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The state of health-care reform

What Greg Sargent is hearing tracks roughly with what I'm hearing: The House and Senate are nearing a compromise bill that the president can present at the Blair House Summit. That compromise looks a lot like we expected it to look: Nationally regulated exchanges, a deal on the excise tax, somewhat better subsidies and so forth. The question is simply whether the summit will give Democrats the courage to move forward. Or whether the Democratic leadership can convince its members that not moving forward is actually scarier:

Senate Dem leaders are warming to the use of “reconciliation” to fix their bill after the summit, a senior Senate aide says.

“We’re getting closer,” the Senate aide says of reconciliation, adding that the leadership is more likely to pursue that course if the summit doesn’t yield any kind of compromise with Republicans, as expected. “People want to get rid of health care. They want it off the agenda. The simplest answer is that reconciliation may be the most expedient way to do it.”

That's an important point: Pass health-care reform and it moves off the Senate's everyday agenda, which also means it moves out of the daily news cycles. Continue to let it linger and it will haunt Democrats right up until Election Day.

I'll also note that I'm detecting more confidence among Hill aides lately. They sound a lot less down and a lot less uncertain than they did a few weeks ago. The prevailing view is that everybody realizes they have to pass something, and though passing something will be hard, most are willing to bet that it will happen.

By Ezra Klein  |  February 18, 2010; 12:42 PM ET
 
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Comments

Rationality is winning out, as it generally does, eventually.

Posted by: HalHorvath | February 18, 2010 12:55 PM | Report abuse

It will soon be "fish or cut bait" time - if the summit goes well, there can be no more excuses.

It's too bad we don't have a "well-being index" that can give feed back in real time, like the stock market does. Way back when the house first rejected TARP, the stock market tanked immediately, and scared (and pressured) a lot of politicians into rethinking their vote. Unfortunately, the downside of a "no" vote on health care reform won't be immediately visible or explicit, or cause the fear and panic that a crashing stock market does.

Posted by: tnoord | February 18, 2010 1:04 PM | Report abuse

agree- now it's game theory with two rational, self-interested actors. The problem is that democrats haven't been rational for the past couple of weeks.

Posted by: Quant | February 18, 2010 1:05 PM | Report abuse

Maybe they finally realized that they will never have as big majorities for a decade, and would look like fools if they missed this opportunity to pass reform.

Posted by: jeirvine | February 18, 2010 1:07 PM | Report abuse

No chance. Holy Joe and several others will badmouth reconciliation, and the Dems will let it die, passing a few meaningless tidbits.

Posted by: AZProgressive | February 18, 2010 1:09 PM | Report abuse

Ezra- They don't have the votes in the House or in the Senate if they need 60 again. It's done

Posted by: mbp3 | February 18, 2010 1:10 PM | Report abuse

It's all well and good that they realize they have to pass something, but what I want to know is: Are the willing to pass something even if there are no GOP votes? After the health care summit they need to come out and loudly say that something will pass, and if no GOPers are willing to reach a compromise, then reconciliation is the way to go. You can't be shy about your willingness to use it.

Posted by: shmalex1 | February 18, 2010 1:14 PM | Report abuse

I wouldn't enjoy watching them try so much if I honestly thought it could pass.

It's dead, and every minute spent working on it means I'm gonna like November even more, too!

Posted by: cpurick | February 18, 2010 1:14 PM | Report abuse

Is the bill still going to have the individual mandate in it? As long as that is in there, I cannot support it without the single payer option.

Posted by: seatech1 | February 18, 2010 1:14 PM | Report abuse

"Continue to let it linger and it will haunt Democrats right up until Election Day."

Largely because, you know, it's so damn unpopular with the American people and, if past is prologue, they'll like it even less the more they learn about what's in it.

Posted by: tbass1 | February 18, 2010 1:20 PM | Report abuse

Seems like Anthem picked a lousy time, from their perspective, to jack up rates through the roof. I wonder if all this talk about rate increases will help pass health reform?

Posted by: AuthorEditor | February 18, 2010 1:21 PM | Report abuse

I'm still selling short health care reform passing the Congress and being signed by the President is still in place. Whether its the pro-life Stupak lobby, or the moderates, or the progressives, this isnt going to make it.

Posted by: zeppelin003 | February 18, 2010 1:31 PM | Report abuse

How can a political party that doesn't understand the difference between revenue and profit do anything business-related competently? Have you heard the new anti-insurance rhetoric? They are still completely ignoring the insurers profit margins. Their rate increases reflect rising healthcare costs. Their profit margins aren't significantly changing. The problem is rising healthcare costs and they aren't even focused on exploring solutions to that problem. The only thing they can process through their minds is a politically motivated anti-business rant.

Posted by: fallsmeadjc | February 18, 2010 1:47 PM | Report abuse

Can anyone walk me through the timeline for a compromise?

The Blair House meeting is one week from today, and the White House has promised in writing to post the Democrats' proposals online in advance by when...Tuesday?

Assuming that is roughly correct, that would mean that any deal between House & Senate Dems that Reid and Pelosi are confident can be passed has to be struck over the weekend...is that about right?

Posted by: Patrick_M | February 18, 2010 1:49 PM | Report abuse

I think that the Democrats will pass the bill. Republicans have understood all along that the bill, once passed, would be hugely popular and that passage would be a political catastrophe for them. Their opposition to the bill is really just a sign of desparation. Republicans are fighting for their political lives in trying to keep the Democrats from passing health care, and they are hoping that Democrats won't notice this before the elections. But Democrats have recently started to call Republicans on their bluff, so I'm pretty optimistic at this point.

Posted by: opinionpieces | February 18, 2010 2:06 PM | Report abuse

Reconcilliation may not be your silver bullet, if the goal is to get the bill off the Senate's agenda.

I hear Sen Gregg has 800+ amendments waiting if Democrats pull the nuclear trigger and ram this bill through.

Posted by: JackIL08 | February 18, 2010 2:27 PM | Report abuse

Ezra,

I would like to think they could sign the senate bill and I'm not a fan of the reconciliation part that will water down one of the few remaining cost control features of the bill (the excise tax) for our lucky union folks. I'm fine with increasing the subsidies as long as everyone realizes that that further blunts our feeling towards costs and will continue the defecit spiral out as far as the eye can see.

It's like we're the unemployed and the government's giving us the ARRA subsidy so its OK but the fact is that its not. Costs are still and will continue to spiral out of control, we just will be immune to it.


And I don't believe that the bill is popular. Most pieces out there have its approval at all time lows. And then we get to the taxes next year. Just in time for 2012 election talk.

Posted by: visionbrkr | February 18, 2010 2:34 PM | Report abuse

During the Bush years the republitards rammed a whole lot of crap down our throats that was not in our best interests. I don't understand why the scaredicrats can't do the same with bills that are in our best interest.

Posted by: charlie51 | February 18, 2010 3:14 PM | Report abuse

Does this look like negotiation or "We are open to new ideas or suggestions?"

QUOTE: Or whether the Democratic leadership can convince its members that not moving forward is actually scarier:

Senate Dem leaders are warming to the use of “reconciliation” to fix their bill after the summit, a senior Senate aide says.

“We’re getting closer,” the Senate aide says of reconciliation, adding that the leadership is more likely to pursue that course if the summit doesn’t yield any kind of compromise with Republicans, as expected. “People want to get rid of health care. They want it off the agenda. The simplest answer is that reconciliation may be the most expedient way to do it.”
UNQUOTE

Looks to me as if they have their minds made up and either the invitees go along or Mr. Ried and Obama will put their ear muffs on. Some compromise meeting. What a sham@!

Posted by: nancycrichton | February 18, 2010 3:32 PM | Report abuse

When reconciliation works for health care/insurance reform it will be the END for ex-dixiecrap southern republican hopes for November 2010. It will be followed by energy, cap and trade, education, jobs and every other public interest initiative that has been bottled up in the country since Lyndon Johnson left the White House.

Get ready for it.....

Obama will be seen as the greatest President since Lincoln and General Washington....

Economic Prosperity will follow in SPADES.

Posted by: project2 | February 18, 2010 3:44 PM | Report abuse

With the addition of a public option, the popularity of the bill would go up. Insurance companies nor Republicans want that to happen which is why they keep trying to bury it. Come on, Senator Reid, put it to a vote.

Posted by: breinecker | February 18, 2010 3:48 PM | Report abuse

Reconciliation WITH a public option sounds great to me.

Posted by: frrichl | February 18, 2010 3:58 PM | Report abuse

Are you people serious with all your Public option BS !!! This HCR bill is so inflated with Billions in ear marks it's no even funny !!! And you really want your party of ear marks to pass this monster of a bill, How many of you have taken the time to read this Bill ??? or even the first 100 pages of this Bill other than believing what someone tells you whats in it ?? I'm sure there's non of you that has read page one !! Reconciliation is and will not nor is it allowed in the rules of either house this isn't a bill for spending, this is a bill to create a new program therefore reconciliation can not be used understand how Congress works before running your mouths about what Congress should or shouldn't do and you wonder why we are were we are in history !!!! Get people to work and put the rest of TARP and Stimulus back to pay down the deficit and you will see business hiring again, get the unions and special interest out of DC once and for all, We The People are and should be Congress only special interest we all should be treated equal, if you don't like it here leave, France, the EU, Spain are all doing oh so well move the hell over there !! You can have the same effect with HC over there and see first hand how wonderful it is and I bet money your'll be changing your tune on having this HCR bill passed !!! OH and expect all your taxes to go sky high no matter if this HCR is passed, look at all the F!@#ing spending the DEms are doing now, and look, no job's, Wait until next months GDP numbers come out, there not going to be as rosy as they were this last month either !!!! You Liberals are all the same, give me give me give me !!! How about getting a 4 lettered word JOB and stop sucking off the GOv't and other peoples money for once in your lives, Please !!!!!!!!!!!

Posted by: dwenzel2 | February 18, 2010 4:39 PM | Report abuse

Bottom line. Passing reform is the right thing to do. So they need to do it and not worry about making everyone happy. I don't like some of the things, but as someone who beleives we have a responsibility for the greater good, it needs to happen. We need another Lyndon Johnson in Congress. We need a leader.

Posted by: Sachem68 | February 18, 2010 4:42 PM | Report abuse

I have heard pollsters including Andy Kohut say that when people are asked if they support the proposed health reform bill, many say no. But when asked if they support various features, listed one at a time & not identified as the current plan, there's a high degree of support.

From listening to people talk & reading what they write on the opinion pages of local papers, it seems that few people actually have any idea what's in the bills, but that doesn't keep them from opposing. It's their fear of the unknown, coupled with their susceptibility to the opposition buzz words (massive government takeover, death panels, etc etc) that is driving a lot of the public opposition.

We all feel apprehension about the cost & this needs sustained attention, even after any reforms are passed, to keep finding ways to control costs. However we need to understand that not everyone means the same thing when they say 'control costs.' Some are looking at the overall costs to the economy, regardless of who is picking up the tab. Others think of costs only in terms of how much is paid out of public coffers (taxes). BOTH have to be considered! You can squeeze publicly sponsored expenditures to the bone, without reducing the overall costs to the economy - which means that instead of, say, Medicare, the VA, Medicaid etc paying, individuals/families pay out of pocket. Well-to-do people can do this. The rest of us can't. It's the OVERALL cost of health care to the economy, that really must be controlled. This needs a lot more thought & work on a continuing basis.

Kohut said that polls show that a majority of people say they want Congress to keep working on health reform and get something passed.

I believe that if people shut out the scare-words and actually learned what is in the bill, support for it would go way up. Hopefully, the upcoming summit will help to get across some real information and also let us hear some debate and analysis of various aspects and viewpoints. I'm really looking forward to it!

Posted by: PeggyB1 | February 18, 2010 5:09 PM | Report abuse

Let it die Ezra and give the electorate 8 months to forget about it. It's the economy stupid

Posted by: green102 | February 18, 2010 5:12 PM | Report abuse

While the Dem leadership considers Reconciliation they might like to consider a couple of salient points:

First, will passing some sort of HCR using Reconciliation pass the Senate Rules test. We are not discussing a budgetary expenditure, but an entire new [entitlement] program. Since this procedure was intended to be used to settle finance questions it would probably end up thrown out in the Courts. (Of course, like any other lawsuit, it will take years to go through the system; by which time HCR will be such a boondoggle it cannot be undone.)

Second, outside of many WaPo readers, HCR as being presented by either House has a negative popularity coefficient. Push a bill like either on the American People and you could end up with something that makes the TEA Parties seem like the good old days. Any Senator not from the bluest of blue states who votes affirmative puts their seat on the line. It is the non-aligned voter that will show our displeasure in the voting booth. (In full disclosure: I am opposed to either HCR bill as written, cannot see a compromise bill that does not include any opposing viewpoints as a compromise, and live in a state where the Dem Senator is showing some weaknesses.)

Posted by: Erisian | February 18, 2010 5:20 PM | Report abuse

Keep your eye on the letter circulating around the Senate supporting a public option through reconcilliation. It's at 19 now. If it gets close to 50 watch the Republican's cave on the filibuster. A public option through reconcilliation will be a plan the Republican's corporate masters cannot support through a process the Republicans will have no control over.

Posted by: joe_potosky | February 18, 2010 5:22 PM | Report abuse

Mr. Klein is one good Obama sycophant but he is fighting the tide of history and the anger of the citizens of this country that work and pay taxes and do not live on the dole. Just look at who were the mentors and teachers of this Obama, they were communists, Marxists, traitors, socialists,
black nationalists, and misfits. Obama cannot help himself, it is ingrained in him to be an arch-leftist radical and activist, and nothing more. He has been a disaster as President and will destroy the Democrat Party.

Posted by: walterndebby | February 18, 2010 5:30 PM | Report abuse

Well excuse me while I sit down! Gawd.

T.S. Elliot wrote: "And, at the end of all our journeying, will be to arrive where we started, and know the place for the first time."

Well, Congressional Democrats may finally be arriving....and it's where they've been all along. They're all alone in this...together.

To our elected Democrats in Congress:

1. Healthcare Reform. Pass the damned thing. Put the public option in and MOVE ON!
2. Be bold. Change the things you said you would. Pass real and effective banking reform and for the love of God regulate the OTC derivatives market before its too late AGAIN.
3. You'll never get an ounce of anything but obfuscation from your 'colleagues' across the aisle. Ever. Get right with that.
4. Show what we've always known: Americans don't hate all government, just stupid and ineffective government.
5. Stop being such a bunch of spineless wimps when things get tough. It's embarrassing. When you hear incoherent crap from Republicans and Tea Baggers, call em' out! You've got nothing to lose but collapsing poll numbers.
6. As the saying goes "hang together or hang separately."
7. Follow Obama, he's the only one you've got that can step into the ring alone with 140 Republicans and make THEM regret it.

I promise you, bold and effective governance in the face of economic stagnation is your only hope of recovering independent voter support, not to mention your base.

This recession is so structural that elevated unemployment will be with us for YEARS to come. It won't be 'Morning in America' for a long while.

Posted by: sdavis3398 | February 18, 2010 6:25 PM | Report abuse

Ezra,
I noticed you have not changed your middle name to OBAMA, yet. When will you stop being a cheerleader for the Far Left Wing of the Democratic Party? We need factual unbiased reporting from the Post and they allow you to be a lap dog of the President. With the status of Social Security, Medicare, Fannie Mae, and Freddie Mac how do you expect the government to run anything? The current Socialist regime has only one goal and that is to make everyone dependent on the government. If you continue to buy into their big government agenda you will find yourself without the right to work for the Post. The administration will start to write your articles as it appears as if they already have. How about some critical journalistic analysis rather than water cooler talk from a bunch of Leftist aides? When are you going to grow a pair and start leveling with the people. The government is incapable of creating jobs and based on the performance of their Census Team are incapable of handling Health Care either. Good luck on getting a job once the Obamaites Nationalize the press.

Posted by: Raven7 | February 18, 2010 8:41 PM | Report abuse

Everyone agrees that we MUST save money. Medicare for all is the only real way to save money. Profits for a few rich people are NOT a public purpose.

Medicare for all NOW is the only thing which make sense.

Posted by: Allannde | February 19, 2010 12:26 AM | Report abuse

The New York Times is reporting that the White House is drafting a reconciliation bill, that Congressional Dems have not seen it, and that the proposed legislation will be posted online on Monday evening:


http://www.nytimes.com/2010/02/19/health/policy/19health.html?hpw

Posted by: Patrick_M | February 19, 2010 1:19 AM | Report abuse

I am all for Democrats taking the reconciliation step. It will be a good move for Democrats until they can take away the always used weapon of the filibuster. Republicans have gone to the darkest and most wicked position to keep from disappointing corporations and the ultra wealthy. Unfortunately we can add the conservative republican democrats who are with them 100. If these people cared about Democratic principles above greed and profit then Lieberman, Landrieu, Nelson and Lincoln would not have been so opposed to the best policies in Health Care Reform like the public option. These are the gutless ones that join the obstructionist republicans who want corporations to run our country.

Posted by: equalon | February 22, 2010 1:24 AM | Report abuse

Democrats will have to get a spine and a baseball bat. If republicans are so determined to tell lies, attack the President of the United States with lies, and just lie if they are talking how can any Christian in any area of the country not realize how much more satanic republicans have become.

Posted by: equalon | February 22, 2010 1:31 AM | Report abuse

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