Stop the bluster and get with the program.

Most progressive members of the House will vote for health care reform. But there are a handful of liberals making loud noises about rejecting it. They may not be bluffing. Some of them, like Dennis Kucinich, actually cast nay votes against the House bill last November. But this time, every vote will count. So, those liberals may be the difference between success and failure.

Why would any liberal vote against this bill, a bill that Democrats have spent a year toiling on?  Because at its core, the legislation is a centrist plan that achieves liberal ends. Rather than creating a single payer system, it builds on the system we have. 

Of course, that is both the political virtue and challenge of the legislation: It’s not easy to explain a system that creates insurance exchange markets, coupled with tax credits to make sure the insurance sold on the exchanges is affordable. But these exchanges, modeled on the reformed system in Massachusetts, were the best way to avoid reshaping everyone's health care. This, after all, was the promise that the president made two years ago: that people could keep their doctor or insurer if they wanted. Still, liberals clung to the hope that the public option would at least serve as a proxy for a single payer approach. Well, that dream is gone.

The frustration of the left is understandable. But at the end of the day progressive members have to ask themselves whether the ends justify the means. Yes, it's a centrist bill. But it also provides 30 million or so Americans with health insurance that they wouldn't otherwise have. Representative Raul Grijalva, head of the progressive caucus, has mused that this bill isn't worth his vote. But Arizona, his state, has 1.3 million uninsured. Dennis Kucinich's home state of Ohio has 1.4 million uninsured. 

There's no other choice on the table. The public option won't return no matter how loudly the congressmen protest. At this point, the choice is the Senate bill (and the reconciliation package) or nothing. 

My hope is that any liberal threatening to vote against the bill is doing just that-- threatening. As a former Hill staffer, I understand the incentives to announce the possibility that you will vote no. When you do that, the leadership will quickly return your calls. But my hope is that we all wake up and recognize the real alternative to this bill: the dysfunctional health care system, as we now know it, and all the suffering it entails.  

Neera Tanden is the Chief Operating Officer of the Center for American Progress. She served in the Obama and Clinton administrations.

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