In today’s New York Times, Paul Krugman has an op-ed criticizing moderate Democrats for wanting health care reform to be bipartisan. In the past week, I’ve been increasingly convinced that the prospects for passing health care legislation will largely hinge on how uncompromising liberal Democrats are, most significantly, when it comes to the inclusion of a government-run plan. Right now, it looks like the Democrats simply do not have the votes to pass a very liberal bill, but they might be able to pass scaled-down legislation without a government-run plan that offers lower subsidies, less intrusive regulation, and requires less tax increases. Of course, that’s only if Democrats can pare down the legislation without eroding liberal support. From the liberal mindset, reform without a government plan is not actual reform, because then you’d be left with a system in which government is merely providing subsidies for people to purchase private insurance — and to liberals for-profit insurance is at the root of the problems with our health care system. Rep. Lynn Woolsey, who chairs the 80-member House Progressive Caucus, has said repeatedly that a majority of the caucus would not vote for a bill that did not include a strong government plan. If Republican opposition to health care legislation holds, then just 40 Democratic defections would be enough to stop legislation from getting out of the House. If the progressives are as serious about drawing a line in the sand as Woolsey suggests, the bill would die even if Republicans lose some votes. Or, alternatively, we could end up with a situation in which the House passed a bill which includes a government plan, but it can’t be reconciled with a Senate bill that does not. Either way, it seems that for legislation to get passed, there will be a point at which pragmatic Democrats will have to be able to convince liberals that even if they don’t get exactly what they want, moving the ball down field is still worthwhile. That could be a tall order.
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