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Will Enough Democrats Go Along With Health Reform?

After more than a year of legislative wrangling and Republican obstructionism on health care

After more than a year of legislative wrangling and Republican obstructionism on health care, the Democrats and the president find themselves now having no choice but to take the strategic approach that progressives have been urging for months: ignore Republicans and move ahead on a majority-vote bill through reconciliation.

But the political landscape has shifted so dramatically, with polling showing that what’s labeled as Obama’s plan is rejected by a majority of the public that’s also grown increasingly impatient of the drawn-out process (even if the public option dropped from the president’s proposal and other reforms are popular). So, now a tactic once advocated by the party’s left wing as a way to pass a robust public option is seen by many as the last, best chance to pass any health care reform at all. As The New York Times reported:

“If nothing comes of this we’re going to press forward,” said Senator Richard J. Durbin of Illinois, the No. 2 Democrat. “We just can’t quit. This is a once-in-a-political-lifetime opportunity to deal with a health care system that is really unsustainable.”

But doing so would require mustering the support of centrist Democrats in the House and the Senate who have expressed apprehensions about both the health care bill and the reconciliation process, which Republicans are portraying as an unfair parliamentary tactic to skirt the normal rules.

It was unclear if the event had won over any of those votes, especially among House Democrats who opposed the bill in November, and whose support could be critical to reviving it.

Yet, despite the importance of retaining Democratic House members’ support after health reform passed by a mere five-vote margin last year, much of the liberal netroots and groups like Democracy for America are still focusing on building momentum for a public option in the Senate. So far, they’ve gotten 25 senators to declare openly their support for the measure by signing on to a letter calling for passing a public option through reconciliation. After the summit, three progressive groups, including DFA and the Progressive Change Campaign Committee, issued a statement:

President Obama gave Republicans one final chance, and the verdict is in: Bipartisanship is dead. It’s clear that no Republicans will vote for health care reform. So Senate Democrats should pass the highly popular public option through reconciliation. Starting tomorrow, we will ramp up our pressure on Senate Democrats to do the will of the people – and do what’s best for America’s health care system – by passing the public option into law.

But as one labor strategist told Truthout, “Our biggest problem is: What if the votes aren’t there in the House? The blue-dog Democrats, the fiscal hawks, all they’re thinking about is, ‘Will this vote sucker me again? How will it affect my re-election?’ They think the public mood’s gone south and they soured on the process.” Another major stumbling block: by some estimates, about a dozen anti-abortion Democrats may vote against the bill because they don’t believe that the Senate version is strong enough in barring abortions as the draconian Stupak amendment that passed the House, while some pro-choice House members say they’ll vote against any bill that contains that same amendment.

Almost as dangerous to reform hopes, Republican talking points about Democrats using reconciliation to “jam” a bill through Congress that the public opposes – even if Republicans have used the same approach over 20 times – could find a receptive audience among many members of the public. That’s because they’re so ill informed about legislative aracana most people don’t know, for instance, that Democrats need 60 votes to overcome the Republican filibusters that have been blocking Congressional Democrats from taking action.

Even more worrisome, a new Gallup poll appears to show that the public is opposed to using reconciliation by a 52 percent to 39 percent margin, another sign that the White House and Democrats could be on the way to losing this final stage of the messaging war over health care reform.

But reconciliation to pass any form of health care – even without a public option – remains the Democrats’ best hope. But the netroots-based reformers are continuing to focus – for understandable reasons – on the public option. Meanwhile, they are also dismissing even progressive skeptics about the public option’s passage – who now include Tom Harkin, Howard Dean (who favors expanding Medicare to age 55 citizens) and Jay Rockefeller – as having essentially a “loser mentality.” Presumably, they can add the House’s Progressive Coalition to their list of sell-outs because, as CQ reported (hat tip to Daily Kos):

A critical bloc of liberal House Democrats has thrown its support behind President Obama’s bid to pass a health care package before the fall elections.

The backing of the powerful House Progressive Caucus, which is the largest bloc in the 255-member Democratic Caucus, had been far from assured.

So much for the proclamations last August from leaders of the Progressive Caucus, hailed by Firedoglake, that they’d draw a line in the sand and would vote against any plan without a public option. The endorsement of the president’s plan, while justifiable as an accommodation to political reality, also seemed to undermine the coalition’s support for a public option on the day of the summit – and even their full-throated support for it just last week.

“A public option is the best way to save the government tens of billions of dollars while making sure Americans are covered affordably and do not go bankrupt due to catastrophes,” said Rep. Raul Grijalva (D-Arizona), co-chair of the Progressive Coalition. That view, of course, makes sense to many progressives and policy experts, but despite the new push by activists to get it through Congress, the public option is now being marginalized in Washington almost as much as the single-payer solution – despite the growing announced support in the Senate, even if far from 50 votes.

Not so long ago, it was seen as likely that a majority of Democratic senators could be persuaded to support the public option, although the need to win a 60-vote filibuster-proof super-majority was given as the reason Democrats couldn’t get it passed. Even with a majority vote, in the absence of aggressive leadership for the proposal by either Majority Leader Harry Reid or President Obama, the likelihood of passage of the measure still remains slim, despite the appearance of “momentum” – in truth, proclamations by mostly liberal senators needing to keep their progressive base happy.

Times change, but the strategies of grassroots progressive groups don’t seem to change with them as health reform faces real peril in the House of Representatives. Wednesday’s support for Obama’s plan by the Progressive Coalition is a sign that they realize, along with pundits such as Paul Krugman, that failure to pass a modest bill could pave the way for a domino-like effect of Democratic failures and electoral defeat. The Obama compromise measure improves somewhat on the Senate bill by delaying the impact of the excise tax on costly health plans and raising subsidies for buying insurance, but it’s still too weak for many of the most dedicated activists and bloggers.

Yet, the need for stronger grassroots action from unions and progressive groups targeting wavering centrist and conservative House members could be what’s missing now. It’s not at all clear that even the claimed one million contacts in one day in a “virtual march” Wednesday organized by progressive groups, including Political Action, made much of a difference. After all, it comes long after the GOP reshaped the terms of the debate: a drumbeat of media-savvy, right-wing lies and disinformation about death panels, socialism, high taxes and the government take over of health care reform.

Even worse for Democrats, Republicans, even to some pro-reform commentators, didn’t come across at the summit as bad as Democrats have portrayed them: obstructionist ideologues willing to let millions of uninsured Americans die to serve their twisted laissez-faire ideology and corporate paymasters. As the blogger Digby observed:

if I were to tune in to this summit without having a fairly good grasp of the politics in play, I’m afraid I might come away from it thinking that both sides are equally earnest in trying to fix the problems with our health care system and they both have equally good ideas. After all, they told us that all day and the picture of these people all sitting around a table politely exchanging ideas creates that appearance. But the fact is that the substantive disagreements between the two parties represent more than an abstract philosophical difference of opinion. They represent a hardcore, political impasse.

Much, as always, depends on how the media chooses to frame this summit, but I’m afraid that many people are nonetheless likely to be left with the impression that problems passing this bill are the result of Democrats refusing to put all these neat Republican ideas into the mix – and if they can just agree to do that, we can all hold hands and sing kumbaaya. This is, of course, nonsense. Republicans do not want to pass any health care reform that will be signed by President Obama and even if he agreed to implement their ideas in whole cloth and call it a day, they still wouldn’t vote for it.

John Dickerson of Slate, a former Congressional correspondent with Time, pointed this out in his article headlined, “Obama and Republicans seemed reasonable. That’s bad news for Democrats.” He noted:

This is why it wasn’t a good day for congressional Democrats. According to strategists involved in 2010 races, fence-sitting Democrats needed to see Obama change the political dynamic. He needed to show how health care reform could be defended and how Republicans could be brought low. He did neither. White House aides and the president himself said he was going to press Republicans for how their plans would work, but he did that only twice-and mildly. There was no put-up-or-shut-up moment.

Obama debated Republicans vigorously and with precision-but it looked like a debate among people with actual philosophical differences, which in part it was. After an in-the-weeds debate about how the Congressional Budget Office accounted for premium increases, it became clear that the debate was between Democrats who want to set minimum standards for coverage and Republicans who want the market and individual choice to rule. The Democratic plan is more expensive but covers more people. The Republican plan is cheaper and doesn’t.

As it played out, the event didn’t look like one reasonable person aligned against a company of hooting morons.

In fact, the centrist pundit David Gergen, who has worked for both Republican and Democratic presidents, claimed on “CNN”:

The folks in the White House just must be kicking themselves right now. They thought that coming out of Baltimore when the President went in and was mesmerizing and commanding in front of the House Republicans that he could do that again here today. That would revive health care and would change the public opinion about their health care bill and they can go on to victory. Just the opposite has happened.

Obviously, to those who follow health policy closely or have bothered to look at the voucher-and-tax-cuts plans offered by Republicans, their free-market nostrums are, to be blunt, hogwash that doesn’t truly address the crisis in health care.

On the plus side for Democrats, the president artfully made clear in his presentation that right-wing talking points weren’t a substitute for action, even if, in fact, he hasn’t moved until recently to exert leadership over the endless Congressional process that has weakened his standing and that of his party. But he scored political points in his wrap up by emphasizing two of the most popular elements of health care reform – extending insurance to the millions without it and preventing companies from barring people with pre-existing conditions – while expressing an openness to looking at Republican ideas. As Kevin Drum of Mother Jones pointed out, ” There’s no chance of Republicans making any concessions, of course, but Obama’s stated willingness to consider their ideas might help win over public opinion and stiffen some Democratic spines.”

Obama’s closing arguments underscored the weaknesses of the Republicans’ lack of response to the serious failings of the health care system:

The concern, I think, that a lot of the colleagues both in the House and the Senate on the Democratic side have is that after a year- and-a-half, or more appropriately after five decades of dealing with this issue, starting over, they suspect, means not doing much, or doing the proposal that John Boehner or other Republicans find acceptable.

And that it’s not possible for our Republican colleagues to move in the direction of, for example, covering more than 3 million people. It’s not possible to move more robustly in the direction of dealing with the preexisting condition in a realistic way. It’s not possible to make sure that we get people out of a high-risk pool and get them into a situation where, as Tom Harkin put it, healthy people, young people, rich people, poor people, old people, the sick, everybody is part of a system that works. That, I think, is the concern.

Having said that, what I’d like to propose is that I’ve put on the table now some things that I didn’t come in here saying I supported, but that I was willing to work with potential Republican sponsors on. I’d like the Republicans to do a little soul-searching and find out are there some things that you’d be willing to embrace that get to this core problem of 30 million people without health insurance and dealing seriously with the preexisting condition issue.

I don’t know, frankly, whether we can close that gap. And if we can’t close that gap, then I suspect Mitch McConnell and Harry Reid, Nancy Pelosi and John Boehner are going to have a lot of arguments about procedures in Congress about moving forward.

I will tell you this, that when I talk to the parents of children who don’t have health care because they’ve got diabetes or they’ve got some chronic heart disease; when I talk to small business people who are laying people off because they just got their insurance premium, they don’t want us to wait. They can’t afford another five decades.

So, in the end, he gave the 39 wavering House Democrats, who voted against health care reform the first time around, some solid reasons to vote for it, but it’s not clear that they’ll be willing to do so in such a poisoned political environment.

Video Update:

If case you couldn’t sit watching “C-Span 3” on your computer screen or TV for nearly seven hours, here is a seven-minute summary video from Politico of the highlights:

Equally useful is this PBS “NewsHour” panel raising doubts over whether any minds or votes were changed by the summit, and whether coming so late in the process it could make any difference:

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