Future of US healthcare reform in doubt

Republican Scott Brown’s stunning victory in the Democratic stronghold of Massachusetts is a dramatic setback for President Obama’s plans for healthcare reform.

Republican Scott Brown’s stunning victory in the Democratic stronghold of Massachusetts to win Ted Kennedy’s own seat is a dramatic setback for President Obama’s plans for healthcare reform.

Obama has spent most of his political capital on the healthcare bill and the loss of his 60th seat in the Senate means that Republicans can now filibuster the bill to prevent passage. This forces Democrats to find a way to pass the Senate’s existing bill through the House of  Representatives rather then pass a new compromise bill through both the houses of Congress that would require Senate passage.

US political experts dismiss the chances of gaining a 60th vote in the form of Republicans Olympia Snowe due to her previous failure to vote for the reform combined with bad blood between herself and Senate Majority Leader Harry Reid. Thus attention is now focusing on passage of the existing Senate bill through the House without changes. Ezra Klein, Washington Post domestic policy blogger, said:

“It could be passed by the House and signed by the president. House Democrats are reticent to do that, because there are compromises and tweaks and modifications they want made. But those changes are far too small to be worth killing the bill over. And they could be added to the bill separately, through the 51-vote reconciliation process*”.

“The bottom line here is that if the health-care bill fails, it will be Democrats who killed it, not Scott Brown. And people should be clear on that point.”

Joshua Marshall, Editor of Talking Points Memo agreed, arguing that:

“The House simply needs to pass the senate bill without revisions and await changes that will be passed in a separate bill that can be pushed through reconciliation (the content of a particular piece of legislation is critical to determining whether the rules allow it to go through reconciliation). Letting the bill die now would be stupid, frankly suicidal in political terms and good evidence that the Democrats just aren’t prepared to govern the country.”

But the Atlantic’s Marc Ambinder, a journalist with some of the best access to Democratic policy makers in Washington warns:

“Good luck with that! Not only will a Brown victory make moderates even more skittish about health care, but it will probably fortify the ten or so Democrats who’ve said they will under no circumstances support the Senate bill’s abortion language. Plain language: Democrats don’t have the votes in the House to pass the Senate bill, and they don’t trust the Senate enough to “fix” the bill through the reconciliation process later on.”

Against this backdrop House Speaker Nancy Pelosi has pledged “Let’s remove all doubt, we will have health care — one way or another.” One key Democratic aide at the centre of the healthcare negotiations said, “If Nancy Pelosi pulls this off, she will be remembered as the greatest Speaker in the history of the United States.”
* the 51-vote reconciliation vote is a budgetary means by which money elements of a bill can bypass the Senate’s filibuster.

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10 Responses to “Future of US healthcare reform in doubt”

  1. Joe

    Ouch. It really hurt reading this.

  2. Joe Walker

    This is a bit of a mess. From the beginning Obama should have backed a government-owned insurance alternative that would have competed with private insurance companies.

  3. John Booth

    Obama only has himself to blame. He campaigned on standing up to the special interests and said he was a strong supporter of a public option, which was in itself a watered down way of providing more health coverage. But this year he cut backroom deals with the special interests and didn’t pressure Congress to back a public option. Now the version of health care “reform” that the Senate will tell the House to swallow is so watered down that the only merit in its passage will be so that Dems can say they passed it. It doesn’t even kick in until 2014, so the inevitable Republican-controlled Congress will repeal it well before then.

    Obama: Weak Sauce.

  4. John Booth

    @Joe Walker, absolutely. People are saying progressives shouldn’t have expected Obama to be reliably left-of-centre, but we’re not even saying that: we’re trying to hold him to promises he made during his campaign, that got us all hopeful for the future. For him to turn around and then break each of those promises not only makes him as bad as most politicians are perceived to be: it makes it that much harder for the public to ever trust any promise politicians make ever again. Thanks Obama!

  5. The Parallax Brief

    This is awful, but the thing that shocks most is how the Republicans can get away with it. Their lies, perfidy, demagoguery, scaremongering, and hypocrisy since Obama was elected has been breathtaking.

    America has a healthcare system that is completely FUBAR. It MUST change, and both parties, and every serious observer, knows this, yet the GOP is just blocking everything and whipping up hysteria to help. How can they complain about the costs, yet object to every single Democrat effort to cut Medicare and Medicade costs?

    For that matter, how can they complain about the deficit AND demand tax cuts while making no effort to outline, even roughly, where they’d cut spending?

    More here: http://www.thinkpolitics.co.uk/blog/2010/01/20/thank-god-for-the-british-electorate/

    But generally this is a very disappointing day, as it looks like the GOP tactics have worked.

  6. Silver

    Whilst healthcare reform is probably going to be the major casualty, how much of this is down to the economy rather than the healthcare bill? As the current ruling party the Democrats are taking a LOT of flak over their handling of the credit crunch etc. (and while I doubt the GOP would be doing a better job, that’s honestly quite a weak defence)

  7. Alan W

    You’ve got to hand it to the Republicans – they’re no shrinking violets when it comes to putting their case forward, no matter how barmy, or mendacious it may be. They seem to have an inate confidence that if they just argue forcibly enough for what they want, they’ll both convince enough waverers and, crucially, motivate their core supporters to come out fighting. To focus on their grubby tactics is to miss the importance of this overarching strategic confidence.

    Obama, meanwhile, is continuing the long-standing Democrat tradition of splitting the difference, backing away from a fight at the first sign of trouble, and trying to be all things to all people, thus inevitably ending up pleasing no one. I can’t claim to feel surprised or disappointed by this, since I could never understand during the 08 campaign why anyone thought he was so radical to begin with.

    It seems to me the key thing the right understand, most clearly in the US but also elsewhere, is that the political centre-ground does not exist in a vacuum, but sits on shifting sands that are largely shaped by the radical ideas of the extremes. Before you capture it, you first need to mould it in your own image, otherwise you will forever find yourself being led by the nose further and further away from where you want to be.

    In both the US and Britain recent governments of the left have stumbled and disappointed because they have been content simply to accomodate the centre-ground as they found it, defined by radical right-wing ideas and assumptions, rather than attempting to reshape it.

    Sadly I expect Obama’s response to this setback will most likely be to moderate his positions even further, which is a recipe for electoral disaster come November.

  8. Jack Storry

    @ John Booth and Joe Walker – To be fair to Obama he was never going to get the votes in the Senate for the public option. Lieberman, Nelson, Baucus, Lincoln and Landrieu would have definetly voted against which means they couldn’t have broken the filibuster. The only other way would have been using reconcilation but what this article doesn’t state is that reconcilation is a lengthy and extremely complex process.

    At the end of the day the sad fact is that Obama’s agenda cannot pass without the support of ConservaDems like Nelson, Landrieu and company. If it means having watered down legislation then that is what must be done

  9. Richard Blogger

    the message I am getting from progressives in the US are that the Senate bill has been so disfigured (the bogeymen here is Lieberman) that if it died it would not be a bad thing. In fact many progressives say that the Senate bill is *worse* than the current situation.

  10. Marcus Roberts

    Hi guys, great discussion, difficult topic. I’ve been fixated with US healthcare reform for over a decade. Here’s what I think the lay of the land is:
    Parralax Brief: you’re absolutely right: GOPers could have made the Senate bill even better at cutting deficit by embracing Medicare and Medicaid cuts and reforms as well as prescription drug reform (not to mention that a strong public option would have done wonders to lower costs!) that would have gone further then the bill – but they, as ever, are playing politics instead of policy.
    As Jack Storry notes, the votes simply weren’t there in the Senate for the public option, more generous subsidies, a full fledged national exchange programme or a 55-65s expansion of Medicare.
    But the idea as some have suggested that the bill is somehow “*worse*” then the status quo is as wrong as it is dangerous:
    Per MIT’s studies, the Senate bill reduces the annual premium for a family of four 150% above the poverty line (an annual income of just $36,275) from $12,042 to $1,966. http://www.tnr.com/article/health-care/recognizing-reform?page=0,1
    In 2006, the Institute of Medicine’s methodology said that 22,000 Americans died because they lacked health insurance whilst a recent Harvard study put the number closer to 45,000. http://voices.washingtonpost.com/ezra-klein/2009/12/is_the_senate_health-care_refo.html
    The Congressional Budget Office projects that the Senate bill will provide coverage to 31mn Americans – the biggest expansion of healthcare in America since LBJ. http://www.pbs.org/newshour/updates/health/july-dec09/senatehealth_11-19.html
    But it’s not just about the insurance, if it was then reconciliation would be a viable means for Senate passage, but because the bill deals with “non-budgetary” matters, only the money parts could go through the Senate. That would lose vital elements of reform like ending the ability of insurers to deny access to Americans with pre-existing conditions as well as ending the process of recission whereby insurers can deny coverage even to those with insurance. http://www.clinicalsocialworkassociation.org/alerts/senate-health-care-reform-bill-close-passage-12-20-09
    And the Senate bill isn’t the only game in town, with even conservative Democrat Kent Conrad showing willingness towards an additional reconciliation bill if the House passes the Senate bill. http://voices.washingtonpost.com/ezra-klein/2010/01/is_health-care_reform_stabiliz.html

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