Tuesday, December 15, 2009

If HCR Falls ... What's Next?

When Sen. Jim DeMint (R-S.C.) said over the summer that he wanted to make health care reform President Obama's "Waterloo," the comment was met with chuckles and eye rolls from the left, but given recent developments, the question begs asking ... if reform fails, would that in fact happen?

First, Senate Democrats struck a tentative deal last week that jettisoned the public option in favor of expanding Medicare to people aged 55 or older. Only now, in an inexplicable effort to placate Sen. Joe Lieberman (I-Conn.), the Medicare buy-in could be on the chopping block. The compromise of the compromise of the compromise has left some liberals wondering if we're all better off just killing the bill.

Progressives might have a point: if we're left with a bill that requires Americans to buy insurance without really controlling costs and premiums, then are we really getting anything better than we have now?

To some degree, yes; the bill would still do away with pre-existing condition denials and policy recission, and there's still the matter of the House bill containing a public option and a provision that would require insurance companies to spend at least 85 cents out of every dollar it receives in premiums on health care.

Assuming the Senate bill actually gets passed, it would have to be merged with the House bill in conference committee, and you better believe progressives in Congress are going to be fighting mad that they've already had to give up as much as they have. A lot of progressives are single-payer advocates -- or at least vocal supporters of a public option that is available to everyone and has rates tied to Medicare -- so voting on a health care bill that features none of these things wouldn't be appetizing to them.

For example: Rep. Dennis Kucinich (D-Ohio), a longtime single-payer advocate who co-sponsored H.R. 676, voted against the House bill because he saw it as nothing more than a giveaway to the insuance industry ... and this was with a public option, insurance cost provision and an anti-trust exemption removal.

The Senate bill has none of those things.

Let's assume for a moment that the Senate bill dies -- either because Lieberman doesn't get his way or because progressives in the caucus decide the status quo is better than a shell of reform. How does this potentially affect President Obama? Would it in fact be his Waterloo?

That's hard to say; President Clinton failed to pass health care reform in the 1990s, yet he still managed a second term of office and actually left office with a massive surplus -- of course, a sex scandal helped a lot of people forget his health care failure. But reform failed back then in part because Congress didn't appreciate the Clintons telling them what to put in the bill; does the fact that Obama has been almost completely hands-off through the entire process change things?

The landscape of Congress will likely change in 2010, whether reform passes or not. And as much as progressives might want to think otherwise, both chambers aren't going to get more liberal; sure, conservative Democrats might face liberal primary challengers, but the likelihood of a significant number of those challengers winning is low. If anything, the GOP will probably pick up seats in 2010 -- simply because incumbents rarely fare well in the first midterm elections following a presidential race.

The Democrats' collective failure with regards to health care reform -- a signature policy of Obama's campaign -- won't help matters. I don't see Republicans gaining a majority in either chamber, but there'll probably be more red than blue next November.

But what of Obama? Would he face a primary challenger is 2012? Would whoever the GOP trots out there (short of Sarah Palin) beat Obama in 2012 simply because of the public outrage over what's occurred -- or hasn't occurred -- over the past year? We know that progressive tend not to turn out on Election Day if they're upset or disenfranchised, while GOP voters always turn out, no matter what.

But looking more short-term, would a health care failure make it more difficult for Obama to pass his other legislative agendas? Climate change, job creation, civil rights issues ... if Congress ultimately rebuffs Obama on health care, would they do the same on other issues? It's hard to say; though Lieberman is proving to be a giant pain in the ass on health care, he could prove beneficial on other issues.

Though few things in Washington can be viewed in a vacuum, legislative issues generally can be. Just because a Senator is trying to block health care reform doesn't necessarily mean he or she would try to block a bill repealing Don't Ask Don't Tell. They're separate issues; unless the Senator is question has a personal vendetta against President Obama (looking at you, GOP), a vote on one doesn't affect a vote on the other.

The effects of a health care reform failure are hard to predict; I'm not even willing to consider it a failure yet. Anyone who reads this blog knows I don't fly off the handle like message board reactionaries, willing to let things play out before ultimately making up my mind. I know what I want with regards to health care reform -- Medicare For All is my preference -- but I understand how legislating works (or doesn't).

But if reform does fail, it will be labeled a failure for President Obama ... fairly or otherwise.

No comments:

Post a Comment