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For Democrats, it's do or die
The legislative machinery is in place and the GOP opposition is irrelevant. Only Democrats can prevent health reform from passing now.
Robert Shrum
Robert Shrum
T

he Republicans were appalled, outraged, aghast—and running out of means to describe their horror, indignation, and righteous anger. It seems the president, after a year of trying to induce the Party of No to say “yes” to something, finally called for an up or down vote on health care. Majority rule in a democracy—oh the shame of it! Although, come to think of it, the 2000 election showed the GOP is only too happy to dispose of the concept when politically convenient.

The Republican opposition to reconciliation—passing the health bill without facing a filibuster—is transparently cynical for a party that has used the process, from Reagan to Bush II, to reshape the tax code and redefine the role of the federal government, which, unlike health care, constitutes not one-sixth but close to one-quarter of the entire economy.

But the truth is that in the health debate, the Republicans are now irrelevant. They constitute a solid wall of opposition, impervious to fact or argument. But they are also a static Maginot Line, and Democrats have enough votes to get around the GOP’s servitude to ideology and the insurance industry. All they have to do is call the roll and cast the votes. 

Nancy Pelosi, who’s been a brilliantly effective House speaker, regularly producing majorities for far-reaching measures on issues from financial reform to climate change, now has to persuade her caucus to set aside its injured sense of prerogative and pass the Senate health bill. Harry Reid, the majority leader of the Senate, where most of the House’s progress has so far gone to die, is now freed of the search for 60 votes and the extortionate tactics of senators 58, 59, and 60. To pass amendments to the Senate bill through reconciliation, he only needs 50 votes plus Vice President Biden. And he can probably count on the suddenly primaried Sen. Blanche Lincoln of Arkansas, who can’t afford to alienate her base by acting like a pseudo-Republican. 

So the only thing that stands in the way of health reform is the Democrats themselves. 

There’s the parochial temptation, irresistible to many members of Congress, regardless of ideology, to attempt their own version of Sen. Ben Nelson’s despised and discarded “Cornhusker Kickback,” which nearly sank health care under the weight of a special deal for Nebraska. New York Democrats are now demanding special breaks for their state. If they and others with an instinct for the capillary let their particular notion of the perfect become the enemy of the universal good, they don’t deserve to be called “progressives”—and they won’t deserve to be re-elected. 

The same goes for those who favor or oppose abortion rights. The president’s compromise doesn’t give either side all it wants. But in the end, it's not pro-life or pro-choice to deny more than 30 million Americans the chance for potentially lifesaving health coverage.  And there likely won’t be a public option now, even if 50 or 51 senators come to favor it; its absence may be critical to rounding up enough Blue Dog Democrats in the House. A last stand on the public option barricades could bring the most illiberal result of all—failure once again on the great unfinished business of social justice in our society. That battle can be fought another day, in another Congress. 

Then there’s the uncertain and often miscomputed political calculation, which tempts electorally threatened politicians to break with their own president and party. That won’t work this year, just as it didn’t work for scores of moderate Democrats who openly scorned Hillarycare in 1994; voters angry about the economy and congressional dysfunction that year chose the Republicans and tossed incumbents out. This year, as then, Democrats will have to run alongside health reform even if they run away from it. They will have to run with the phantom or the reality of the bill.  Pass it—and voters will see that there are no death panels, just as there is no rationing and no loss of the right to pick your own doctor. Instead, Americans will soon discover that they can no longer be denied coverage because a child has a pre-existing condition like asthma and that their insurance can’t be canceled when they get sick, with a bean-counter cutting off their chemotherapy because they’ve reached their annual limit. Better to campaign on that than on the defensive claim that a defeated bill wasn’t your fault, wasn’t your idea, and somehow wasn’t your failure—in short, “re-elect me for doing nothing.”

It's time for Democrats to prove that they’re a governing party—or in Congress next year, they won’t be governing at all.

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