The prospects for comprehensive health care legislation remain dim, despite this week’s political theater.
President Obama on Monday removed speculation about whether he would scale back his health care ambitions in the current political environment, releasing a plan that increases taxes, spending, and regulation even more than the Senate health care bill that has been overwhelmingly rejected by the public.
The brazen move, coming just days before a scheduled health care summit, was accompanied by a renewed willingness to use the reconciliation procedure to ram a health care bill through the Senate with just 51 votes. Taken together, some commentators see a growing momentum for finishing the health care legislation that was put on life support after Sen. Scott Brown’s surprise victory in Massachusetts.
But regardless of what happens at this week’s superfluous summit, it’s difficult to see how Democrats cobble together enough votes to pass a final health care bill in the House.
Back in November, in a much better political environment for Democrats, Speaker Nancy Pelosi was able to muster only a narrow 220 to 215 majority in the House to pass its version of health care legislation. Since then, Rep. Joseph Cao, the one Republican who voted for the bill initially, has indicated he wouldn’t do so again because of objections to the abortion language. In addition, Florida’s Robert Wexler unexpectedly resigned, Rep. Neil Abercrombie announced plans to retire at the end of this month to run for governor of Hawaii and Rep. John Murtha passed away. Taken together, that brings Pelosi down to 216 votes — which would be insufficient to pass a health care bill.
The Obama administration has pushed the argument that Democrats will be attacked on health care anyway, so they may as well pass a bill so they have an accomplishment to run on. “We own the bill and the health-care votes,” Obama adviser David Plouffe wrote in the Washington Post after Brown’s win. “We need to get some of the upside.”
The problem with this analysis is that even if one were to accept the fact that jamming through a massive and highly unpopular piece of legislation could be a political winner for the Democratic Party as a whole, it doesn’t mean that it’s necessarily good for each individual Democratic member of Congress. This is especially true for the Democrats who hold seats in conservative districts. While some liberals have noted that the failure of Hillarycare didn’t save Blue Dog Democrats in 1994, in that year, the bill never came to an actual vote on the House floor. By contrast, last year 39 Democrats went on the record and voted against the House bill. They will be in a much stronger place to counter any Republican attacks by holding firm in their opposition than if they flip and support the bill at the behest of Obama and Pelosi. A deeper look at votes by Congressional district makes this even more apparent.
Of the 39 Democrats who voted against the House health care bill, 31 of them were elected in districts that went for John McCain in 2008, according to a TAS analysis. One of the Democratic “no” votes, Rep. Parker Griffith of Alabama, has subsequently switched parties. Given that a Republican who campaigned on being a vote against the health care bill was just elected to fill the Senate seat once held by Ted Kennedy in a state that went for Obama by 26 points, it’s hard to see why anybody in a McCain district who already voted “no” would decide switch their vote to “yes.”
While Obama won the districts of the remaining eight “no” votes, in six cases, he won by only single digits, making them potentially competitive races this time around. And a closer look at several members who represent these areas are not very encouraging to proponents of Obamacare.
For instance Rep. John Barrow, representing a Georgia district that Obama carried by 9 points, called for hitting the “reset button” after Brown’s win. “I don’t think we need a comprehensive, sweeping overhaul of our system,” he told the local Effingham Herald. “I think what we need is incremental change.”
North Carolina Rep. Larry Kissell, who represents a North Carolina district that Obama carried by five points, voted against the health care bill in November citing cuts to Medicare — which still exist in the current bill. A January poll by Democratic firm Public Policy Polling found overwhelming opposition to the bill among his constituents, and concluded that “Kissell’s no vote appears to have insulated him from some of the ill will toward national Democrats in the district.”
Freshman Democratic Rep. Glenn Nye of Virginia won in a district that Obama carried by just two points. In last November’s governor’s race, the same district went for Republican Bob McDonnell by a 24-point margin.
There are two Democrats who voted “no” the first time around that come from solidly Democratic districts, but neither of them is likely to change his vote. Rep. Dennis Kucinich is a committed single-payer advocate who viewed the first bill (which included a public option) as too favorable to private insurance, and he’s attacked the Senate version as a handout to insurance companies. Rep. Artur Davis is now running statewide to be governor of Alabama, and not only has he maintained his opposition to the health care bill, but he has attacked his Democratic rival in the primary for supporting it.
This analysis, keep in mind, is under the best-case scenario in which Pelosi hangs onto every vote she originally had. In reality, Pelosi could have a tough time convincing nervous Democrats in moderate districts who voted against the bill the first time around to vote for it a second time.
The biggest problem she faces is that President Obama’s proposal maintains the abortion provision in the Senate bill, rejecting Rep. Bart Stupak’s more restrictive language. When the bill passed the House the first time around, 41 Democrats voted for the health care bill only after voting for the Stupak amendment. Any of them could explain switching to a “no” vote on a final bill by citing abortion funding. Stupak himself has said there are at least 10 to 12 Democrats who voted for the bill the first time who would vote against it if it didn’t include his amendment (he reiterated Tuesday morning that the Senate abortion language adopted by Obama was still “unacceptable”). One of his co-sponsors, Rep. Brad Ellsworth, said at the time that he was only able to vote for the bill after the Stupak language was adopted, and he’s now running for Senate in Indiana, where a Rasmussen poll taken last month shows voters oppose the health care legislation by a 23-point margin.
Pelosi will have to make up for any votes she loses by picking off members among the 39 Democrats who already voted “no.”
None of this is to say that it’s literally impossible for Pelosi to find the votes necessary to pass a health care bill. There are several retiring members who may be willing to vote for it because they don’t have to stand for reelection, some may be won over by provisions in the latest version of the bill, and a few may be willing to take suicide votes for the team. But this week’s political theater shouldn’t obscure how difficult it will be for Obama to get a comprehensive health care bill across the finish line.
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