Last week, I had an exchange with Armando about the Obama administration’s strategy for passing health care reform. I want to follow up on that a bit. As references, I want you to take a look at Joan McCarter’s recent piece at Daily Kos and David Kuhn’s piece at Real Clear Politics.
Since we’re talking about strategy, we’re going to be looking at the situation that presented itself when the Obama administration took office. Despite a lot of heated rhetoric and the August recess nuttiness, not much has changed since January. Back in January, the whole Democratic caucus knew exactly what kind of health care plan Obama had run on as a candidate. They knew, for example, that Obama and Clinton had differed mainly over the issue of a mandate. Clinton said a mandate was needed to make the plan affordable (in the budgetary sense) and Obama said he couldn’t see how a mandate would be fair to the buyer if it wasn’t affordable (in a premium sense). At the time, I argued that this minor difference didn’t matter at all because any bill would have to get through Congress, where these decisions would be made by congresspeople.
But most of the issues that matter to me are either mainstream Democratic issues that all serious candidates for the Democratic nomination know to support or they are so out of the mainstream that all serious candidates know better than to publicly embrace. For example, I want single payer health coverage for every American. I have no ideological interest in the health care plans being put forward by Edwards, Clinton, or Obama, and I could give two shits about the minor distinctions between them. When I see someone like Paul Krugman get all worked up about mandates to make every American purchase health insurance from a giant health insurance corporation, I think Paul Krugman is a complete pinhead asshole. The idea that someone would throw a temper tantrum over someone’s campaign proposal for a shitty (and bound to be profoundly unpopular) boon to the insurance corporations…a policy masquerading as progressive policy…is enough for me to put a fist through a Princeton professor’s office wall. But I recognize that if you have dedicated the last decade of your life, under Republican congressional rule, desperately trying to cobble together a lukewarm pro-corporate health care plan that might pass through Tom DeLay’s House, you might just get upset if people don’t leap for joy at your plan to force every American, no matter how poor, to become a customer of some giant HMO provider.
So, of course, the way to make this bag of shit smell better is to offer people the option of buying their health insurance from the government. Yeah, maybe you are only going to give that option to the self-employed, uninsured, and impoverished, but it’s a far-sight better than just compelling people to become customers of the very corporations they hate the most.
Even before Obama took office he started canvassing the Senate to see what kind of support there was for his health care plan. He quickly discovered that there was no Republican support for the plan he ran on. He also discovered two disconcerting things about the Democratic caucus. They were more favorably disposed to Clinton’s mandate than his own plan, and there were a few Dems who opposed the public option.
He realized that he probably wouldn’t have 60 Democratic votes in the caucus (Kennedy and Byrd were ill, Specter was still a Republican, and Franken’s election was tied up in the courts). Therefore, he made sure to get a provision included in the budget that would allow him to come back in late October and pass a bill using the budget reconciliation process (which only requires 51 votes). But he knew he couldn’t announce that he was going to go that route without giving an honest effort to pass the legislation under regular order. Even if it was a pipe dream, he had to try to win over a few Republicans.
So, the first thing he did was cave in on the mandate. Then he made sure to get the provision for budget reconciliation. He knew he would have to pass the bill through three House committees and two Senate committees. The only committee that would present a problem was the Senate Finance Committee. The sticking point there was the public option. If he announced that he wouldn’t sign anything without a public option, the bill would get nowhere in the Finance Committee, and the effort to pass a bill without resorting to the budget reconciliation process would die an early death, with the administration taking the blame for their intransigence. But, if he dropped his support for the public option, the Democratic Party and all their health care activists would lose their enthusiasm for reform. The only solution was to maintain a degree of creative ambiguity. In not insisting on a public option, he could maintain the narrative that he was flexible and willing to negotiate and make concessions to the Republicans.
If the bill was not going to pass through the Senate, he needed to make sure the public saw the problem as one of Republican obstruction, not executive rigidity.
To get the bill he ran on, he was going to have to make sure that the public option passed on the House side and, since it could not pass on the Senate side, that it be included in the Conference Report. At that point, one of three things would happen.
- 1. If the Dems didn’t have 60 votes, the Republicans would filibuster and take the blame for obstruction, setting up the argument for using reconciliation.
2. Seeing the momentum for health care reform, one or two Republicans would vote for cloture and the bill would pass.
3. If the Dems did have 60 votes, they could muscle the few doubters to vote for cloture, even if they opposed the underlying bill.
The only thing that could go wrong is if there were any Democrats who were willing to filibuster the president’s highest priority item. This was the strategy, and it hasn’t changed much at all.
The Democrats are in good position. Sen. Byrd is still frail and misses most votes, but Franken is now a senator, Kennedy has been replaced, and Specter is a Democrat. If the Dems stay united on cloture, the bill can pass with a public option and without using budget reconciliation. Yet, Obama can’t say that because we are still in the stage of passing something through the Finance Committee. We’re still in the stage of appearing willing to compromise and make concessions. And, most importantly, we’re in the stage where we need to line up all sixty Democrats in favor of cloture. That means all their views must be respected and treated with deference. The administration cannot afford to alienate anyone.
If, at any point, the administration had taken the position that the public option absolutely must be in any bill that Obama signs, then the bill would never have passed through the Finance Committee. And that would have put the blame for failure on the Democrats, crippling the effort to pass the bill through regular order and the argument for using the reconciliation process.
So, what we’ve been witnessing has been a careful dance. What people say is different from what they mean.
The plan to plan to force every citizen of Massachusetts, no matter how poor, to become a customer of some giant HMO provider isn’t as unpopular as one might think.
what’s your assessment of how Baucus is doing? likelihood of PO being included as an amendment by fin. committee?
This is persuasive a take on Obama’s strategy as any I’ve seen. Whether one sees it as a credible explanation depends not on the rightness of the strategy but on one’s belief in Obama’s good intentions and determination.
The downside of the strategy itself is that it misdirects lefty pressure from Congress to Obama, who according to this theory is already on our side. It also doesn’t touch on the refusal of Dems to start negotiating from single-payer as their default position.
Interesting.
Perhaps “that it misdirects lefty pressure from Congress to Obama,” the White House prefers this. It might be an attempt to protect a Democratic majority (Obama may not care about ‘purity’ as much as he cares about a majority) knowing that Obama can survive any left criticism, which he almost certainly can.
nalbar
The real downside here is that we have a proposal that is, according to the polls, supported by somewhere between 70% and 80% of the public, and yet getting it passed is going to be a major undertaking.
If that isn’t irrefutable evidence that our democracy is broken, I don’t know what is.
Exactly! The fight over the reforms in health care are proof positive of how beholden our national legislators are to the corporate hands that feed them. What with all this support of the masses for a new health bill and the continued reluctance of Congress people to provide it shows a massive disjunction in our democracy itself. Foreign policy already evidences that the US has become an empire. Domestic policy begins to follow suit.
I think (and hope) you’re spot on with your analysis.
Hope you’re right. It feels about right, anyway.
And the push from the netroots and progressive caucus doesn’t hurt either. The stronger the support for a public option is in the polls and from supporters in both Houses, the better. Cultivating that support is part of the strategy.
It’s nerve-wracking to watch on a day-to-day basis, but it seems to be sloooowly heading more or less in the right direction. ::knocks on wood::
yes, and Howard Dean pushing from outside the admin helps imo.
I can’t understand how people can take any real comfort from rationalizations explaining Obama’s luke-warm support of health care reform. Even accepting the argument that strong opposition has forced pragmatic choices to be made to ensure the bill has a fighting chance of passing the question must be asked – can what is currently being discussed be remotely considered actual reform? Has no one considered that when we haven’t even defined what “public option” means the possibility for any true reform coming from this bill is dead on arrival? Methinks Obama seems far more intent on the symbolism gained from passing a bill with “Health Care Reform” in its title rather than actually carrying out any constructive reform. This apparent affection for style over substance is increasingly becoming his administration’s defining characteristic.
You believe the “possibility for any true reform coming from this bill is dead on arrival” because “we haven’t even defined what ‘public option’ means”? But even putting aside the public option, how is it mere “symbolism” that the bills voted out of committees so far virtually assure a final bill that
However much more we want, these things are huge and long overdue–they are substance and not mere style.
There are two problems with the present system which have by far and away the most serious impact on Americans’ lives – the cost of their health care and the number who aren’t covered. The proposed changes constitute mere refinements of the current status quo. They address none of the system’s entrenched inefficiencies, require everybody to buy insurance (thus guaranteeing fat profits for the health insurance lobby) and ignore how on earth all of this is going to be paid (pardon me, most of the anticipated cost has been pruned by dropping some thirty million from subsidized insurance). Oh, I’m absolutely delighted at how our representatives are demonstrating they are of the people, for the people, and by the people. Just delighted. How many billions of dollars are being spent on Afghanistan? How many Americans die from inadequate health care every year? It’s what, 45,000? Almost twenty times 9/11 every freaking year and this is where the Senate and Congress are drawing the line? It’s a disgrace to democracy and everything America stands for. I never thought I’d see the day when Americans are standing holding an empty bowl asking their masters for some more gruel, “Please Sir, can I have some more?”, and being grateful when given some extra slop.
If this country does not adopt some form of the health care which every citizen in every other industrialized country in the world possesses; a system which is both less costly and provides better health care, then democracy as we have been taught in school is dead in this country … and we let them take it away from us.
I know you’re right, because this is exactly what I’ve thought of his strategy. 🙂
But seriously folks, I’m reassured to see someone else reach the same conclusion. While I think the strategy is pretty clear, few on the blogosphere appear to agree.
Thanks for laying it all out coherently.
agree, and the screeching over at the orange place is starting to hurt my ears. thanks for some calm reason, Booman
first, l’d like to point out a misspelling in in kuhns’ Milbank quote: “Baucus is suffering the consequences of being one of the
lastleast serious men in town.”secondly, baucus is either a willing shill, or a dino…personally, l think it’s the later.
I agree with (and as always value) your analysis.
It was maddening this summer to watch many of my favorite blogs ratchet up cynicism based on nothing more trustworthy than AP or WaPo’s anonymous sources “signaling” supposed betrayal by the White House. It was even more absurd to see the WH’s repeated reassertions of support for public option dismissed as “shifts” bespeaking loss of message control. I appreciate getting the benefit of your thoughts here. They are so much more cogent than echo chamber outrage based on unsourced or badly parsed quotes from sub par MSM stories.
But it must be admitted that much of the big reaction to every rumor happened because Obama was such a blank slate when it came to specifics. Maybe that was necessary to a strategy, but it has its consequences. When there are no explanations given they will be supplied from somewhere else.
Did you see blogs bullet-pointing what was in the 4 bills that passed the congressional committees? I didn’t, so I question whether this summer’s rage was about specifics, much less how Congress’s differed from those Obama outlined in his town halls. (His iteration of specifics there was barely remarked upon, compared to unsourced articles about “signals”.) The flashpoint was the public option, and no matter how many times the WH stated that it remained committed to it, unreliable MSM sources citing anonymous sources stirred new cries of betrayal on blogs.
So you subscribe to the 11 dimensional chess theory. I don’t. I’m just preparing for whatever additional burden Congress puts on me to benefit their corporate
masterscontributors.Does the Baucus bill have a requirement for Medigap insurance or Medicare “Advantage”?
Here’s how I look at it:
I don’t care what his strategy is, the liberal base needs to be active and pounding down the White House door.
If this is his strategy, then great. He doesn’t get the credit, because almost certainly the liberals will attribute this as a win on their belt, not his (which may or may not be true). However, looking at his work in the Illinois State Legislature, he never cared for the credit in the first place. In fact, that was one of his key strategies to getting things done.
Anyway, back to my main point: whatever his strategy, it doesn’t matter. Liberals and the people need to pressure him even if he said “I won’t sign a bill into law unless it has a public option.” The pressure must not stop.
Part of me wants to agree with your post, Boo, but my skepticism of “political reality” and Obama looking for a win inside that reality just won’t let go, either.
Thanks much, Booman, for being an oasis of logic and clarity.
Yours is the only explanation that makes sense. I knew that there had to be some method to what Obama and his team were doing. Given Obama’s intelligence, and his brilliant execution in the 2008 general election, and all else that we know about him, it is simply credible or logical to believe that:
He is so naive that he truly believes the Republicans are going to play ball with him, and that his continued overtures to the likes of Grasley and Enzi, etc. were driven by that conviction;
He would go on record as saying that he would “own” whatever health care reform legislation that signs, that would be nothing more than a Baucus style gift to health insurance conglomerates;
He would give the Rethuglicans a gift of a campaign issue, mandates to pay tribute to insurance conglomerates with no price controls (the other side, given its proud pathological hypocrisy, WOULD use that as an issue);
That the “trigger” is nothing more than a gimmick, and glorified loophole for the insurance conglomerates (if all of us see that, it is certain that he does).
I’ve told more than one person I know that I’ve decided not to go into rages at every one of the different steps/plays in the process. I’ll wait for the final result.
I voted for Obama because I trust him; we all appreciate how inconceivably complicated and delicate the process of legislating such a major piece of legislation is. I’m not ready to write him off on this before there is even a reconciled final bill.
I’ve been disappointed in him in regards to a number of issues, but I don’t think Obama’s pragmatism is such that he is willing to drive a stake through the heart of his legacy before the first year of his administration is out.
OOPS–typo
Sorry. I meant that “it is NOT logical or credible to believe that” etc….