Your Morning Health Care Roundup: Exeunt Snowe, Republicans

So Snowe's left the building on health care reform, barring miracle.  That means that the Democrats pass this on a straight party-line vote, if they pass it at all, making the parallels to Social Security reform ever more compelling.  As I thought might happen, the fact that Baucus wants to pay for his bill by taxing high cost health plans has alienated Snowe, since she comes from a state with some of the highest premiums in the country.  Baucus has added a provision to scale the tax to local cost--but of  course, when you do that, you don't raise so much money with it.

I'm reliably informed that the Democrats think they're better off doing this alone than not doing it at all, and so it has to pass.  If so, it will be the first time in history that I can think of that a single party passed anything of this size--certainly not a major new entitlement.  Medicare and Social Security both had considerable Republican votes, something I don't see this time around.

At the very least, this changes the tenor of the debate.  I'm willing to bet that the Democrats start throwing the less popular provisions out of the bill.  If you're going to pass a $1 trillion bill all by your lonesome, you don't want to, say, piss off 25% of seniors who like their Medicare Advantage, even if you and all of your fellow party members hate the program. Unfortunately, the popular bits are the expensive things.  The unpopular parts are where you pay for them.

Luckily for the Democrats, outside of the Concord Coalition, no one votes on deficits.

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Megan McArdle is a columnist at Bloomberg View and a former senior editor at The Atlantic. Her new book is The Up Side of Down.

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