Obama's continued audaciousness on health reform could backfire

By Ruth Marcus
Wednesday, February 24, 2010; A13

The White House description of President Obama's health-care proposal as his "opening bid" raises the question: With whom is he bidding? The public dance is with Republicans, but this is hardly serious. The White House does not enter Thursday's summit expecting Republicans to make a deal.

The real target of presidential bidding is his own party -- specifically House Democrats. The White House hopes that Blair House will be the new Baltimore, a venue, like Obama's meeting with the Republican caucus, where a nimble president outdebates the opposition, thus stiffening Democratic spines for the difficult legislative road ahead.

In Monday's blueprint, the president made the decision -- certainly audacious and perhaps foolhardy -- to press for the comprehensive, near-trillion-dollar package. Getting there would require two steps. The Senate, using the majority-vote process of reconciliation, would tweak the measure as suggested by the president. The House would pass both the tweaks and the underlying Senate bill.

The arithmetic of this approach is unforgiving. Even before the shock of losing the Massachusetts Senate seat, there was no margin for error in either house. Now the politics in both chambers have become that much harder.

The House wants the Senate to lead, for a change. For parliamentary reasons, this is unlikely. But no matter what the order, getting even 50 Senate votes will be a challenge. Some Democrats are reluctant to take this divisive step. Assuming enough can be brought along, Republicans will be able, even under reconciliation rules, to bring the Senate to a virtual standstill.

That would be the easy part.

In the House, the only way to cobble together a majority will be to secure votes from moderate Democrats who balked at passing the bill the first time around. These are the lawmakers who are most rattled by the Massachusetts vote -- with good reason. For a Democratic House member in a swing district, the politics counsel against voting yes. "This is a career-ending vote," one Democrat told me -- and this was a lawmaker who voted for the original bill.

With the House down a few members, 217 votes will be needed for passage. The original House measure passed with 220 votes -- with 39 Democrats defecting. But two of those yes votes are gone: John Murtha of Pennsylvania died; Robert Wexler of Florida resigned. A third, Neil Abercrombie of Hawaii, is leaving at the end of the month to run for governor. The lone Republican voting for the measure, Joseph Cao of Louisiana, is no longer on board.

Meanwhile, the president's proposal does not include the anti-abortion language inserted in the House-passed measure by Rep. Bart Stupak (D-Mich.), largely because the Senate would have difficulty fiddling with abortion language under the restrictive rules of the reconciliation process. So Stupak will be gone, and with him another five votes, perhaps more.

There are a few liberal lawmakers who might be wooed back -- Ohio's Dennis Kucinich, for instance, voted against the first version -- but not enough to make up the difference. So the fate of the measure rests with the conservative Democratic Blue Dogs. A few are retiring -- including John Tanner and Bart Gordon of Tennessee -- and might be persuaded to switch their votes. This would help, but probably not enough.

Will other Democrats switch? The president's blueprint is more moderate than the House measure but more expensive and less tough on cost control than the Senate version. According to one person present at her meeting with House Democrats Monday night, Speaker Nancy Pelosi bragged that 80 percent of the excise tax on high-cost insurance plans -- a central cost control measure that is hated by House liberals -- had been eliminated. Meanwhile, more and more Democratic senators are signing on to a letter urging that the public option be included. None of this seems conducive to securing moderate votes.

Maybe the president can pull this off. My worry is that going for broke and failing will leave no time or appetite for a fallback, scaled-down plan. And the moment to do something on health care -- not everything, but something significant -- will have evaporated, once again.


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