As one might expect given my recent hiatus to work on health care reform in the House, many of my future posts will be devoted to the politics of health care reform. Rather than try to write the comprehensive 500-word essay on the subject, I will offer a series of observations based on six months buried in the subject and 15+ years of working in and around Congress on a range of issues.
The only smart Democratic vote is ‘yes.’
A lot of Democrats voted against the House health care bill (as did all but one Republican – answering the question, what does $90,000 in a freezer buy? Answer: a bi-partisan health care bill). Some voted against the bill for philosophical reasons, some likely believed that the failure of this reform effort, which would almost certainly kill serious health care reform efforts for at least another decade and allow the current system – with its increasing costs, decreasing coverage and growing drag on the economy – was better than what might emerge from a conference committee. Others however may have voted against the bill because it would help; them back home.
Philosophical disagreement with the bill is understandable and principled. A politically motivated vote against the bill was, in my view, a mistake.
A Democrat who voted against the House health care bill did not pick up a single Republican supporter as a result of the vote, but did manage to lose important parts of his or her base. In addition, voting against the bill made the legislation look weaker and possibly provides a weapon to Republicans running in November (every Democrat who said something critical will turn up in Republican direct mail – “how bad is Obamacare? This is what Obama’s own supporters had to say…”). It also risked taking away the support of the White House which can send Cabinet Secretaries to the district, direct projects to the district, and so forth. Finally, if health care reform doesn’t pass, Democrats will have failed to address one of the issues about which Americans care the most and make the party look like a bumbling group of dingbats who couldn’t manage to turn massive majorities in Congress into a policy everyone agreed was critical. That is not a recipe for electoral success.
Some might suggest that to get re-elected they need to vote against Obama, they can’t be Pelosi-Democrats. That is absolutely correct. Those folks should have voted against Cap and Trade (and many did). But health care cannot be finessed as easily – the most important words in whatever the President signs will be “Obama” and “Democrat.” This will be Obamacare, and every Democrat in America will own it. This is Democratic Obamacare, and if you’re a Democrat it is strapped to your back. The politically rational action is to support this bill early and aggressively, arguing it isn’t perfect but is a whole lot better than what we have now, and hope like heck that it works.
Many in the House who voted against the bill are learning that lesson, and I suspect many of those folks will vote for whatever emerges from the conference committee. Those who continue to believe they can finesse this vote should probably enjoy the sights of DC while they can.
