Obama, Democrats ready to move forward on health-care reform

By Michael J.W. Stickings

It looks like the process has been worked out:

Sen. Tom Harkin told POLITICO that Senate Democratic leaders have decided to go the reconciliation route. The House, he said, will first pass the Senate bill after Senate leaders demonstrate to House leaders that they have the votes to pass reconciliation in the Senate.

It's not clear how Senate Democrats will "demonstrate" their commitment to use reconciliation to pass so-called patches to the Senate bill -- remember, reconciliation won't be used for the entire package, or even most of it, just for a few relatively minor changes -- but it could be something like a letter signed by at least 51 of them.

The bigger question, though, is whether House Democrats have the votes to pass the Senate bill, and that, for now, is where all the real drama is. Some who voted Yes the first time may vote No now, perhaps because of weakened anti-abortion provisions, perhaps because reform isn't popular back home (and they think they can only win by rushing to the center and embracing the Republicans), perhaps because they've bought into all the right-wing propaganda -- or perhaps because, if they're on the left, they object to fact that the public option is no longer in play. (There is indeed great concern that the Senate bill will lose progressives in the House, which could be a disaster. Seriously, while I admire and generally agree with these progressives, now is not the time to hold out. Doing so could hand a major victory to the Republicans, endanger the Democratic majority, and set back health-care reform for another generation. Better this bill, which is still significant, than nothing at all.)

What Pelosi needs is for the loss of those votes to be offset by members moving the other way, from No the first time to Yes now. And there should be some -- perhaps those who are not running for re-election and so don't need to pander to a frightened electorate, perhaps those who finally see that it is in the best interests of all Democrats that reform be passed, even if the reform bill itself is flawed and inadequate, perhaps those on the left who understand that this is it, that it's now or never, or at least not for a long, long time, and who, as I suggest above, agree that this bill is better than nothing, perhaps even those in the center who are persuaded by skeptical Senate centrists, like Bayh, Nelson, and Prior, who "recognize the political imperative of passing a bill and are endorsing it openly."

I don't want to be overly optimistic, let alone delusional, but this seems to be trending in the right direction.

**********

And it helps that President Obama is all in now, too, demanding an up-or-down vote, embracing a few Republican ideas but generally seeming prepared to move forward without any Republican support.

(Which, as we've known for a long time now, isn't coming. Which begs the question, why reach out to obstructionist Republicans and skeptical Democratic centrists instead of to enthusiastic liberals and progressives with, say, a robust public option and broad Medicare expansion? Well, because the votes wouldn't have been there in the Senate and perhaps wouldn't be there in either house now. But that was then, before initial passage, when 60 Senate votes were needed. Now that we've passed that point, and now that reconciliation is on the table, it's not clear how making the bill even less progressive makes it more likely to pass the House, unless there really are too many centrists to appease. Couldn't a union of 51+ reconciliation-bound Senate Democrats and 216+ House Democrats have been formed in support of a more progressive bill (including patches)? Well, I've said before that Obama's strategy seems to make a lot of sense, and I'll stick to that now. Let's just hope that Reid and Pelosi and the rest of the Democratic bean-counters on Capitol Hill know what they're doing.)

Anyway, as Jonathan Cohn notes:

[I]f Obama on Wednesday was implicitly giving up on his hopes for constructive, bipartisan governing, he wasn't giving up on his hopes for what governing would achieve. He ran for president on a promise to tackle the nation's most challenging problems -- and, since winning election, he's gleefully defied those who warned him he was trying to do too much. Nowhere has that been more true than on the issue of health care. At any point in the last few months but particularly in the wake of the Massachusetts election, it would have been easy to back away from comprehensive reform -- to cut a deal, be done with it, and move on. Instead, Obama on Wednesday committed himself more fully to comprehensive reform than he has at any time since this effort started. There's no backing off now.

Obama has made his mistakes and the plan he's put forward has its flaws. But I don't think he gets enough credit for the determination he's showing now. Americans always say they want leaders who lead rather than follow -- who do what they think is right rather than what they think is popular. And liberals, in particular, say they want politicians who will think big and pursue far-reaching reforms, rather than triangulate their way with incremental measures. Say what you will about Obama, but he's living up to both ideals--as much as any president in my lifetime.

The proof is in the pudding, as they say, and so I won't go quite that far. Yet. There has been far too much dithering and poor leadership on the part of Obama and the White House -- and I say that as one who has generally given the president the benefit of the doubt on this and other key issues and who considers himself nothing if not an enthusiastic supporter of the president -- to assume that his apparent determination and his "living up to both ideals" are truly genuine.

I suspect they are, and I am fairly confident that Obama has crossed the Rubicon, but I'll hold my applause. After all, there is still much that could go wrong.