The Health Lady Has Yet to Sing

ObamaCare is still no sure thing.

Republican Scott Brown is running strong in Massachusetts on a promise to be the 41st vote against health care in the Senate. Democrats' bigger worry right now is whether Mr. Brown might prove the 218th vote against health care in the House.
The drama of a Christmas Eve health vote left the country with a feeling of ObamaCare inevitability. The Senate was, after all, the heavy lift. If the White House could just bag Nebraska's Ben Nelson and other Senate teases, this debate would be over, save the regulating. A brief ping-pong between the chambers, and Mr. Obama would have his State of the Union triumph.
Political memories are short. Think back to November, when Nancy Pelosi was attempting her own clean-and-jerk of health care. It took three weeks of bribes, cajoling and threats for speaker to eke out a three-vote margin. The action is now back in the House and here's what Ways and Means don Charlie Rangel had to say about it this week: We've got "a serious problem."

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Martin Kozlowski 

 

The biggest problem is that January isn't November. In November, when moderates such as California's Dennis Cardoza were being squeezed for last-minute yes votes, they could take solace that the public was still open to congressional action. This week's Quinnipiac poll has 34% of respondents "mostly" approving the bill. A token 26% of independents back it. In November, House Democrats were being reassured by a relatively popular president. Gallup this week has a mere 37% of Americans approving of his handling of health care. The president has moved from asset to liability.

In November, House Democrats had not yet absorbed the wipeout of the Virginia and New Jersey elections. They hadn't witnessed four prominent House members choose to retire rather than face defeat, or two powerful incumbent senators follow suit. They hadn't seen Alabama Democrat Parker Griffith sprint to the Republican side. They weren't holding 40 of the 50 most competitive House seats.
They hadn't caught a new poll that is all the congressional gossip right now, showing that North Carolina freshman Democrat Larry Kissell remains relatively popular in his conservative district and easily leads potential Republican opponents. Mr. Kissell was a no vote on health care. What makes the poll particularly relevant is data that shows that among the 44% of voters who incorrectly believe Mr. Kissell voted for the bill, the matchups are tied. Among the 29% who correctly understand he voted against the legislation, Mr. Kissell wins huge.
Finally, House Dems hadn't been presented with the mind-blowing sight of a Republican Senate contender running openly against health-care reform—in a state that went 26 points for Mr. Obama—and getting somewhere. "There are a lot of [Democrats] asking the question: There's a need for health-care reform, but our constituents just don't want this, and who are we to say they are wrong?" said one Democratic staffer for a member from a more conservative House district.
This is why Mrs. Pelosi (still) has a math challenge. Of her three-yes-vote margin, Democrat Robert Wexler has resigned; his seat remains unfilled until April. Republican Joseph Cao won't be the final vote for a Democratic bill. As for the 39 Dems who initially voted against the legislation, a vote flip now would be an invitation to be singled out—a la Blanche Lincoln—as the individual who brought the nation ObamaCare.
The potential for flips the other way is big. Michigan pro-lifer Bart Stupak is still vowing that he and up to 10 other Democrats will bolt without his abortion language. Some 190 members have signed a letter demanding the end of the tax on high-value health plans—which President Obama needs to fund the bill. Liberals are still vowing revenge for the death of the public option (though the Award for Most Empty Threats in One Debate still goes to this crew.)
House Republicans smell at least a whiff of blood, enough to launch a campaign targeting 37 Democrats who may have a case of yes-vote regrets. These include members like Oregon freshman Kurt Schrader; 49% of his seniors are enrolled in Medicare Advantage, which will be gutted under the legislation. Also up for special attention are Democrats hailing from flat-broke states that will nonetheless be saddled with huge new Medicaid costs under the bill.
Critics of the legislation shouldn't get their hopes too high. The Democratic leadership is now clinically obsessed with passage. No first-round yes vote has yet jumped ship, and even if some do, Mrs. Pelosi has options. Prior no votes might be convinced that a more "moderate" Senate bill gives them cover to flip. Three no votes, including Tennessee's John Tanner, are retiring, and may feel liberated. The White House no doubt has a list of plum jobs it can offer people as consolation prizes for voting yes and losing their seats.
The point is rather that there is now officially enough nervousness that anything can happen. Whatever the Tuesday election outcome, Mr. Brown already claims victory for rattling Democratic minds. And should he win, health care becomes even more toxic. This isn't over yet.
Write to kim@wsj.com