You are using an outdated browser.
Please upgrade your browser
and improve your visit to our site.
Skip Navigation

I'm Back. So Is Health Care Reform

By sheer luck, I think I picked a fairly good time to go on vacation. Mainly what I missed is a bout of hysteria and elected Democrats coming around to the obvious. Last Wednesday, in the wake of the Coakley fiasco, I predicted that health care reform remained a better-than-even bet:

Here is what I think will happen. The shock and panic will play itself out over a few days. Then the Democrats will assess the situation and realize that letting health care die represents their worst possible option. And then they will make a deal to pass the Senate bill through the House. I am not positive this will happen, but it's my bet, because elected officials at the national level, dim though they can be, are usually shrewd enough to recognize their political self-interest.

That seems to be how it's playing out. First, you had a big freakout. Then the national media declared reform dead. But the more perceptive reporters can see that the basic structural dynamics favoring a deal remain as strong as ever. Here's Karen Tumulty:

After looking at all their other options--drafting a smaller health care bill, or passing the most popular parts piecemeal--Democratic leaders in the House and Senate have come down to the realization that they've got one play left on health care: Get the House to pass the Senate bill, with the assurance of a set of revisions to be included in a companion measure passed under the budget reconciliation process, to circumvent the Senate's 60-vote majority requirement. ...

But leaders have yet to figure out how that would work. Trust between the two chambers is frayed, and not likely to grow as more and more Senate Democrats come out against using reconciliation to get a health bill to President Obama's desk. Already, we are seeing the defections of moderates such as Nelson, Indiana's Evan Bayh, and Arkansas' Blanche Lincoln. Budget Committee Chairman Kent Conrad is no sure thing; nor is independent Joe Lieberman. Meanwhile, Republicans are certain to drag out the bill as long as they can.

Jonathan Cohn has been making a more cautious version of this case for a few days now. In my opinion, the issue is in a similar place as last summer, when the national media was also declaring reform dead, or on life support. But the structural dynamic remains the same -- Democrats understand that they have to pass this bill or face even deeper electoral catastrophe than they're likely to suffer anyway. They suffer from disorganization, lack of urgency, and extreme parochialism. The good news is that, having passed a bill through the Senate, the largest procedural roadblock by far is now behind them. The Democrats now just 50 Senators to cut a deal with the House to fix a bill through reconciliation, and 218 House members to vote for the Senate bill. (I interpret the complaints of Nelson, Bayh, and Lincoln as a message that they want to go to the front of the line to be among the nine Democratic Senators who can vote against the reconciliation fix without killing it.)

Again, I don't see this as a sure thing, but the outlook remains a lot better than you'd guess from reading the national news headlines.