Byron York
writes that the Democrats might ram a health care bill
through the Senate using reconciliation, even if that means not
getting everything they want. He quotes "one old Senate hand" as
saying, "You can build a building that's missing certain
features. Maybe the plumbing's not there, or the wiring. But the
bottom line is, you have laid the foundation, and built the
structure, and it becomes easier later on to add the plumbing,
and add the wiring. You have set up a structure so that all you
have to do in the future is make incremental changes."
The problem with this is that reconciliation probably can't be
used to create health insurance exchanges or to require insurers
to cover people with pre-existing conditions, among other things.
Those two provisions are more fundamental to the Obama approach
to health care reform than the public option. You can be missing
the plumbing and the wiring, but without those elements you
haven't laid the foundation or set up the structure.
Second, while I think an incremental strategy would serve the
Democrats well, that doesn't seem to be where their base is right
now. They don't want another SCHIP or an expansion of Medicaid.
They want federal universal health care. And for single payer
advocates among them, the public option is the
incremental compromise. Take that element away and the plan's
poll numbers dip, its grassroots support melts away, and some
liberal House members' votes are lost (or at least that's what
they are claiming right now). Plus, a stripped down health care
bill that would be worth passing from the perspective of an
Obamacare supporter would politically be all pain -- it would
have to contain an individual mandate now while saving the public
option for later.
Granted, the Democrats could still go this route. And maybe
they'll be able to roll the parliamentarian, so that things that
are technically extraneous to the budget process still get passed
through reconciliation. But to move away from the building
metaphor, they seem to want to go for the touchdown rather than
call in the field goal unit.
