Posted by: Jeff | February 3, 2010

Health Care Round-Up: “It’s Alive!” Edition

In one of those funny little acts of thematic convergence life sometimes hands you, I haven’t been posting much on the continued drama of health care reform in the last few days because I’ve been, well, sick. Which is too bad, since The New Republic in particular has been on a roll. Here’s Jonathan Cohn:

According to these sources, Democrats have made progress–more progress, certainly, than might be evident from all the dire headlines of the past few days. There seems to be a plan in place for enacting reform, even with the Massachusetts setback.

But it’s not an easy plan to execute, at least in this political environment. And it’s not clear–to me and to many of the people I’ve interviewed–whether Democrats in the House, Senate, and administration are sufficiently committed to making it work.

On paper, the plan is straightforward and sensible: Pass the Senate bill, but only after coming to agreement on a set of amendments that would make the bill more acceptable to the House. Because the Democrats now have “just” 59 members in their caucus–one shy of what it takes to break united Republican filibusters–they’ll almost certainly have to pass those amendments through the budget reconciliation process.

OK, you probably know all of that. What you might not know is that House and Senate leaders are already finding common ground on issues like improving the Senate bill’s affordability protections and getting rid of the “Cornhusker kickback.” Instead of the federal government picking up the entire cost of Nebraska’s Medicaid expansion–a special deal that became an embarrassment even to Nebraska Senator Ben Nelson, for whom the deal was made–the federal government would simply cover a greater share of Medicaid costs for all states. This would actually be good policy, as well as good politics, so it’s win-win.

He goes on to list the big hurdles yet to be cleared – primarily what to do about the excise tax, though I’ve gotten the impression from what I’ve read that abortion funding could be a big problem as well – and suggests that, regardless of whether it was a good idea before, the Obama team’s stand-back-and-see approach to shepherding health care reform is no longer going to cut it.

Jonathan Chait agrees with that, while maintaining that regardless of the Massachusetts special election the political fundamentals remain largely unchanged, and remain in favor of passage. And both Chait and Cohn aren’t too terribly worried about Rahm Emanuel’s snub of health care reform as a priority last week. Finally, Chait continues to persuasively argue that passing the bill is less politically risky than not passing it, as the latter choice will thoroughly demoralize an already disappointed liberal base. This poll would seem to back him up on that.

Meanwhile, in a development that could be read either as possible good news or one more cruel twist of the knife, it turns out the Democrats basically had the disagreements between the House and Senate bills all worked out before the Scott Brown bomb dropped. Andrew Sullivan reacts:

So why isn’t the blueprint for a reconciliation package relatively easy now? Or are they simply waiting for tempers to cool, for an outreach to Republicans to show the public that nothing is being rammed through, for an exposure of the paltry nature of the GOP’s plans, a re-establishment of the focus on jobs and the economy … and then HCR through reconciliation? Without the drama. Outside the framework of the Massachusetts victory.

Cohn thinks this may be exactly what’s going on. But adds the crucial point that a short delay will only work, and avoid turning into a de facto death for the bill, if concerned citizens keep up the pressure on their legislators.

So. Health care reform remains officially stalled, but there is movement under the surface. Everybody keep your heads up, and for God’s sake pester your representatives in the House and Senate.

California’s two senators, Barbara Boxer and Dianne Feinstein, have comment forms you can fill out online. Phone numbers and addresses here. Figuring out who your House representative is in L.A. is a complete clusterfuck, so I direct you to this map. And here are some tips for communicating with your congressman.


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