By Dan Froomkin
1:10 PM ET, 06/ 9/2009
When it comes to getting President Obama's health care overhaul through Congress, Republicans don't really matter. Even in the Senate, they can be circumvented, if it comes to that.
Liberal Democrats certainly don't matter. They're not about to withhold their votes, no matter how far from ideal they find the final legislation.
No, the only really important swing vote in Congress right now is those technically Democratic but often conservative-leaning members who, in the House, call themselves the Blue Dogs. Their capricious political philosophy has put them in the catbird seat -- and they know it.
So how will Obama play them? Will he let them dictate the terms of his most precious and defining legislative initiative? Or will he find some other way of stroking their egos so they don't feel like the only way to make themselves feel important is to derail some significant element of his proposed solution?
I'm thinking the latter: That Obama, the great conciliator, will be spending a lot of time in the next weeks and months lavishing positive attention on the Blue Dogs where it doesn't cost him anything more than maybe a little teeth-gritting.
Ergo, today's big event at the White House, at which Obama gave a speech about the need to adhere to the basic principle that new tax or entitlement policies should be paid for – often called PAYGO.
As the White House press office has been at pains to point out this morning, "Members of Congress, including members of the Blue Dog Coalition, will attend the event in the East Room."
Here is Obama, from his remarks as prepared for delivery:
Paying for what you spend is basic common sense. Perhaps that's why, here in Washington, it has been so elusive.
Of course, there have been those in Washington leading the charge to restore "pay as you go." Many of them are here. I want to recognize Congressman George Miller, who introduced the first PAYGO bill in the House. I also want to thank the House Blue Dogs and their leaders, especially Baron Hill, who has been a driving force in favor of PAYGO.
As Lori Montgomery wrote in The Washington Post this morning:
If approved by Congress, the rules would forbid lawmakers from expanding entitlement programs such as Medicare and Social Security, creating new entitlement programs or cutting taxes unless the cost is covered by spending cuts or tax increases. If lawmakers fail to pay for their initiatives, Obama's rules would subject entitlement programs to automatic cuts, said sources who spoke on condition of anonymity because the plan has yet to be announced.
The most contentious issue in the health-care debate is likely to come over as aspect dear to Obama's heart: the so-called "public plan." (Washington Post blogger Ezra Klein has a great "public plan" primer.) And, unless he neutralizes them, the Blue Dogs will be Obama's biggest obstacle.
Alex Wayne wrote last week for CQ about how the Blue Dogs set
strict conditions Thursday for any government-run insurance plan Congress creates as part of a health care overhaul, ruling out support for a plan that resembles Medicare — the option favored by many liberals.
And Daily Kos blogger McJoan yesterday described how the centrist Democratic group Third Way is trying to kill the public plan by advocating one that won't work.
Meanwhile, over on the Senate side, John Fritze writes for USA Today:
As Congress considers an overhaul of the nation's health care system, pressure is mounting on a small circle of Senate moderates who helped advance President Obama's economic stimulus this year.
Centrists in both parties, including Sen. Susan Collins, R-Maine, and Sen. Ben Nelson, D-Neb. — both of whom played a critical role in shaping the stimulus — are being courted by interest groups and the White House as lawmakers seek a way to provide health care to 46 million uninsured people.
Finally, here come the lobbyists. David M. Drucker and Kate Ackley write for Roll Call (subscription required):
As health care reform takes shape in the House and Senate and shows signs of veering decidedly left, business lobbyists are considering joining their Republican allies and mounting a public relations offensive to put the brakes on President Barack Obama’s overhaul plans.
Advocates for health insurance companies, hospitals, provider groups and employers have so far been engaged in a marriage of convenience, hoping that by maintaining radio silence in exchange for a seat at the negotiating table they could influence the process and obtain a reform bill to their liking.
But as legislative details have emerged in recent days and suggested the business community could be stuck with costly mandates and a government-run, public plan option, lobbying groups are preparing to step up their opposition messaging.
Christopher Hayes wrote recently in the Nation:
It seems strange, almost surreal, to say this, but the Republican Party, and arguably the whole conservative movement, is not the left's biggest enemy at the moment. On keeping a public plan in healthcare reform; streamlining student lending; and passing the Employee Free Choice Act (EFCA), cap and trade, financial regulation and a host of other structural economic reforms progressives hope to enact, the GOP is more akin to the garbage men than the alderman....
While the Republican Party shrinks, corporate interests are deftly molting their old K Street Project skin and crawling en masse inside the big tent being pitched by the Democratic Party. These same corporate interests have always had a purchase on Democrats, of course. But for much of the last decade, business interests had the luxury of spending most of their resources aiding their allies in the GOP.
No more....So far in this cycle, Democrats have captured two-thirds of the donations from the healthcare industry.
If big business's old legislative strategy was centered on relentless opposition to progressive initiatives... the new strategy is to subvert legislation through co-optation... By converting themselves, ostensibly, from opponents to "partners," corporate lobbies are trying to have it both ways: to block reforms while changing overt power struggles over the future of the economy into seemingly cooperative negotiations. At these negotiations, to use the president's favorite phrase, "everyone has a seat at the table"--except, the lobbyists get by far the best seats.
Ceci Connolly has the first in article in a Washington Post series on fixing the health care system: "Nowhere else in the world is so much money spent with such poor results," she writes, noting that the goal of health reform
is to finally get our money's worth, say industry leaders, policymakers, consumers and business executives.
They envision a health-care system that guarantees a basic level of care for everyone, shifts the emphasis to wellness and prevention, minimizes errors, and reduces unnecessary and unproved treatment. Such a system would coordinate care, track patients and doctor performance electronically, and reward good results.