Posted by
Andrews on Thursday, October 15, 2009 11:23:01 AM
In recent comments on this blog I have been discussing the signs we will have that health care reform has become a dead issue. For those who have not been following the discussion, the short answer is this: As I described in "
Desperate Media" the fact that the Baucus bill made it out of committee, and even got Olympia Snowe's vote, means nothing. Even a senate victory would be largely meaningless. It won't be until we actually see the house vote that we will know.
Of course that is not that helpful, as the house vote will not only be definitive sign, but also decide the fate of the bill. So, is there an earlier sign? Something that can give us a hint of what is in store? Or what the Democrats believe their chances are?
And there are. At least a few.
First, that senate vote may be the first sign. I do not doubt that, being more secure in their seats, and with only one third up for reeleciton in 2010, many in the senate will have no problem staying loyal tot he party and voting for the bill. Most who do so will likely expect that by 2012 or 2014other issues will be prominent and no one will recall their vote on this bill. (In that, especially regarding 2012, they may be wrong. With Obama up for reelection, health care reform may be a very big issue.) But that does not mean the vote will not be telling.
Two things will let us know which way the wind is blowing. First, the overall senate vote. While it will mostly be along party lines, it will be interesting to see how many of either party cross over. If there are even a handful of Democrats either crossing over, or even simply abstaining, that is a good indication that some think the bill is toxic and that they expect the house to fail to pass it. On the other hand, Republican crossovers are less meaningful. I even expect the "usual suspects", the liberal New England Republicans and a few others, to vote with the Democrats in exchange for concessions. So, while Democrat crossover votes are interesting, Republican ones tell us less.
The second sign will be the way those up for reelection vote. More than the total senate vote, the vote of those up for 2010 election will show us which way things are tending. If they vote in smaller numbers than the general senate, then we will know that they anticipate a vote for the bill might be problematic. And if a senator thinks so, then a member of the house is even more likely to be concerned.
But the Senate vote is not all. There is one more sign, which may be even more informative, though it will be harder to spot, as it will be a very quiet event.
If, as the Baucus bill wends its way through the senate and house a Democrat introduces a bill to either increase SCHIP funding or to establish some sort of insurance co-op, even a plan to encourage cheaper individual coverage or other means to increase coverage for some small group of uninsured, that is a clear sign that things are going badly for the health care reformers. You see, Obama has staked a lot on "health care reform". He hopes to make it a big reform, like the Baucus bill, or even better, from his perspective, a single payer system (that is de facto nationalization). But, if he can't get that, he needs something for his party fellows to take home in 2010, and for him to use in 2012. So, if he can't get a big bill, likely he will try to inflate a small bill. The same way Clinton followed up the HillaryCare fiasco with a number of extensions to various programs, I would expect Obama will try to paper over a defeat of health care nationalization by claiming credit for SCHIP extensions, "well baby" plans, insurance co-ops, individual incentives and other half-steps.
So, that may be the best indicator of the Democrats' own assessment of their chances. If they have heard from enough blue dogs that they lack support, then expect them to quietly introduce some sort of half-way reform. That way, if they need to postpone, or silently kill the big reform, then they will still have a way to claim victory, even if it is really quite a hollow victory.
POSTSCRIPT
Don't imagine that I think such plans, extending SCHIP or creating less than universal co-op coverage, are not damaging. Clearly they harm the economy and drive medical costs, they are just not as harmful as total nationalization, or even universal insurance through a "public option" would be. So, though it will hurt to have such half-measures passed, it will hurt a lot less than the full Baucus bill will.