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.