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Congress gets another voice on health-care reform

225px-JGcolorpress.jpgBrian Beutler looks at what "yesterday's overwhelming, historic Republican victory" means for health-care reform:

The NY-23 seat abdicated by Republican John McHugh (who resigned to become Secretary of the Army) went to Democrat Bill Owens -- the first Democrat to hold the seat in over a century. And the CA-10 seat abdicated by Democrat Ellen Tauscher (who resigned to become Under Secretary of State for Arms Control and International Security Affairs) went to Democrat John Garamendi.

That creates some simple arithmetic. Yesterday, Democrats had 256 voting members in the House. By week's end, they'll have 258. Last week, House Speaker Nancy Pelosi could afford to lose no more than 38 Democratic votes on a landmark health care reform bill. Next week, after Owens and Garamendi are sworn in, she can lose up to 40. For legislation this historic and far-reaching, she'll need every vote she can get -- and both seem likely to support reform.

Garamendi has a long history in health-care reform. In the early ’90s, he was serving as California's Insurance Commissioner. Working alongside Walter Zelman and, later, Paul Starr, he developed the framework that would later become Clinton's health-care plan -- a triumph of health-care policy, if not politics (you can read a bit about this in Paul Starr's "The Logic of Health Reform" [pdf]).

In other words, Pelosi got more than another health-care vote out of Tuesday's election. She got another health-care wonk. It's probably a bit late for Garamendi to establish himself as a player in this reform fight, but the proposal is going to need guidance and modification after it's passed into law, and it'll be interesting to watch whether he proves a player in that phase.

Photo credit: California Department of Insurance

By Ezra Klein  |  November 4, 2009; 3:07 PM ET
Categories:  Health Reform  
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Ezra, only vaguely on-topic but: I was thinking about the compelling graphs you showed that many procedures are so much more expensive in the US than in Canada in elsewhere. So I got to wondering, if it's so much cheaper in Canada, why don't more Americans go there for non-emergency care? I mean if TV's cost 50% in Canada what they cost in the US, there would be huge northbound traffic. So why not CAT scans? Why doesn't some enterprising health insurance company find a way to incent its patients in northern border states to get treated in Canada? If it only costs half as much for the same level of care, you'd think they'd find away to pass some of those savings to the consumer and everybody wins.

Posted by: crust1 | November 4, 2009 3:52 PM | Report abuse

That's why Nancy Pelosi said that she "won" last night. She got 2 more health care reform votes from last night's election.

They are going to need EVERY SINGLE vote for I suspect that Nancy is going to give some of the blue dogs a "pass" to not have to vote for the legislation.

Posted by: maritza1 | November 4, 2009 3:57 PM | Report abuse

Ezra - you should make it a little clearer what this means:

John Garamendi is more a clear cut progressive than Tauscher and much more likely to support the strongest healthcare proposals put foward. Tauscher wasn't a Blue Dog, and not anti-reform. But the NDC like the DLC is more than a bit Corporate and willing to water things down more than Progressives want.

As you say, this is a significant upgrade.

In NY-23, we had a seat that wasn't going to vote for the Healthcare bill at all even when a "moderate" Republican held it. With Owens, we do get a Blue Dogs. But he also seemed to read the tea leaves as the summer unfolded, moving from his anti-Public Option stance to this just days ago:

Owens is also a new Dem in Congress, with the vote coming right up. It seems unlikely that he would want to cast his first major vote so soon *against* the bill his own party is floating.

Garamendi can strengthen the Progressive Caucus and their efforts to keep the bill from getting increasingly watered down in the remainder of the process. Owens gives Leadership another Vote to work with to get 218: a vote that didn't exist on the weekend.


Posted by: toshiaki | November 4, 2009 4:09 PM | Report abuse

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