- A harsh reality is sinking in among Democrats -- that a Republican victory by Scott Brown Tuesday could spell the end of health reform because there is no good option to rescue the plan from this latest brush with political death. Photo: AP
Ever since health care reform flamed out in the 1990s, Democrats thought lots of things might derail their longtime dream this time around. Losing a Senate seat in liberal Massachusetts was not on the list.
But that is the harsh reality sinking in among Democrats — that a Republican victory Tuesday could spell the end of health reform because there is no good option to rescue the plan from this latest brush with political death.
Publicly, the White House and top Democrats held firm to their stance that health care reform will pass this year. And Speaker Nancy Pelosi (D-Calif.) said Monday that Democrats will need to figure out a way to proceed if Republican Scott Brown wins, “but that doesn’t mean we won’t have a health care bill.”
“Let’s remove all doubt that we will have health care one way or another,” Pelosi told reporters in San Francisco.
But privately, Democrats are getting cold feet about pushing ahead full bore on health care. Moderate Democrats who have long been skeptical of the administration’s focus on the issue could begin to peel away in the face of a convincing loss for Democrat Martha Coakley, dealing a fatal blow to legislation that had no room for error in either chamber.
Democrats have options to salvage reform following a Brown victory, but all have serious deficiencies.
One idea that looked promising a week ago — passing a bill through the House and Senate before Brown was seated — has dropped down the list of alternatives, as Democrats fear it would look like a partisan power play that ignored the will of Massachusetts voters.
The White House-favored option is to ask the House to adopt the Senate bill, with a promise to make additional changes later through the budget reconciliation process. But House Democratic liberals, as well as some conservatives, don’t like key parts of the Senate bill and don’t want to make it their own.
Ron Pollack, a longtime health care insider and executive director of Families USA, has floated a variation on this theme with the administration and congressional aides: a two-step process that would reassure House members their wishes would be met in the bill.
Under Pollack’s proposal, the House would take up the Senate bill only after the White House and congressional leaders struck a deal on key issues, such as taxes and the subsidies to purchase insurance. They would incorporate those changes into a separate budget reconciliation bill.
The House would pass both the Senate bill and the reconciliation bill, possibly on the same day. The Senate would then take up the reconciliation bill, which would require only 51 votes for passage.
“It is eminently doable — and quickly,” Pollack said Monday. “It is the combination of two things that wouldn’t work separately but, when done in tandem, make a lot of sense.”
This approach, however, would prevent any fixes that did not have a direct impact on the federal budget, such as changes to language on abortion and immigration and, possibly, even the insurance exchanges. The exchange question could be particularly problematic for House Democrats who have sacrificed the public option in return for the national insurance exchanges under the House bill.
“Progressives and conservatives in the caucus won’t go for it,” one aide predicted Monday. But they may not have a choice. Another aide acknowledged a Brown win would force party leaders to recalibrate and said that Obama and Pelosi would have to convince a skeptical rank and file that this was the only course of action.