Over the past three election cycles, congressional Democrats have rebuilt an arithmetic majority. By the end of this year, they will demonstrate whether they constitute a governing majority. Now, as in the early 1990s, the acid test is health insurance reform. And now, as then, the failure to act as a governing majority will jeopardize, and could erase, their arithmetic majority.
Despite the waning of their post-Civil War southern bastion, Democrats remain ideologically diverse--far more so than Republicans. A recent Gallup survey showed that about two-fifths of rank-and-file Democrats regard themselves as liberal, another two-fifths as moderate, and the remaining fifth as conservative. To be sure, the ideological center of gravity among House and Senate Democrats is more liberal than at the grassroots. Still, congressional Democrats include in their ranks many who consider themselves moderate or even conservative, and whose election since 2004 has made a major contribution to the new majority.
As Michael Tomasky pointed out this week in a carefully researched piece, most of the 49 House Democrats hailing from districts John McCain carried are not as vulnerable as that bare fact might suggest. But that's only part of the story. Twenty-six out of the 35 House Democratic freshmen (not all of whom identify with the Blue Dogs) won seats previously occupied by Republicans and are more vulnerable than established incumbents. For that reason, they demanded and won a delay in the House vote until after the August recess, giving them a chance to consult closely with their constituents. As for the Blue Dogs themselves, they tend to represent districts that are more rural and small town; small business comprise a greater than average share of their economic base. Citizens in these districts also tend to be more skeptical about the efficacy and integrity of government than those from (say) Nancy Pelosi or Charlie Rangel's districts. Moderate Democrats understand the people in their districts, they represent their interests and values, and more often than not, they agree with the people they represent. The stances they adopt and the votes they cast represent conviction as well as calculation, much like their liberal counterparts.
This is not to say that they're right and liberals are wrong. It is to say that if health insurance reform is to succeed, it must represent a blend of, and balance among, the diverse points of view within the Democratic coalition. The White House chief of staff seems to understand this, reportedly playing a key role in bringing Henry Waxman and the Blue Dogs back to the table after previous efforts had collapsed in acrimony. But the White House shouldn't have to do all the heavy lifting; it's up to the Democratic leadership and chairs of major committees to show some leadership as well. After all, they are supposed to be acting on the behalf of the party as a whole, not just on the basis of their own preferences. Henry Waxman drafted a bill with minimal input from moderate Democrats, in effect daring them to oppose the finished product. But that is not a good way for committee chairs to proceed, as John Dingell, the ex-chair of the House Energy and Commerce Committee pointed out this week. And because the Senate bill will probably need 60 votes to pass, a process that includes all the moderate Democrats (and some less ideologically entrenched Republicans as well) is essential.
The stakes are very high, substantively and politically. The past four decades have witnessed a series of missed opportunities to reform our health care system. In the early 1970s, President Nixon proposed a comprehensive, employer-based health insurance plan, complete with employer mandates and subsidies for small business. But not even Senator Kennedy could persuade Democrats to go along with an approach that would have left room for private insurers. Since then, unattainable aspirations have consistently trumped practical possibilities.
Will history repeat itself? We'll know by December. But one thing is clear: If we are to avoid yet another round of what health care expert Henry Aaron has analogized to Charlie Brown and the football, Democratic leaders in the House and Senate will have to persuade their colleagues not to make the best the enemy of the possible once more. In all probability, the public option (if there is one) in a bill that can pass will not be nearly as robust as liberals would like, subsidies for middle income families will not be as large, more small businesses will be exempt from the employer mandate (if there is one), the wealthy will be taxed less, and insurance plans above a defined threshold will be taxed in some way. Will Democrats hoping for something better torpedo such a bill? If so, we will have missed what may be our best chance in this generation to achieve near-universal coverage while restricting the ability of insurance companies to cherry-pick insurees and deny coverage arbitrarily. Millions of citizens would pay the price. And so would the party that once again failed to act as a governing majority.