Assessing what needs to be done in 2023

Last year the federal government made significant and surprising progress on protection of voting rights and democracy, addressing climate change, slowing growth of the national debt, and enhancing access to healthcare. It now needs to take the next steps towards resolving those systemic problems.

2022 ended with sighs of relief and celebrations that the red wave didn’t happen, that voters in several states rejected efforts to codify strict anti-abortion laws, that the budget deficit was half what it had been a year before, and that several pieces of legislation passed with bipartisan support for climate change action and improved access to healthcare.

Now that the celebrating is over, it’s necessary to make sure the public is aware of those achievements and to take a more sober look at the progress made and the work that remains to be done. Both actions are vital to earning the public’s trust and keeping our democracy strong.

Voting Rights and Democracy

Democracy held the line, at least for the moment.

Enough Americans, including Democrats, Republicans, and Independents, heeded the alarm bells and crushed the expected red wave. In upending historical precedent, which favored Republicans in this midterm election, pro-democracy voters defeated some of the high profile Trump-supporting election deniers who ran for offices that would have given them oversight and influence over future election results.

Still, a large majority of the MAGA candidates won in the general election – 83% according to Ballotpedia, which tracked 250 Trump-endorsed candidates who ran for Congress and state executive and legislative office. Apart from four local races that were tracked, two each in Florida and Texas, the number of MAGA candidates who won at the county and city levels is not known.

The rise of Donald Trump exposed the ugly underside of the Republican Party, a festering stew of anti-democrat white supremacists, nativists, and Christian nationalists who were courted decades ago, however reluctantly, by more constitutionally principled conservatives to secure electoral victories. The Tea Party wins in 2010 gave the former fringe members of the GOP a legitimate foothold within the establishment framework, and Trump emboldened them to be more aggressive and outspoken regarding their aspirations. Today, many remain in office at the local, state, and national levels of government, and groups like the Freedom Caucus continue to hold substantial power in the Republican Party, as the battle for Speaker of the House has revealed. The threat they pose is not behind us.

Passage of the Electoral Count Act was a first step in restoring the guardrails protecting our democracy, but as we’ve learned from the machinations that gave us a religiously-driven Supreme Court, more guardrails need to be articulated and codified.

Climate Change

The Biden administration, Democrats in Congress, and a small cadre of Republicans pulled off what many thought impossible: bipartisan legislation that is an important step in national action to curb emissions of greenhouse gases (GHGs) and address the challenges of climate change. According to a preliminary analysis by Princeton University, the Inflation Reduction Act, passed in the summer, builds on existing policies and will further reduce GHG emissions and enable the country to meet and exceed its 2030 target.

As we saw during the Trump administration, however, policies that support the public good can be all too easily unraveled by politicians who want to undermine the achievements of their opposition for political gain. This is what Richard Viguerie, considered the “funding father” of the modern conservative movement, was referring to when he wrote in 2004 that his Republican Party of “limited, constitutional government has been virtually silenced, co-opted by my-party-right-or-wrong partisanship.”

Enacting and implementing strong climate change legislation requires courage and persistence over the long term, not just from government leaders but from voters too. Voters, especially conservative voters, will need to do a better job in future elections of making sure they elect people who will continue to support our democratic institutions and fund policies that favor climate sustainability and adaptation.

National Debt

Much of the ballyhooed deficit reduction in 2022 is attributed to the fading urgency of the pandemic, meaning no new covid relief spending was needed. Covid relief legislation passed in 2020 and 2021 required the government to borrow trillions of dollars, causing a rapid rise in the national debt. Despite the government’s boasting about deficit reduction last year, the budget deficit still contributed about $1.2 trillion to the debt.

That amount might have been 30% lower if not for President Biden’s executive order that canceled a portion of student loans. The Committee for a Responsible Federal Budget estimated that the unfunded cancellation plan cost the government and taxpayers $360 billion.

The bottom line: With emergency spending for the pandemic no longer needed, the government returned to its “old normal” ways of conducting its financial affairs. It used the power of government to address a market-made problem – student loan debt – that is restricting the economic output of a generation of college educated Americans. At the same time, it failed to find the revenue needed to cover the cost of the debt cancellation program, thus further fueling the rising debt. Regardless of the pros and cons of the debt forgiveness program, failure to respect the debt problem – both politically and economically – is risky business.

Access to Healthcare

In addition to its climate change provisions, the Inflation Reduction Act for the first time allows the government to negotiate drug pricing on behalf of Medicare patients, estimated to save the government $237 billion over 10 years. Importantly, the final law does not require the negotiated prices to be offered through private insurance. So, while Medicare patients with diabetes will pay no more than $35 a month for their insulin – a huge step forward – non-Medicare patients could continue to pay $200 or more per month. It is possible that businesses and organizations that offer private healthcare insurance to large pools of employees or members could negotiate their own reduced pricing. Such an approach, while not standard, is also not unprecedented. The state of Montana flipped the script on its insurer and negotiated a payment system for healthcare services that saved the state’s employee benefits plan from bankruptcy.

The Inflation Reduction Act (IRA) also extends until 2025 the enhanced healthcare marketplace subsidies first required by the American Rescue Plan Act (ARPA). When ARPA became law in March 2021, it increased the subsidies for people who fell within the income range specified by the ACA – up to 400% of the federal poverty level – and it made subsidies available for the first time to people with higher incomes. The enhanced subsidies were set to expire last year.

While it was in general a good year for healthcare access, the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization struck down the federally-guaranteed right to abortion and opened the doors to a hodgepodge of restrictive and confusing state legislation. Patients are suffering as they are turned away by doctors who fear legal repercussions. Many women must travel long distances at significant expense to seek medical support in other states. And yet, the Court’s decision further galvanized the voting public who were already outraged by the January 6 insurrection and army of election deniers running for office. The pro-healthcare votes helped place a sea wall in front of November’s red wave.

The Road Ahead

Despite the forward progress made in the last year, there is still much work to be done, as is always the case in a democratic society that seeks to build a more perfect union. It’s important to note the successes but also where the imbalances still lie. Those imperfections are the roadmap for the coming months.

Before we move forward, though, it is worth acknowledging one more time the significance of last year’s achievements. The Biden administration and members of Congress have shown that Washington is not broken. At the same time, the American voters made clear that they are paying attention and are unwilling to allow their democratic freedoms to be taken away. And most importantly, some Republicans in Congress and among the electorate have demonstrated that there are still conservatives in the GOP who have the courage to put the interests of their country before the interests of their party.

Democracy is sometimes slow and messy and exhausting, but it still works. That is cause for optimism as we face the challenges ahead.

Author: George Linzer
Published: January 6, 2023
Updated: April 6, 2023

Feature image: George Linzer

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Jesse D. Jenkins, Erin N. Mayfield, Jamil Farbes, Ryan Jones, Neha Patankar, Qingyu Xu, Greg Schivley, “Preliminary Report: The Climate and Energy Impacts of the Inflation Reduction Act of 2022”, REPEAT Project, Princeton University, Aug 2022,, accessed Jan 2, 2023

Richard Viguerie, David Franke, “America’s Right Turn”, Bonus Books, 2004, pg. 346

Aris Foley, “Biden touts federal deficit: ‘Largest one-year drop in American history’”, The Hill, Oct 21, 2022,, accessed Jan 6, 2023

David Lawder, “U.S. 2022 budget deficit halves to $1.375 trillion despite student loan costs”, Reuters, Oct 21, 2022,, accessed Jan 2, 2023

Statista, “Public debt of the United States of America from November 2021 to November 2022, by month”, Jan 2, 2023,, accessed Jan 2, 2023

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Berkeley Lovelace Jr., Reynolds Lewis, Gadi Schwartz, “Insulin costs will be capped in 2023, but most people with diabetes won’t benefit”, NBC News, Dec 29, 2022,, accessed Jan 2, 2023

Rachel Chang, Nicole Rapfogel, Emily Gee, “The Inflation Reduction Act Will Save Families Thousands of Dollars”, Center for American Progress, Sep 12, 2022,, accessed Jan 2, 2023

Rebecca Pifer, “‘I am terrified’: Doctors warn lawmakers of grim health impacts from Roe reversal”, Healthcare Dive, Jul 20, 2022,, accessed Jan 2, 2023

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