Is Health Care Reform Falling Apart?

I find it hard to believe that Congress is going to get a good, substantive bill passed before the August recess.  The leadership will not bring it to the floor unless it is basically guaranteed to pass.  That means either buying people off with increasingly expensive giveaways, and then letting Republicans run ads in Blue Dog districts asking about the budget deficit, or a considerable amount of lengthy log-rolling and arm-twisting.  Meanwhile, all Democrats who are afraid to vote for it have to do is . . . stall.

Ezra Klein makes a persuasive case that they need to deliver health care reform for the party's survival, and thus their own electoral fortunes:

Minnick represents Idaho's 1st District. He took office in 2008, after squeaking by the Republican with 50.6 percent of the vote. According to The Washington Post's vote tracker, he's the least reliable Democrat in Congress, voting with his party a mere 65 percent of the time. The question is, what should Minnick do?

The place to start, it seems, is to ask how Minnick won. And there the story is clear: He was carried in on the Democratic wave that washed through Congress in 2006 and 2008. His district is heavily Republican. But disgust with the Republican Party let him eke out a win in 2008. Minnick, however, is exactly the sort of marginal congressman who is likely to be turned out of office if voters turn against the Democrats. And they will do that if the tide turns against major Democratic initiatives and health-care reform fails and Barack Obama begins to seem less popular and Democrats like Minnick begin to distance themselves from the party.

Minnick is thus in a tricky position: His district will always be more conservative than the Democratic Party. But he needs them to not hate the Democratic Party so totally that they will vote for any Republican who runs against the specter of Obamacare. He needs, in other words, for Democrats to be successful even as he appears independent of them.

There's another former congressman who was frequently associated with the centrists and who learned this lesson rather well. Before Rahm Emanuel was Barack Obama's chief of staff, he was in Congress trying to get guys like Minnick elected. In September of 2007, he gave an interview to Politico on the lessons he learned from 1994. "You've got to have a plan for universal coverage," Emanuel said. "But you also have to have some product at the end of the process you can deliver." You may not win, in other words. But you cannot fail to pass a bill.

Emanuel has carried that lesson with him into the Obama White House. "The only thing that's not negotiable is success," he likes to say. The worst outcome for the party -- in part because it's the worst outcome for its marginal members -- is defeat. Voters punish defeat. That's what happened to Minnick's Democratic predecessor in Idaho's First District, Larry LaRocco. LaRocco captured the seat in 1990 only to lose it in 1994, the last time Democrats failed to sign a health-care reform bill. It's possible, of course, that LaRocco would have lost his seat with or without health-care reform. But it's evidence that a bill not passing was not a great outcome for Idaho's lonely Democratic congressman. If you're a centrist in a district that doesn't like Democrats and events turn your constituents further against your party, your odds of survival are very poor.

Ezra may be right.  But I'm not sure.  For one thing, this assumes that everyone in Minnick's district admires the Democrats for passing national health care.  But let me propose a couple of alternative scenarios.  One is that basically center-right districts elect Democrats because the Republicans did things they didn't like:  raising taxes, raising spending, getting into costly wars in the Middle East that don't go so well.  When a national health care program passes, this reminds them that delivering a gigantic raspberry to the GOP has a price.  Another is that the health care plan passes, the mid-session budget review delivers the bad news that we're missing a few more percent of GDP, Republicans start running effective ads in your district about hog-wild Democratic spending.  Maybe five years down the road everyone in your district is won over, but meanwhile, you, Congressman Minnick, are back to hawking shrubbery at the SummerWinds Garden Centers.

These are not precisely unlikely scenarios in the heavily Republican 1st Idaho.  Congressman Minnick might well be better off distancing himself from his party and trying to ride the incumbents advantage into a second term.  Best case scenario might be that your party doesn't do anything to piss the voters off; second best is that they do, but you vote against it.  Neither bodes well for the bill.

That doesn't mean that Obama won't pass something.  I am pretty sure that something called "health care reform" will go through Congress and be signed.  But I am increasingly sure that it will be a very bad bill--larded with pork and inefficiency in order to bribe districts like Walt Minnick's into keeping him in office.