Should Democrats pass the healthcare reform bill?
Reconciliation is thirty years old, and there’s nothing at all wrong with using it to pass legislation. What’s more, pass and patch (or pass-then-patch) involves passing health care reform through perfectly normal, regular, procedures — and then fixing the original bill through reconciliation. Now, granted, Republicans are apt to complain about procedure, and it’s true that Americans don’t like partisan squabbles and don’t like hearing about procedure. But once the bill is passed, it seems very likely that the national press will tire of procedural complaints about a bill passed weeks, and then months, ago.
Second, it’s a real mistake for Democrats to worry too much about how Republicans will portray things that they do. Republicans are naturally going to bash Democrats for everything; should Democrats respond by doing nothing? Surely not. Democrats should do things that they believe are good for the nation. Democrats believe that health care reform is good for the nation. They are, like it or not, going to be attacked for health care reform. Those who get their information only from Republican news sources will believe those attacks — but people who get their information only from those sources are not swing voters.
Regardless of my own feelings about this bill – which are mixed, to say the least – I think Bernstein is correct. The electorate has a short memory. Tangible results stick in that memory far more than abstract procedures. Six months after the bill is passed, most Americans will still not know what reconciliation is, which deals were struck, and so forth, but a healthy portion of voters will know that healthcare reform succeeded (for now). More Americans will be glad to hear that an end to pre-existing conditions clauses has been hammered out then will become emotionally revved up over the Democrat’s handling of the process. It’s possible that the bill will remain unpopular, but it’s hard to see how giving up entirely will look any better for the Democrats.
That being said, I don’t think the Democrats have what it takes to push this thing through reconciliation or patch it up after passing it in the House. Unlike their opponents, the Democrats have very lackluster party discipline. The centrists are already calling a halt, and the progressives in the House seem unwilling to pass the Senate bill because it’s too conservative for their taste. The president hasn’t taken much of a leadership role either, and so the bill remains in legislative purgatory. My guess is that Keith Hennessey is correct, and the bill is dead.
Perhaps legislators can come back with more modest proposals in the future, but I imagine it will be far in the future. While I would love to see market reforms in the health insurance market, I don’t believe that Republicans are very serious even about their own ideas. This is largely the basis for my own support of the Democrats’ bill. While there are certainly libertarians and conservatives with alternative proposals for healthcare reform, Republican leadership has historically been against any changes to the status quo. I don’t think the status quo is sustainable. If the bill dies, I’m not really sure what we can expect. If I thought the Republicans would take up the cause of a bill like Wyden-Bennett and join ranks with Democrats to push something through as an alternative, I would be more optimistic. As it stands, every outcome looks grim. Healthcare costs in the public and private sector continue to rise unsustainably, and our system is too broken to do anything about it.
P.S. Reconciliation is not necessarily a budget-restricted procedure, however due to the Byrd rule that is now the case. However, anyone who thinks that the budget and healthcare reform are not inextricably linked needs to talk to Paul Ryan about the matter. Healthcare is the budget, and without addressing it we will never be able to right this fiscal ship.