Breathe: On the aftermath of Massachusetts I

Breathe.

Take a step back.

You need to make sure you don’t get caught up in perhaps the most damaging features of our public life: our inability to look beyond the day’s news and put each day in perspective.

The world and American politics did not change dramatically last night. The prospects for health care reform are not all that different than they were yesterday.

The Election

To begin with, don’t over-interpret the election. Special elections are always odd because, as much as we tried to convince them to do so, voters don’t think of these elections as determining the future of the country. And the idiosyncratic, local phenomena that get washed out when you look at 30 Senate and 435 House races can play a huge role in any single election.

They did so in this one. Coakley ran a horrible campaign. At a time when the Republican theme was that the Obama was out of touch, over-reaching, and arrogant, Coakley ran a campaign that played into their hands.

And she was not helped by the unpopular Democratic Governor and legislature of Massachusetts.

So this election was not mainly a referendum on health care reform.

And to the extent it was, it was a weird test case because Massachusetts already universal health insurance—which is quite popular in the state. So voters in Massachusetts could vote against health care reform without losing anything.

Indeed, while Scott Brown ran in opposition to the federal bill, he did so in support of the Massachusetts health care plan, which he voted for and which remains enormously popular.

“In September, 2009, a new poll by the Harvard School of Public Health and The Boston Globe found 59% of Massachusetts residents who are aware of the state’s health reform legislation, which was enacted in 2006, support it. A little more than one in four oppose it…Massachusetts is currently facing the impact of a severe recession, state budgetary and fiscal problems, and continued rising health care costs. Despite this difficult environment, the poll found that 79% want the law to continue, with 57% favoring continuing it with some changes and 22% continuing it as is. Only 11% of state residents favored repealing the health reform law. There has been no change in the last year in those supporting repeal of the legislation–12% in 2008 versus 11% in 2009.” http://www.medicalnewstoday.com/articles/165572.php

During the campaign, Brown said

 “Why would we subsidize and why would we pay more for something we already have. It makes no sense.” http://dailycaller.com/2010/01/13/republican-scott-brown-defends-his-vote-for-mitt-romneys-massachusetts-health-care-plan/

If there is any national implications of the race, it is, first, that the national economic climate has hurt Obama and, as I explain in my next post, that by not taking a strong enough principled stand in of favor a government action to make the economy work for all of us, not just in health care but in regulating financial markets and in protecting peoples homes, Obama has allowed himself to be tarred with the failure of the Bush administration and Brown (and previously Christie in New Jersey) to present themselves as agents of change.

The Consequences of the Election Generally, Part I
Right now we have 60 votes in the Senate. But on any given issue, the reliable Democrats range from 57 to 59. We couldn’t get top sixty to enact all of our progressive ideas on any issue really important to us, health care, EFCA, cap and trade, or financial regulatory reform.

Now we have 56 to 58 votes. We still can’t break a filibuster in order to enact the most progressive legislation. And so we will have to compromise a bit more than we might have with one more vote. But the difference is not that great. If that one vote were so important, the Senate health care bill would have included a public option.

The Consequences of the Election for Health Care

I’m not sure what our strategy for moving forward on health care is going to be. I’ll have a better idea in a day or two. My guess, however, is that we are going to call for a two step solution. Step one is to pass the Senate bill as is. Step two is to fix it with a second bill that improves some of the worst features of the Senate bill: the excise tax, the less generous affordability tax credits for people with low incomes and, perhaps, a better employer responsibility plan than the Senate bill. That bill will pass the Senate through the reconciliation process. Whether we can enact a national Exchange instead of state Exchanges through reconciliation is not clear. But I think it is possible. (We clearly can enact a public option through reconciliation and perhaps the use of reconciliation will revive that idea, if not now than in the future.)

So we will get a decent health care bill. It may not be as good as the one House and the Senate were going to pass. But it will have the most of the insurance market regulations, the affordability tax credits, the Exchange, and maybe even employer responsibility (or at least a fix to the lousy Senate employer responsibility provisions.)

The bill won’t be close to ideal. But it will help many, many people. And it will be a base on which we can build.

Perhaps there will be other ways of dealing with this new situation. But I’m fairly confident that we will find one.

The Consequences of the Election Generally, Part 2

Moving forward, losing this 60^th seat might embolden Democrats to do something that they should have been considering all along: revising the filibuster rules, perhaps along the lines that Joe Lieberman suggested five or six years ago, by gradually reducing the number of Senators needed to break a filibuster over time.

This will not be easy to do. The Senate is a hide-bound institution; powerful interests like the filibuster, including many Senators; and Democrats will be worried about being charged with changing the rules after the game has begun. But continued stalemate and frustration concentrates the mind and might lead to re-thinking the filibuster which, I believe, if fundamentally unconstitutional.

Keep Breathing

One of our problems in politics is our short attention span and impatience. That’s partly why Obama is getting blamed for the economic failures created by the Bush administration. It is why progressive get so incredibly frustrated by every glitch on the road to health care reform. And it is why leftist can’t seem to grasp that reform in America has always been incremental.

If we want to be effective, however, we have to take a bit longer view and keep our wits about us as circumstances change form day to day. That, and plugging away at the slow process of change, will get us health care reform and more.

More

To get more¸ however, I think we need to recognize that some of the strategic and rhetorical choices we—and especially the President—made in the fight for health care reform are problematic. I turn to them in a second post.