HOWARD MEGDAL: From a political perspective, President Obama’s Health Care Summit is absolutely perfect.
The primary problems with the HCR in 2009, from a political viewpoint, is two-fold. One was that the nature of discourse in the country allows the Republican Party to get away with opposing the plan without providing, in any kind of forum, a plan of their own. They can wave their solutions in the air without anyone paying much attention to whether their math works.
As we saw at the GOP House Retreat, when the discussion actually turns to substantive issues, Barack Obama can point out not only how this bill works, but that it includes many of the GOP individual ideas, and just how far short they fall in resolving the problem of rising costs and the millions uninsured.
At this summit, the GOP has two choices, neither of them politically workable: to publicly refuse to participate, reinforcing their inability to participate in the basics of governing, or to join the discussion, with results similar to the GOP retreat. My bet is on the former, incidentally, but this could go either way.
Now, assuming the published reports are true, and Obama will be able to announce the HCR agreement between Harry Reid and Nancy Pelosi, the moment will be nothing but positive. Again, this is the difference between legitimate bipartisanship- which simply isn’t possible when one side has concluded they have no vested interest in getting anything done- and making it clear that this approach on health care is measured, moderate, and far most importantly, lowers premiums and covers millions of people!
Ask yourself this: if Americans were convinced that their worries over pre-existing conditions and caps on coverage were over, that they wouldn’t be in danger of going without health insurance if they lose their jobs, and that they will save money across the board- would they oppose the plan, even if it were anything approaching Socialism? The view from here is, they certainly wouldn’t. And again, this plan has about as much in common with Socialism as Richard Nixon’s plans for health care.
So get the damn thing signed, while making a final push to let people know what it does, and show the Republicans to be the recalcitrant children in public life. That’s what this summit should do. And it is exactly the right play to call here.
JESSICA BADER: I generally agree with Howard on the political implications of the upcoming healthcare reform summit (although I think an all-HCR version of the GOP retreat showdown is more likely than the empty-chairs scenario, despite the current posturing from John Boehner, Eric Cantor, and Mitch McConnell). As much as Obama is often accused by some of his liberal critics of fetishizing bipartisanship at the expense of watering down his policies, that accusation is far more true of moderate and conservative Congressional Democrats (especially those in the Senate). Without a public demonstration of both the Republican-friendly ideas already incorporated into HCR legislation and the GOP’s unwillingness to negotiate in good faith, the right flank of the Democratic Party is likely to keep insisting on letting Lucy hold the football one more time.
We know that negotiations are taking place between House and Senate leadership on working out some of the differences between the bills the two chambers have already passed, with the assumption being that these changes would have to go through the budget reconciliation process to avoid the inevitable filibuster (yes, there’s always the possibility that, say, some grand bargain on tort reform brings a Republican Senator on board or convinces the GOP to allow an up-or-down vote, but the distance between possible and likely is rather far in this case). Most of the major sticking points between the House and Senate bills (subsidy levels, the excise tax threshhold, federal funding for Medicaid in states not represented by Ben Nelson) can be included in a reconciliation bill, while other differences such as abolishing the anti-trust exemption for insurers (in the House bill, removed from the Senate bill to placate Nelson), could be voted on as stand-alone legislation (it’s theoretically possible that this could receive Republican votes if separated from HCR as a whole – when similar legislation was introduced in 2007, Bobby Jindal was one of the original sponsors).
But it’s worth pointing out that, as much attention is being paid to all of the tinkering at the margins, the overall structure of HCR remains remarkably intact despite all of the twists and turns in the saga to get a bill to the President’s desk. The underlying linked concepts of insurance regulations, individual and employer mandates, exchanges,and subsidies for individuals up to a certain income level have remained in place even when reform seemed most in peril and the temptation to rip apart what had already been worked on to start over was at its highest (for all of the turmoil following last month’s Massachusetts special election, the days leading up to Obama’s healthcare speech to a joint session of Congress last September held even more potential danger for the future of HCR, especially since the process was not nearly as far along then). Even when the rhetoric surrounding the next next step on HCR shifts to a new emphasis or plays up the addition or subtraction of a specific element, the framework around which the whole thing is being built stays untouched, and that’s no small accomplishment in an environment where overreaction reigns. In the end (provided, of course, that a bill is passed), it will be the policy itself, rather than the descriptions and explanations, affecting millions of Americans, which is why it has been so crucial all along that the architects of the legislation know what can and can’t be compromised and act accordingly.