Health Care: Pass It or PerishNow that Obama has finally put a health care proposal on the table, the Democratic leaders in Congress have only one rational course of action: pass the thing, and quickly, or risk their party becoming the loyal minority.
Better late than never. Now that President Barack Obama has finally put a health care proposal on the table, the Democratic leaders in Congress have only one rational course of action: pass the thing, and quickly, or risk their party becoming the loyal minority.
Should the president have done this a year ago? Yes, it would have been nice to know where his bottom line was — indeed, that he had a bottom line — given that health care reform was his top legislative priority. At least some of the pointless drama could have been avoided.
House Democrats might not have dug in their heels over the need for a public option if they had known that, in the end, Obama wouldn’t call for one. There might have been less angst over taxing “Cadillac” health plan benefits if everyone had known that Obama, despite his campaign pledge, would ultimately support the idea.
And there might have been less nervousness among Democrats in both the House and Senate if they had known that Obama’s plan would include a novel component that sounds like a political winner: giving federal officials the power to curb abusive and unjustified premium hikes by insurance companies. This gives incumbents a much better story to tell when they face the voters this fall.
The president’s proposal, essentially a reworking of the bill passed by the Senate on Christmas Eve, establishes a framework for the bipartisan “summit” on health care reform scheduled for Thursday. If Republicans are serious about wanting to engage in this debate, Obama has provided a starting point. Of course, I don’t believe for one minute that the Republican leadership really wants to join any process that leads to meaningful health care legislation, because the party’s political strategy to this point — say no to everything — has worked quite well.
House Minority Leader John Boehner promptly complained that Obama has “crippled” the summit’s credibility by proposing a plan based on the Senate bill. The Republican position is that the thing to do is start over with a clean sheet of paper, tossing out a year’s worth of work. That’s rhetoric, not leadership. If the summit consists of one side debating concrete proposals and the other chanting “Start over,” observers will be able to draw conclusions about who is being constructive and who isn’t.
But we already know who isn’t interested in health care reform. If Republicans are really committed to bipartisanship, they can jump in. If not, Democrats need to pass Obama’s reform bill — if necessary by using the filibuster-proof “budget reconciliation” procedure that requires only a simple 51-vote majority in the Senate.
Republicans will howl to wake the dead. But what’s the alternative?
Democrats have already paid a political price for tackling health reform at a time when voters are hurting from the recession, anxious about the economy and wary of new government initiatives. There is no way they can avoid facing this line of attack in the fall. The question, at this point, is whether Republicans will be able to toss in allegations of gutlessness and incompetence: The Democrats controlled the White House and all of Congress, and still couldn’t get it done.
And how will Democrats answer? “Um, we worked really hard on health care reform, and we’re still convinced that it’s vitally necessary, but we got scared by the polls and so we backed off. Vote for us!”
If the party is going to take a political hit anyway, it might as well get the benefits — which are considerable. When Republicans scream about “big government” and “socialism” and all that, Democrats need to be able to tell voters that this whole exercise brought real change: no refusals of insurance coverage due to pre-existing conditions. No arbitrary increases in insurance premiums. Coverage for 31 million Americans who are now uninsured. A major step toward limiting the unsustainable long-term rise in health care costs.
House Democrats, who passed a more progressive reform bill, may have to hold their noses to accept Obama’s proposal. Senate Democrats may need their spines stiffened to go through with the reconciliation maneuver; perhaps it will give them courage to imagine how they will look if they reject a bill that is all but identical to one they passed a couple of months ago.
The hour is late. The time is now. Just do it.
Eugene Robinson’s e-mail address is eugenerobinson(at)washpost.com.
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