I don't think I've ever been so angry at Democrats across the board. It isn't just the fumbled special election in Massachusetts. It's the total meltdown among Democrats in the House, the Senate, and the White House. Near-universal coverage bills have passed each chamber of Congress. We are one yard from the end zone. Just a week ago, we were on the cusp of a cross-chamber agreement.
Yet ever since the Massachusetts election, we're at in an unbelievable impasse. The Senate is telling the House "ball's in your court." The House is saying "We're not gonna." And the White House seems to simply be saying "you guys figure this out."
Now, we're getting articles about scaling the bill back? House progressives want to break the bill up? Are people going insane? The Senate bill is the last, best game in town. This is no time for brinkmanship. It is not the time for redesigning the wheel. It is not the time for backing down. Just pass the f***ing Senate bill, as Paul Krugman says.
Right now, numerous proposals and trial balloons are being floated by members of the House, left, right and center. Some have called for pairing the bills back to just a "Patient's Bill of Rights." Others have called for starting breaking it into multiple bills, and Raul Grijalva has proposed a bizarre scheme to put budgetary changes through reconciliation and, instead of passing the Senate bill, creating a whole new bill full of insurance regulations that the Democrats should challenge Republicans to filibuster.
I'm sorry, but this is crazy. The best, simplest, quickest way forward is for the House to pass the Senate bill. Period.
But don't take my word for it, take Krugman's:
Tuesday’s Republican victory in the Massachusetts special election means that Democrats can’t send a modified health care bill back to the Senate. That’s a shame because the bill that would have emerged from House-Senate negotiations would have been better than the bill the Senate has already passed. But the Senate bill is much, much better than nothing. And all that has to happen to make it law is for the House to pass the same bill, and send it to President Obama’s desk.
Right now, Nancy Pelosi, the speaker of the House, says that she doesn’t have the votes to pass the Senate bill. But there is no good alternative.
Agreed. Let's look at some of the alternatives being floated:
To the Centrists: A pared-back, moderate bill is non-starter. It will eat up even more of your time, take several months, still have to get through a 60-vote Senate hurdle, and probably won't pass. Moreover, trying to pass the insurance regulations alone will be unworkable.
To House Progressives: You've been on the right side of these issues for most of this debate. And yes, the Senate is the one who got us into this mess. But you need to take a cold, realist appraisal of the situation. With health care reform on its deathbed, you need to consider that if a bill was good enough for Bernie Sanders, it counts as a step forward. This isn't the time for brinkmanship or holding the bill hostage for extra concessions. Just pass the bill.
To the rest: The idea of breaking the bill into multiple pieces is equally mind-boggling. Again, if only certain parts pass, the whole system becomes unworkable. Again, from Krugman:
Alternatively, some call for breaking the health care plan into pieces so that the Senate can vote the popular pieces into law. But anyone who thinks that would work hasn’t paid attention to the actual policy issues.
Think of health care reform as being like a three-legged stool. You would, rightly, ridicule anyone who proposed saving money by leaving off one or two of the legs. Well, those who propose doing only the popular pieces of health care reform deserve the same kind of ridicule. Reform won’t work unless all the essential pieces are in place.
Suppose, for example, that Congress took the advice of those who want to ban insurance discrimination on the basis of medical history, and stopped there. What would happen next? The answer, as any health care economist will tell you, is that if Congress didn’t simultaneously require that healthy people buy insurance, there would be a “death spiral”: healthier Americans would choose not to buy insurance, leading to high premiums for those who remain, driving out more people, and so on.
And if Congress tried to avoid the death spiral by requiring that healthy Americans buy insurance, it would have to offer financial aid to lower-income families to make that insurance affordable — aid at least as generous as that in the Senate bill. There just isn’t any way to do reform on a smaller scale.
And do you really want to start over from scratch and take dozens of new votes on this subject? All you need is ONE vote. ONE vote for the Senate bill, and that's it. You could by done by next week, campaign on the considerable benefits, and move on to jobs.
What about reconciliation? I think we should pursue fixes via reconciliation. And up until recently, I was of the opinion that the House should not commit to voting for the Senate bill until those fixes were passed.
The problem is that, legally, it isn't clear Congress can pass a law amending a law that hasn't been passed. Moreover, the fixes being looked at - changes to the excise tax, extending the Medicaid deal to all states, and increased subsidies - all are things that, on their own, are uncontroversial. Holding the passage of the rest of the bill hostage to these demands, however, dramatically increases the odds of failure. Reconciliation can be a very messy process, especially if Republicans and centrists don't want to play along. Yes, the final vote only requires 51 votes, but Republicans can propose unlimited amendments and they can call numerous points of order requiring 60 votes, all of which would mean passage of the bill remained an uncertainty.
By contrast, if the Senate bill is passed and the bulk of health care reform is finished, those fixes will be completely uncontroversial and can be incorporated into the normal budgets or appropriations next year. A verbal agreement from the White House and key senators should be sufficient. Both votes be far cleaner than they would be if they were interdependent.
The takeaway?: House Democrats of all stripes need to go home this weekend and seriously consider the situation as it currently stands. Nobody wanted us to be in this position. But the reality is that any further delay could kill ANY health care reform. Moderates need to realize that a longer, messier process is not their friend. And progressives need to realize that, at this point, the Senate bill is by far the most progressive bill they are going to get at this time.
If they want to ban exclusions based on pre-existing conditions; if they want to provide substantial help getting 30+ million people health insurance; if they want to end lifetime caps on coverage, caps on out-of-pocket expenses; if they want $10 billion for community-based health centers -- they should pass the Senate bill.
Again, as Paul Krugman says:
This is your moment of truth. You can do the right thing and pass the Senate health care bill. Or you can look for an easy way out, make excuses and fail the test of history.