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Saving Health Care If Coakley Loses

The Wall Street Journal runs through the options. It suggests hurrying through a new vote in both houses will be difficult:

One liberal Democrat, Rep. Anthony Weiner (D., N.Y.), said many lawmakers have decided that, if she loses, the party would have no choice but to cram a plan through as quickly as possible, while working to delay Mr. Brown's arrival to the Senate.

"We're going to have to finish this bill and then stall the swearing-in as long as possible," Mr. Weiner said. "That's our strategy, a hurry-up-and-stall strategy."

The political risks of such a move are high—independent voters already expressing disillusionment with Washington would likely look unfavorably on such a tactic. Rep. Barney Frank (D, Mass.) strongly rebuffed the idea, saying in an interview that there is "no chance of that happening."

"That would be wrong," he said. "I don't think you could pass the bill in the House, if it was under those circumstances. That would just be a mistake."

I'm guessing if Barney Frank won't do this, neither will Ben Nelson.

Meanwhile, Jonathan Cohn thinks Olympia Snowe -- who, remember, voted for the Senate Finance Committee bill that strongly resembles the current bill, before deciding her new position is indefinite delay -- won't come around:

ever since that Finance vote, Snowe has grown increasingly disenchanted with health care reform. And after her vote against it on the floor, the Democratic leadership has become increasingly disenchanted with her.

Snowe's main complaint--that the process seemed rushed--makes no more sense to me now than it did when she first raised it. But whether I or anybody else thinks it makes sense is ultimately irrelevant. Clearly Snowe does. And that would make winning her over difficult.

So we're really down to having the House pass the Senate bill, then do another reconciliation bill to iron out the differences. The Journal article throws cold water on that option, too:

This is probably the quickest way to get a bill passed. It would cut out several procedural steps and effectively bypass having to slog through the Senate again.

But such a move would be hard to swallow for House Democrats, who've made clear in the past week that they won't go along with every provision in the Senate's version.

House Speaker Nancy Pelosi has signaled little willingness to go that route. And it could suffer a similar political backlash as Option 1.

I'm not buying this. Of course Pelosi and the House Dems are saying they won't do this -- why talk up this plan when they need Democratic voters in Massachusetts to be motivated for a life-or-death vote? And why give up all their negotiating leverage when negotiations with the Senate are still ongoing? The question is, if Coakley loses and health reform appears dead, whether 218 House Democrats can be persuaded to pass the Senate bill and fix it rather than watch all their work go down in flames. Jonathan is more persuasive here:

there are good substantive reasons why both sides should be willing to vote “yes.” And there are some good political reasons, as well.

For centrists, the substantive reason is that the Senate bill is, in most respects, closer to what they originally wanted anyway. Centrist Democrats skittish about the House bill typically complained that it was just too much--too much spending and too much regulation. But the Senate bill has less of both.

The Senate bill also has two key cost-control provisions, the tax on expensive benefits and the commission for calibrating Medicare payments, that many centrists have at least claimed to support. If they are truly concerned about cost control, as they claim, the Senate bill should address those concerns.

Liberals would have a more legitimate complaint. By and large, they hate the benefits tax and Medicare commission. And it’s not as if the Senate bill has other provisions to make those features go down easy. Remember, the Senate bill lacks a public insurance option. It doesn’t extract as many savings from the health care industry. It doesn’t provide as much protection against out-of-pocket costs. And it doesn’t promise as much regulation of employers or insurers.

But the arguments for voting for the final House-Senate compromise are just as relevant here: Flawed though it is, the Senate bill would represent a monumental policy achievement, one that would benefit tens of millions. And House Democrats could always try to fix the bill later on--maybe even quickly, if they can take advantage of the reconciliation process, which would remain available.

As for the politics, it would simply be nuts to think letting the bill die is the best move. Both houses already cast a vote. The marginal cost of one more vote is miniscule, compared with the cost of letting the bill die -- an even more demoralized base, the stench of failure attaching itself to everything Obama and this Congress do from here to November. Not to mention the massive substantive achievement at stake.

Jonathan is really the perfect person to read right now, having good contacts both in Massachusetts and in the Washington health care world. So go read his piece.