Posted by: Jeff | March 15, 2010

Monday Health Care Round-Up

And here we go again. Anyone wanna get off this roller coaster yet?

Nancy Pelosi had a meeting today with a collection bloggers on the subject of health care, and it sounds like she means business about passage. She even went so far as to suggest this bill would be a watershed for ideological debate in America, opening up entirely new distinctions, ideas and questions about the role of government. I happen to agree, and given the way the Republicans are freaking out, I’d say they agree as well. Matt Yglesias attended the meeting, and also thinks Pelosi isn’t kidding around.

And that’s good, because it sounds like Pelosi and the Democratic leadership in the House have settled on a plan, and we’ll be getting a vote in a matter of days. Ezra Klein lays out the details:

Here’s how that will work: Rather than passing the Senate bill and then passing the fixes, the House will pass the fixes under a rule that says the House “deems” the Senate bill passed after the House passes the fixes.

The virtue of this, for Pelosi’s members, is that they don’t actually vote on the Senate bill. They only vote on the reconciliation package. But their vote on the reconciliation package functions as a vote on the Senate bill. The difference is semantic, but the bottom line is this: When the House votes on the reconciliation fixes, the Senate bill is passed, even if the Senate hasn’t voted on the reconciliation fixes, and even though the House never specifically voted on the Senate bill.

At that point, the Senate’s original bill is officially approved by both Houses and goes to Obama’s desk for signature, while the package of fixes goes back to the Senate for passage via reconciliation. Klein and Jonathan Cohn think the politics of this strategy are a bit screwy, but it seems to me things could be worse. This way, the Republicans are cut out of the process of passing the bulk of health care reform – it all depends on the House Democrats keeping their shit together. The only thing the Republicans could conceivably hold up is the package of fixes in the Senate. And that will include very popular things like delays to the excise tax and the elimination of the so-called cornhusker kickback, which no Republican in their right mind wants to be caught opposing.

And speaking of those House Democrats who need to keep their shit together, Jonathan Bernstein lays out the dilemma, calling it primarily a “coordination problem” for Pelosi:

They’re apt to get very close to the vote, and possibly even into the vote, before they know exactly which Members are going to get them to a majority.  What Pelosi is dealing with is a list of fifty or so people, each of whom she understands to be (whatever they say) with her if she needs them, and each of which is probably saying (in one way or another): don’t make me do it.  Put me at the bottom of your list.  And she has to gauge who is bluffing and who isn’t, who she wants to protect from the effects of a no vote and who she doesn’t, who really ranks where on that list.

More political and historical context from Cohn here. Nate Silver is cautiously optimistic that the votes will be there, and David Dayen is continuing his obsessive coverage of the whip count. As of yesterday, he concluded the Democrats need 25 votes out of a remaining 37 uncommitted.

And Norman Ornstein and Thomas Mann go over, for the upteenth time, why passing health care reform is ultimately in the Democratic Party’s best political interests. I won’t go over the reasons again here, but I will note – as other bloggers already have – that if passing this bill really would be an act of political suicide on the Democrats’ part, then wouldn’t the Republicans be falling over each other to clear the way for passage?


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