Down and dirty analysis of election and impact on health care reform

Posted by Bill Pierce

Because of the insular nature of Washington politics, elected officials run the risk of losing sight of who is really in charge. Last night in Massachusetts, voters reminded Washington of the answer to that question. Voters are in charge.
 
So now what do Democrats and Republicans do when it comes to health care, which was on the verge of becoming law? While the path is still a bit cloudy, we should have a pretty good idea in the next 48-72 hours.

Here are paths they could travel:

• Drop health care reform altogether: highly unlikely. The president and Democrats have invested a huge amount of political capital in passing legislation. Dropping it would be the equivalent of waving the white flag. Republicans would use their “victory” in the November elections as part of their attack on Democrats. There is this to also consider: Many Democrats believe that the reason they lost the majority in the House of Representatives in 1994 was not because the Clinton health care bill was a weight around their neck, but instead because they failed to pass the bill. If that’s true, then surrendering now makes no sense.
• Bring the current Senate bill to a vote in the House, paired with a reconciliation bill that reflects the results of the current House-Senate negotiations. This path is very unlikely. More and more moderate Democrats were expressing discomfort with the whole process before the election. With the election of Brown, opposition to such a move is growing, and I would guess privately they are concerned they could be the next Martha Coakley. There are also too many issues they could not settle (i.e., abortion, exact nature of exchanges, excise tax, etc.).
• Wait (a few weeks or months) and pull together a consensus bill that is directed at those with health insurance who felt they were getting nothing out of the current bill (i.e., much-much less cost) and move it forward. This would likely happen as part of a bigger bill, i.e., a jobs bill or even reconciliation. This is the most likely. There are many issues about which, when you pull back the curtain, there is a fair amount of agreement between Democrats and Republicans.

The basic issues that will determine which path they follow are:

• For Democrats, the question is which choice will hurt less or, conversely, benefit them politically/electorally? Failing to pass a bill or passing a bill? Many Democrats feel they cannot let this issue go by given all they have staked on passing reform.
• For Republicans, it is a similar question: Do we genuinely cooperate on a consensus smaller bill, or do we continue to oppose? Which strategy helps us most at the polls in November?

The wildcard is this: The wave Scott Brown rode into office is not a wave for Republican control. While he rode the wave, he did so barely running as a Republican. This wave could change direction before next fall and/or it could throw the GOP off at any point.