With the Senate set to invoke cloture on the Lieberman-Nelson health care bill, the media and pundits are falling over themselves to declare "mission accomplished." Just one fast question: how are they possibly going to pass this thing?
I just had the misfortune to watch Ben Nelson on "State of the Union" with John King. After spouting platitudes about middle America being "center-right" and outlining his heroic struggle to bring the coastal Democrats back to fiscal sanity (this from Mr. Earmark himself, mind you), Senator Nelson reiterated there could be no "material changes" to his health care bill. Pressed for details, he rejected the House millionaire's tax, the public option as the "the very top" of the list of unacceptable changes, and hinted he'd oppose any Medicaid expansion - despite robbing taxpayers to pay for Nebraska's share of such expansion.
Senator Conrad this morning also signaled that the bill would have to hue closely to the Senate "compromise."
This got me thinking about all the problems that will be faced in conference, and ultimately in the House and Senate when this legislation comes back from conference. As most of you know, if they insist on regular order for the conference report, it's subject to a majority vote in the House and the fake 60 vote requirement the Senate made up for itself. Let's list these problems, starting with the most difficult:
- The abortion compromise - Now I know Barbara Boxer signed off on this language: apparently because she's tired of being a Senator? Maybe she drew the short end of the stick when all the female Democratic Senators got together to decide who should take the fall for this? Or she's tacking to the right against failed former Hewlett Packard CEO Carly Fiorina, whose career was distinguished by her ill-conceived acquisitions and outsourcing of American engineering jobs.
But when the National Organization for Women, NARAL Pro-Choice America, and Planned Parenthood reject your compromise, then it's not going to fly very well. This will severely impact Democrats' fundraising, to say nothing of how bad it looks that a Democratic Congress is poised to push restrictions on access to abortions much tougher than Republicans managed over the past two decades (the limited partial-birth abortion fight being a far narrower exception).
- The public option - I know the Democratic Establishment is set to give up on this, but there's room for progressive Democrats in the House to make a name for themselves voting against the bill as insufficient (which it surely is). In doing so, they could make a name for themselves like Rep. Grayson did, and be a hero to MoveOn and the PCCC netroots community. I think this is much more a threat in the House than the Senate, since there aren't any progressive Senators (I think the last true progressive was Robert LaFollette, and maybe Ted Kennedy).
Speaker Pelosi can usually manage such revolts, but I wonder how inclined she'll be to lean on Members, especially when she's gone into campaign mode. Even some of her more progressive colleagues may face primaries or serious challengers in this political environment - and they might be looking for cover on this issue.
- The taxes - Then there's the financing of the subsidies: in addition to higher payroll taxes on high income households, the Senate is proposing a tax on premium health care benefits. The unions have fought for decades to get their members high-quality health benefits, and they'll have none of that. While this alleged "Cadillac" tax on health plans of $8,500 or more applies to only a few percent of the population now, it will explode over the next decade due to the rise of health care inflation. If any group can scuttle this bill in the House (though not necessarily the Senate, since the only friend of workers there is Senator Brown, and to a lesser extent, Bernie Sanders), it's labor. This is clearly the biggest threat to the White House on this bill, which is why I'm surprised they haven't acted to remove this tax already.
With this triple threat to the health care bill, I really don't see how you split the difference in a way that satisfies core Democratic constituency groups and gets a majority in the House and 60 votes in the Senate. The eleventh-dimensional chess types may see a master plan to somehow ram this back through the Senate, but I'm waiting to see what can be done. Do they think they can just bully this through again now that every Senator has "signed on" to some type of health care?
What do you think? How do the Democrats split the difference over all these issues in conference? Quite frankly, I just don't see it... not without fracturing the Democratic Party even further than it has been over this debate.