An article that ran in Politico on Friday provided a Rorschach test for those of us following the health care reform debate.
The story was about reform’s prospects following President Obama’s bipartisan meeting. And it dwelt, at length, with the situation in the House. In order to enact reform, as you probably know, the House will have to pass the Senate bill as written, as well as pass amendments that the Senate can consider through the budget reconciliation process. It won’t be easy, the Politico article explained:
“I just don’t know where they get the votes in the House,” said Pennsylvania Rep. Jason Altmire, a Democrat who voted against the initial House bill. “It’s a huge challenge because…the people who voted ‘yes’ would love a second bite at the apple to vote ‘no’ this time because they went home and had an unpleasant experience as a result of their ‘yes’ vote. I don’t know if there is anybody who voted ‘no’ that regrets it.”
That said, Altmire said he’s reconsidering his own “no” vote. And he’s not alone.
The first paragraph certainly seems discouraging. And if you're looking for reasons to be skeptical about reform, well, that paragraph will give you plenty.
But the actual news in that passage is the second paragraph. In order to get a bill through, House Speaker Nancy Pelosi will have to convince at least a few members who voted "no" to change their minds. Altmire is saying he could be one of them. And others might join him. That's a breakthrough.
Does this mean reformers finally have the upper hand? No. But a variety of administration officials, congressional staff, and lobbyists have said in the past few days they feel the odds for passage are higher than they have been at any time since January, when Scott Brown’s victory in Massachusetts took away the Democrats’ filibuster-proof margin in the Senate.
That's not what a lot of the recent media coverage suggests, I know. But I'm inclined to think these sources are right and the media coverage is wrong.
The steady, if slow, progress since the Massachusetts election has been unmistakable. After an initial period of confusion and listlessness, the administration and congressional leadership have made clear their intentions to continue pursuing comprehensive reform rather than scale back their ambitions. (The statements to that effect were particularly strong on the Sunday morning talk shows.) No less important, they have nearly finished working out a compromise between the House and Senate bills, including changes to the Senate bill that can pass through the reconciliation process.
Still unresolved is the question of sequence. The White House and the Senate want the House to pass the full Senate bill first, with reconciliation changes to follow. They believe this is preferable both politically and procedurally. The House has repeatedly rejected the idea: Its members don't trust the Senate to to do its part and actually pass the reconciliation changes. That would leave House members on the hook for the elements of reform they despise most, including the full tax on health benefits and the Cornhusker Kickback (the agreement to have the federal government cover the cost of Nebraska’s Medicaid expansion).
But there are signs that impasse, too, may be coming to an end. On Sunday's edition of CBS's "Face the Nation," Majority Whip Steny Hoyer said that the House will "go first"--although it wasn't clear exactly what he meant (and my House sources were not able to provide more details). On ABC's "This Week," Pelosi said "we'll see what the Senate can do" before moving ahead rather than reiterating her insistence the Senate go first.
(Some Captiol Hill staffers continue to talk up the idea of a letter, signed either by key Senate leaders or even 51 Democrats, attesting that the Senate will vote for reconciliation when it gets the chance. Such a letter would have no legal significance, but it might assuage nervous House members.)
If the Democrats do work out the sequence, attention can finally turn to rounding up the votes. Over the last few days, Pelosi and her lieutenants have said repeatedly they were confident they'd find 217. As Karen Tumulty notes over at Swampland, there's good reason to think that's not just bluster, even given the reluctance members like Altmire are expressing:
After what she managed to get her caucus to do last year, I would never, ever bet against the Speaker on a vote. And she is looking pretty determined on this one.
Keep in mind that it is not in the interest of the lawmakers who hold the key votes to show any flexibility at this point. The real movement comes at the very last minute. We've seen this again and again and again. Obama himself will have to do some arm-twisting -- which means we may see some scenes like this one.
But until a vote has been scheduled, and we are within 48 hours of seeing it happen, take anything you hear from anyone on Capitol Hill with a full box of salt.
My colleague Jonathan Chait has made similar observations. Among other things, he has noted, media coverage tends to focus on day-to-day conflict and, as a result, downplay the larger forces propelling reform ahead.
Still, I know people on the inside who have their doubts. While they think 217 votes is doable, they're not sure either the administration or House leadership are going to do it. They worry Pelosi may not have enough credibility with centrists, particularly after she pushed them to take a politically painful vote on climate change legislation last year. And they worry that the administration still has a habit of sending mixed signals at precisely the wrong moment--like it did last week, right before the bipartisan meeting, when stories of a fallback "plan b" circulated last week.
So there is reason for hope and there is reason for anxiety. Really, it all depends on how you look at that inkblot.