A sweeping victory for Obama, Pelosi
By Ben Pershing
After months of incremental progress and setbacks, wild momentum swings and then a final frenzy of vote-counting, the news on Monday (is it really Monday?) is about historic accomplishments -- the transformation of a health-care system, the success of a first-term president on his signature issue and the triumph of the first female Speaker's old-fashioned arm-twisting.
"A transformative health care bill is headed to President Barack Obama for his signature as Congress takes the final steps in Democrats' improbable and history-making push for near-universal medical coverage," the Associated Press ledes. The New York Times says "House Democrats approved a far-reaching overhaul of the nation's health system on Sunday, voting over unanimous Republican opposition to provide medical coverage to tens of millions of uninsured Americans after an epic political battle that could define the differences between the parties for years." The Los Angeles Times reports that "[t]he bill, which passed 219 to 212 without a single Republican vote, would make a nearly $1-trillion commitment in taxpayer money over the next decade to help an estimated 32 million uninsured Americans get health coverage. And it would establish a broad new framework of government regulation to prevent insurance companies from denying coverage and, advocates hope, to begin making healthcare more affordable to most Americans."
Who's the big winner? John Dickerson says "President Obama has just completed the most arduous act of community organizing of his career. Two hundred and nineteen of his neighbors down the street joined together in the House of Representatives to pass historic health care legislation. Speaker Nancy Pelosi made it happen, but Obama worked harder and more intensely than he has on any other issue of his presidency. He made 92 direct pitches to Democratic members of the House, according to a White House tally. Last week he gave three speeches, culminating in an appeal to fellow Democrats more personal and philosophical than any he's given since taking office." The New York Times suggests the result "assures that whatever the ultimate cost, President Obama will go down in history as one of the handful of presidents who found a way to reshape the nation's social welfare system. After the bitterest of debates, Mr. Obama proved that he was willing to fight for something that moved him to his core. Skeptics had begun to wonder. But he showed that when he was finally committed to throwing all his political capital onto the table, he could win, if by the narrowest of margins."
Poilitico says "the win was a split decision for Democrats, not a knockout. The victory, almost inconceivable a month ago, provides an immense and immediate boost for Obama. ... But House Democrats, who have endured months of draining debate and attacks from tea party activists, including a derisive serenade from a group of protesters on a patch of grass outside the chamber Sunday, were more relieved than overjoyed -and many may have been casting votes, on a warm spring night, for their own political extinction." The Hill judges that "Nancy Pelosi showed Sunday why she is one of the most powerful Speakers in history. In shepherding one of the most controversial bills through the House, Pelosi achieved what some thought what was impossible after Scott Brown's victory in Massachusetts two months ago." Howard Fineman makes Obama, Pelosi, Rahm Emanuel and drug companies the winners, among others, while the insurance industry, Blue Dogs and Republicans are included in the losers.
The president gets a good deal of credit for the late lobbying campaign. Citing Dennis Kucinich as perhaps his most impressive convert, Roll Call says: "He may not always get his way, but more often than not, President Barack Obama seems to have the Midas touch when it comes to persuading Members of Congress to get on board with his agenda." The Washington Post says "Obama conveyed to the wavering House Democrats who visited the White House in recent days that he had put his presidency at risk by pushing the House to act on the Senate bill. Although many House Democrats found the Senate legislation lacking, passing it was the only option after Republican Scott Brown won a Massachusetts special Senate election in January and cost Democrats their filibuster-proof majority in that chamber." The Wall Street Journal writes: "It's easy to forget that Democrats have substantial majorities in the House and Senate, and control the White House, given how the party has struggled during its yearlong march to pass the overhaul. Democrats spent months fighting over the measure's contents, and blamed the president for not settling their disputes. But in recent days, that same control of the executive and legislative branches formed the backbone of the party's efforts. In addition to the pledge on immigration, the White House tapped officials from its transportation secretary to its top agricultural official. And after staying quiet during the bill's past disputes on abortion, White House officials over the weekend drafted an executive order reinforcing a federal funding ban, securing vital votes."
The victory was clinched when antiabortion Democrats led by Bart Stupak struck a deal with the White House on an executive order. Newsweek says "Bart Stupak arguably saved health care reform, agreeing to sign on to the bill and defending his decision on the House floor, in the face of jeers from Republican opponents and a heckler who seemed to have called him 'baby-killer.' In saving health care reform, Stupak looks to have put his House seat in serious jeopardy. The Family Research Council, a strong anti-abortion rights group, came out moments ago with the news that they're gunning for his seat." Huffington Post reports "A Republican member of Congress apparently called [Stupak] a 'baby killer' near the end of the day-long House debate on health care Sunday night," after Stupak rose to speak against the GOP's unsuccessful motion to recommit on abortion. Politico writes that "[r]eporters in the House chamber said the 'baby killer' shout seemed to come from a group of lawmakers that included Rep. John Campbell (R-Calif.), but he said it wasn't him. 'I don't think it's appropriate at all,' Campbell told POLITICO. Campbell said the voice came from the floor - from someone who was behind him and to the left. 'Some people know who it is but won't say,' he added."
On a practical level, USA Today writes: "Nearly lost in Sunday's focus on protests, process and politics was the stunning array of new federal policies included in the legislation. ... The package of changes would provide coverage to 32 million people through Medicaid, subsidies to families and tax credits to small businesses that can't afford to cover their workers. It would pay for the expansion with the Medicare cuts, new taxes on upper-income workers and expensive insurance plans, and fees on the manufacturers of prescription drugs and medical devices. It also would prohibit insurers from denying coverage based on pre-existing conditions, dropping people when they get sick and limiting lifetime benefits. Children could be covered on their parents' policies up to age 26, and seniors would receive improved coverage for Medicare prescription drugs. Most individuals would be required to have insurance, and businesses with 50 or more employees would have to provide it or pay a fee." Bloomberg notes "Drugmakers and health insurers will gain millions of customers under legislation overhauling the U.S. medical system. The industry also will pay new fees to the government, and face stricter rules that may narrow profit margins and fuel mergers. ... The revamp will cost $940 billion over 10 years, with industry fees and taxes helping defray the cost of adding to the ranks of customers who can afford to pay their doctors, drugstores and hospitals. Because the legislation creates pressure to curb medical costs, companies may merge as a way to lower expenses."
Next up -- the Senate. The Washington Post reports: "The year-long battle over reshaping more than one-sixth of the U.S. economy will now move across the Capitol. The House's approval of the Senate's version of health-care legislation, which President Obama expects to sign into law swiftly, also will send to the Senate a 153-page package of amendments to that legislation. There, Democrats will implement an obscure, but commonly used, reconciliation rule to try to pass the revisions based on a simple majority and avoid a Republican filibuster." Roll Call says "the path forward remains uncertain as Republicans comb the reconciliation package for weaknesses and Democrats hunker down in an attempt to preserve the integrity of the bill. ... A Democratic leadership aide said that much of the Conference's final battle plan will depend on the outcome of discussions with the Senate Parliamentarian, who will be the lead arbiter of procedural challenges to the reconciliation bill. Senate Democratic leaders remain unclear as to how some of those procedural issues will be addressed, and the fight over those arcane rules began this weekend."
David Frum doesn't mince words: "Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s. It's hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they'll compensate for today's expected vote with a big win in the November 2010 elections. But: (1) It's a good bet that conservatives are over-optimistic about November - by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs. (2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now." On that note, Matthew Yglesias looks at GOP suggestions that this will damage Democrats electorally, the way Lyndon Johnson's agenda did more than four decades ago: "It's true that Lyndon Johnson's Great Society -- Civil Rights Act, Voting Rights Act, Medicare, Medicaid, Title I federal education spending, and a suite of other anti-poverty programs -- played a role in the unraveling of the New Deal coalition. At the same time, the Civil Rights Act has not been repealed. Nor has Medicare. Nor has Medicaid. Nor has the Voting Rights Act. Federal aid to education for the poor is more firmly entrenched than ever in the landscape. Some of the other Johnson-era anti-poverty programs have been repealed or substantially scaled back. But we're overwhelmingly living in Lyndon Johnson's America."
Similarly, Paul Krugman writes: "I want you to consider the contrast: on one side, the closing argument was an appeal to our better angels, urging politicians to do what is right, even if it hurts their careers; on the other side, callous cynicism. Think about what it means to condemn health reform by comparing it to the Civil Rights Act. Who in modern America would say that L.B.J. did the wrong thing by pushing for racial equality?" Gerald Seib cautions that there's "one big difference: The Great Society programs were enacted in an era when Americans still tended to trust the government to get things done. By contrast, a principal reason the health bill was so hard to get to this point, and the reason it's such a political risk, is that this landmark legislation proposes expanding the government's role in the giant health economy at a time when Americans are far less likely to trust the government to do things right." E.J. Dionne says, "The passage of health-care reform provided the first piece of incontestable evidence that Washington has changed. Congress is, indeed, capable of carrying through fundamental social reform. No longer will the United States be the outlier among wealthy nations in leaving so many of its citizens without basic health coverage. In approving the most sweeping piece of social legislation since the mid-1960s, Democrats proved that they can govern, even under challenging circumstances and in the face of significant internal divisions."
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