Home  Blog Healthcare Fight Moves to Tougher Stage with More hostile Political Climate
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Healthcare Fight Moves to Tougher Stage with More hostile Political Climate |
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Sunday, 08 November 2009 |
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Washington Bureau - Read-only mm_head
JANET HOOK Reporting from Washington
With the struggle over healthcare entering an even tougher phase, President Obama has hit both a milestone and a speed bump in his duel pursuit of a major overhaul of the nation's medical system and a rebirth of progressivism in America. House approval of the legislation Saturday– even if Democrats could move it no farther--was a signal accomplishment that has eluded presidents for decades. But the close vote and the exertions it took to secure a majority were laden with warning signs as the issue moves to the Senate. Even though the House is a bastion of liberalism, the health care overhaul was a tougher sell than expected and the bill turned out to be more conservative in its price tag, more limited in the scope of its government-run insurance option, and tighter in its restrictions on abortion funding than many Democrats had hoped. Moreover, the narrow victory – 220 to 215 in a chamber where Democrats hold 258 seats – was unsettling for liberals because moderate Democrats have a louder voice in the Senate and Republicans have more delaying power. What is more, the political climate has become more challenging for progressivism than it was when Obama's agenda for change was hatched in his 2008 presidential campaign and ratified with his resounding election one year ago. "The joys and the exultant expectations that rang out from Grant Park across America have been mainly silenced by a year of economic turmoil and international uncertainty," Democratic pollster Peter Hart wrote in a recent memo marking Obama's election anniversary. "But more striking than the domestic and international struggles is the sense of disappointment and disgust the American public feels towards Washington," he said. When Obama was campaigning, publci animus toward President Bush was read as a broad mandate for change; now, polls find many independent voters questioning whether Obama is bringing the change they wanted. A year ago, rising health care costs were at the top of voters' worries; now, with unemployment in the double digits, jobs are paramount. "It's an historic accomplishment but I'm not sure it's consistent of the public mood," said Vin Weber, a Republican strategist and former House member, said of the House health care bill. "They began pursuing it at a time when they believed we were entering a new progressive era in American politics. But the public has shifted in its attitudes toward taxing, spending and the size of deficits in the last 8 to 9 months.'' One telling sign of the shift is the fact that Obama and Democratic leaders have had to lean so hard on Democrats to take a vote many saw as fraught with political risks rather than rewards. "Given the heated and often misleading rhetoric surrounding this legislation I know that this was a courageous vote for many members of Congress,"' Obama said Sunday in a Rose Garden appearance, "and I'm grateful to them and for the rest of their colleagues for taking us this far. "Now it falls on the United States Senate to take this baton and bring this effort over the finish line," he said. That finish line may not be crossed as soon as Democrats had hoped. It looks increasingly likely that a bill will not be ready for Obama to sign until after the New Year. But Democratic leaders still cling to the goal of clearing the measure before the end of 2009. "It's too bad the president has to spend all this time trying to rustle up votes within his own party," said Jim Manley, spokesman for Senate Majority Leader Harry Reid (D-Nev.) "But I honestly believe the House vote gives us momentum that Senator Reid is going to use when he talks to his colleagues about the legislation this week." Reid is hoping to bring the issue before the Senate in a week or so, but he has yet to put the finishing touches on the bill that will be the starting point of debate – a blend of differing versions produced by two committees. Final details have to be determined and analyzed for their impact and cost, but it is clear that the Senate bill will have major areas of overlap with the House's: Both bills will expand Medicaid coverage for the needy, provide private-insurance premium subsidies for people of modest means, and set new rules to make it harder for insurance companies to deny coverage or charge higher rates to people based on their medical status or history. Both bills would require everyone to have health insurance, and set up a new insurance exchange to offer affordable policies for small businesses and individuals who do not get coverage from their employers. Both bills would include one government-run "public option'' among the choices. However, Reid has said that his bill – in a concession to moderates – would allow states to "opt out'' of offering the government plan. The Senate bill may or may not include the House' bill's requirement that employers provide coverage for their workers. In another major difference, the Senate bill will offset the cost primarily with a tax on companies that offer very expensive health insurance policies. The House's financing comes mostly from an income tax surcharge on upper income people. That disparity will be among the biggest issues to be ironed out when, after the Senate passes its version, negotiators in a House-Senate conference committee write the final bill. Senate Republican Leader Mitch McConnell (R-Ky.) on Sunday highlighted the fact that the 39 House Democrats who voted against the bill – mostly conservatives and lawmakers from Republican-leaning districts – represented one in seven Democrats in the House caucus. "It should serve as a stark reminder that Americans don't want a 2,000-page, trillion-dollar government experiment,'' said McConnell. Despite the changes made in the House bill to win enough conservative Democratic and anti-abortion votes to pass it, the measure is still generally regarded as too liberal for the Senate. "The House bill is dead on arrival in the Senate,'' said Sen. Lindsey Graham (R-S.C.) Sunday on CBS's "Face the Nation.'' Senate Republicans do not expect to derail the legislation entirely, but the they do have more latitude than the House GOP to offer amendments that could change the bill – or at least put political pressure on moderate and conservative Democrats. In both the Senate and the House, centrist Democrats have tremendous leverage over the liberal majority of their party. The threat of losing their crucial votes is what drove House leaders to make big concessions on the terms of the public option that liberals did not like – and to allow new restrictions on abortion vigorously opposed by a majority of House Democrats. Even though that abortion amendment was approved, its opponents still swallowed hard before voting for final passage – a show of pragmatism that will likely be required among Senate Democrats as well. "Getting the best possible bill that doesn't pass isn't legislation,'' said Rep. Jim McGovern (D-Mass.), who opposed the abortion amendment but voted for the bill. "That's a therapy session." END IT
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