My favorite health care reporters have gone into "concerned" mode again about the fate of health care reform legislation. I decided to recanvass the sources who've convinced me that reform is alive and kicking to see whether the fundamentals of the debate have changed over the past two weeks. The answer is mixed.
Those commentators who believe that Sen. Harry Reid's leaked (therefore public) reproach to Finance Committee chairman Max Baucus was a major milestone are correct, although perhaps not for the reasons that they assume.
In a meeting of Democratic Senators, about a third of those present made it clear that they were unhappy with the direction Baucus was taking. It wasn't so much that they objected to the specific proposal he's floated to end the exclusion on taxing health care benefits, it was that Baucus's approach to crafting the finance particulars of the bill was inherently flawed and stalling the process.
Once again, the key number here is 60. Not 60 Democrats and Republicans, but 60 Democrats. Or 58 Democrats and two Republicans. There are two ways to write a bill that attracts bipartisan support on the floor. The Senate HELP Committee's model was to create an ideal bill (a partisan bill), and then work backwards, starting from the "ideal" model and making incremental changes to increase the marginal vote totals. Sen. Chris Dodd mastered that approach. Remember that the HELP committee is writing the health care provisions of the bill. The finance committee is tasked with finding the money to pay for it, particularly the money to pay for the inevitable expansions of Medicare and Medicaid that will make up a good percentage of the coverage increases.