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Why Health Care Reform Will Pass

Michael Tomasky analyzes the political logic of red state Democrats:

Look at it this way. There are four possible outcomes on healthcare, or any piece of legislation:

1. It passes, and they vote for it.
2. It passes, and they vote against it.
3. It fails, and they vote for it.
4. If fails, and they vote against it.

So let's look at each of these vis-a-vis healthcare the way a centrist legislator might look at them.

Outcome 1: Not a bad outcome, because it's a big party victory. But there are lots of unknowns. Fear of the unknown is all-consuming for legislators who think they might be vulnerable to defeat someday. Undoubtedly, given something as large and complex as healthcare, there are going to be problems and disappointments with the new system. Will those problems, the solon thinks, be hung around my neck when I seek reelection?

Outcome 2: Preferable to 1, because now, when problems arise with the reforms, they can say, hey, don't look at me. I tried to tell my more liberal colleagues that this would happen, which is why I supported the provision that would have...

Outcome 3: The worst possible outcome, for what I should think are obvious reasons. They've stuck their necks out for nothing and practically begged to be accused of "being out of touch" with the voters of their conservative state.

Outcome 4: In many ways, the best outcome of all, from a purely short-sighted and self-interested perspective. Few unknowns. And to the extent that their president and their party are damaged, they can always say well, they went too far to the left, which makes it all the more important that people like me stay in Washington.

I disagree. I'd order the outcomes like so, from best to worst:

1. It passes, and they vote against it.
2. It passes, and they vote for it.
3. It fails, and they vote against it.
4. If fails, and they vote for it.

If health care reform fails, then Obama is toast, and the Democratic brand along with it. Having voted against the bill will provide little cover for moderate Democrats, as the 1994 elections show.

Now, it's true that you can't pass an effective health care reform without stepping on some toes. That's why the best possible scenario for Democrats is to have the bill pass with them voting against it, so they can't be held responsible for the toes that get stepped on. That's also why they're trying to get bipartisan support, which could give them cover, or possibly even the spare votes to allow them to vote against it.

But, at the end of the day, they're going to have to decide whether to pass the bill or not. Specifically, Democrats will have to decide whether or not to support a filibuster of health care reform that would destroy their president and dig their own grave. And that's the main difference between now and 1994 -- health care can't be filibustered without Democratic cooperation. I can't see them doing it. Members of Congress may not be geniuses, but they're usually pretty good at discerning their own political self-interest. And that's why I think we'll end up with a health care bill. A perfect bill? No. But the distance between the status quo anda perfect bill is so vast that we could have something that's both a massive, historical improvement and a crushing disappointment. That's what I think we'll get.

--Jonathan Chait