankrupt.  

The poor and near-poor in fact got healthcare by going to emergency rooms.   The emergency room was the safety net.  It was not a financial disaster for the poor because they had nothing to lose. It was, however, a financial disaster for the working poor, the taxpayers, and for America's hospitals who had patients with uncollectible accounts.   Republican voters and office holders are not in favor of the redistribution of wealth from the rich to the poor and near poor that was imbedded in Obamacare.   However, by ideology and tradition they are in fact very sensitive to the concerns of taxpayers, insurance companies, drug companies, and hospitals.   

That is who will be hurt by Trumpcare.  Let them get hurt.  They won't stay hurt for long.  
(Yes, a few members of the working poor--those kicked off the Medicaid expansion and those who lose insurance--will be hurt.  Someone in their family will get sick, they will lose everything they accumulated.   They won't be imprisoned; they simply will be made poor, just like a lot of other Americans.  It is tragic for them, but it is what we had 8 years ago so it is an old tragedy and not a new one, and it is a tragedy that the people of the USA voted to risk.  The people have spoken.)

Republican's are at bat

Democrats may need a show of opposition and they need not announce a retreat.  Republican dissent alone is sufficient to create opposition to it and the opposition to it will have more credibility when it comes from Rand Paul and Ted Cruz and the Heritage Foundation than if it comes from Democrats.  There will be plenty of public opposition but the end result must be branded as the Republican plan. 

Democrats can complain bitterly that Republicans have the vote, that Republicans are in charge, that they repealed Obamacare, darn it.

The real problem for Republicans is that do not want to govern because in fact they do not have a governing majority or any plan better than Obamacare.  Their only majority that held together the party is dislike of Obama/Hillary/Pelosi.   

The great tool in the hands of Democrats is that the Republicans are in charge.  Their task is simple:  make certain the public understands that they are in charge.