The future of health care reform

By Carol Gee

Who knows what will happen to the biggest item on the Obama agenda for change, health care? No one can tell for certain but a few are willing to hazard guesses. This is the last week Congress will be in session before the summer recess. CQ Quarterly predicts that the Senate Finance Committee will not report out a health care reform package Due to the inability to reach a bipartisan agreement, as well as the press of much other business, work will resume in September. Prediction: A decent bill will be ready for the President to sign before the end of the year. And President Obama will weigh in with his final requirements only late in the game.

Republicans remain uncooperative -- Taegan Goddard points out that we are still waiting for the Republicans' Health Care Plan. It is a safe bet, in my opinion, that there will be none forthcoming. Prediction: What will be forthcoming from Republicans is fear mongering about raising your taxes, plus everything else they can think of to "throw against the wall."

Progressive Dems vs. Blue Dogs is a continual pull and tug between special interests and voter constituents. Prediction: Progressives will not get a pure public option, but a public plan that is nonprofit "co-op" based. The following piece illustrates that the key swing Blue Dog Democrats could play the largest role in how reform legislation emerges from Congress. To quote Politico.com:

President Barack Obama’s signature proposal, a public plan option to introduce more competition in private markets, would be significantly weakened, reflecting pressure from Blue Cross-Blue Shield plans that dominate many rural states and that were a source of millions of dollars in campaign contributions last year. The small-business lobby, itself a political powerhouse, carved out a larger exemption for operations earning up to $500,000 annually. At the same time, families are asked to dig deeper to afford the promised coverage to be bought through public exchanges.

House Democrats have proposed a sliding scale of subsidies so that new health insurance mandates don’t impose a disproportionate — and ultimately unaffordable — burden on working- and middle-class families. Without that feature, Democrats would risk a serious backlash if costs become too great and households rebel against the health care mandate. And the House maneuvering is important as a preview of the larger battle ahead in the Senate, where the Finance Committee is proposing far less generous subsidies.

The other chamber's conservative Democrats, such as Senator Max Baucus (D-Mont.), are being heavily lobbied via huge donations from health insurance companies and stand to cast votes this year that will reelect them to the Senate in 2010. Progressive Democrats are already using targeted ads to try to force the adoption of a public option by wavering Democrats from conservative districts. To be sure the debate will get noisier as Congress heads home to hear what the folks in their districts have to say. Prediction: The major ad campaign, featuring things of which you should be afraid will encourage timid constituents to seriously pressure lawmakers to either stop entirely or compromise severely.

Senators will speak from experience -- Senator Chris Dodd, who spearheaded the H.E.L.P. Committee's health care reform bill has been diagnosed with prostate cancer. He sat in for Senator Ted Kennedy, himself ill with brain cancer. Lobbyists have paid tribute to Senator Kennedy's heroic fight by donating generously to causes that he supports. Prediction: Using their own health care challenges as either spoken or unspoken backdrops to their reform leadership, several key senators, including Senator Specter, will be articulate and passionate spokesmen for significant reform.

Reference: CQ Politics launched the CQ Election Map for 2010 House races.

(Cross-posted at South by Southwest.)