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Counting the votes for health-care reform


In case you missed it, the big news this weekend was that the House passed health-care reform. But the mild surprise was that it barely passed health-care reform. In the final tally, 220 congresspeople voted for the bill -- two more than needed to achieve passage. But two votes is not a very large margin, and 39 Democratic defections are worth taking seriously.

The hard question to answer, however, is whether there were 39 Democratic defections or 39 Democrats who voted against the bill. Because within that 39 are some Democrats who were solidly against the legislation, but also some vulnerable or conservative Democrats who would have voted for the bill if Pelosi had needed their vote.

You saw the difference between the two groups a few minutes before the final vote. At almost 11 p.m., Eric Cantor (R-Va.) raised a "motion to recommit with instructions." A longer explanation of that parliamentary maneuver is here, but for the moment, think of it as the House's version of a filibuster. If it succeeded, health care would've been thrown back to the committee. It failed. And not by a slim 220 votes. A solid 244 Democrats joined three Republicans (including, interestingly, Ron Paul) to defeat the GOP's effort to stall the bill. Only 13 Democrats defected, suggesting that fairly few of the Democratic "no" votes were out to doom the legislation.

One of the other explanations for the number of Democratic defectors is that a certain percentage of Democrats would like to vote for health-care reform but didn't want to vote for this bill. Most believe that the Senate will pass a more conservative bill with a smaller public option, tighter language on immigrants, no surtax on income, and no employer mandate, among other modifications to the more controversial elements of the House's bill. They also believe that the final bill will look more like the Senate bill than the House bill. If that proves true, they'd prefer to vote against the initial House bill so they're not attacked for supporting policies that don't survive into the final legislation. After all, if you don't think an employer mandate will be in the final bill, why anger local businesses by casting a symbolic vote for one?

All that said, the fact that there might have been more votes for health-care reform if Pelosi had needed them doesn't obviate the fact that more congresspeople didn't vote for health-care reform. However you slice it, 39 Democrats worried that voting for this bill was a political liability, and decided that opposing it was, for the moment, the safer play.

Correction: I'd been a bit confused on the "motion to recommit." Turns out there are two variants: one that effectively kills the bill and is analogous to a filibuster, and one that is used as a rapid amendment process. The version the GOP employed was more of the rapid amendment type, so the bill would've been amended with the Cantor's medical malpractice provision, and then sent back for a vote.

Photo credit: Yuri Gripas/Reuters.

By Ezra Klein  |  November 9, 2009; 10:35 AM ET
Categories:  Health Reform  
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Next: Lieberman will filibuster health-care reform 'as a matter of conscience'


My most important question from the weekend is whether the anti-abortion folks were just looking for a cosmetic political win in the House bill, or whether they really will reject a final bill without their restrictive amendment. If its the latter, then the razor-thin margin of the bill suggests that the Dems don't have the votes without the abortion restrictions.

Posted by: wisewon | November 9, 2009 11:03 AM | Report abuse

The Stupak amendment was indeed bad news and a blight on health care for women, but at least it does show the limits on popular support for health care reform in a way that the Senate process does not. I can only hope that if this first step in health care reform is passed and people become comfortable with it it can be improved in the future in the way that Social Security, Medicare and even welfare reform were improved and expanded past their initial state.

Not that this was ever a possibility, but one can imagine a counterfactual in which single payer was a real possibility. We liberals think that would be a good thing, all else equal. But imagine single payer covering all Americans passed only with the addition of something like the Stupak amendment -- and what would the chances be that it would pass without something like that?

Posted by: robbins2 | November 9, 2009 12:03 PM | Report abuse

Wisewon- Stupak suggested that the vote was all the abortion foes wanted, and that had the ammendment failed, he still would've delivered enough votes to pass the bill as a whole. So I suspect that if it's stripped in Conference, Pelosi will still be able to round up 218. But I really don't know; if I could get in the heads of Conservative Dems, I wouldn't find them so frustrating.

I also wonder- and this is a crazy theory- if the thin vote margin actually STRENGTHENS Pelosi's hand in Conference. After all, can't she go in there now and say, "I only passed it by FIVE votes, and one of those was a epublican who's probably already in Witness Protection. I don't have any room to give anything away"?

I suppose Reid will be able to say the same thing given the filibuster, but this is at least a better position than Pelosi was in on the stimulus.

Posted by: colby1983 | November 9, 2009 12:28 PM | Report abuse

Hey, Mr. Klein, that's a helluva correction. The whole logic of your post depends upon the "house filibuster" characterization of the motion to recommit. If it was really just an expedited amendment process, then the conclusion you draw from the 244 votes is completely invalidated.
Before you pontificate on the finer points of Robert's Rules and effect pretension to incisive comment, maybe you should have a clue what you're talking about.

Posted by: reheiler | November 9, 2009 2:46 PM | Report abuse

RE: Reheiler

I read back the post by Mr. Klein taking your advice in consideration:

Paragraphs 1 and 2 are valid even with the "wrong" interpretation of the "motion to recommit..."

Paragraph 3 which is where the difference in vote is mentioned between the passage of the bill and the motion to recommit, even with the milder interpretation of the "motion to recommit," the statement is valid--even more so.
Paragraph 4 brings in additional thoughts, independent of the "motion to recommit"

Paragraph 5, provides the conclusion that 39 democrats thought it a liability to vote for this bill--pretty much a logical inference from the previous paragraphs.

Finally, Robert's Rules of Order were patterned after the parliamentary procedures in the House of Representatives, but since their creation, these have been revised and modified (the latest are the RONR). There is no motion to recommit in Robert's Rules of Order. The House recognizes three forms of this motion--two of which serve to kill the bill, and one which once adopting an amendment, allows for the main motion to go on in the same session (this latter requires the word forthwith in the motion). So, strictly speaking the House does not follow Robert's Rules of Order.
I believe the gist of Mr. Klein's statements stand.

Posted by: vpepascoe | November 9, 2009 4:32 PM | Report abuse

Rumor is there were at least 10-15 catch and release votes. This seems highly probable if you look at the public statements of those who voted NO.

Posted by: bmull | November 9, 2009 10:30 PM | Report abuse

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