On Health Care Reform, One Hurdle Down, Many to Go

Why the start of the health care debate in the Senate is a prelude to big trouble

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Saturday night, the Senate voted to open debate on the health care bill. This brings Democrats and President Obama one step closer to passing health care reform. But it's not time to celebrate yet, pundits are warning. Here's a glimpse of the hurdles ahead, some of which could still trip up the bill:

  • Ways Health Care Could Fail  Politico's Carrie Budoff Brown and Patrick O'Connor put together a list of items that could derail health care reform, including the public option, abortion rights, the taxes to finance the reform, Medicare cuts (which would irritate seniors), and concerns over the deficit. Any of these could bring progress grinding to a halt. For example, they write, "right now, there is no public option plan that could garner 60 votes."
  • Pesky Senators The American Spectator's Philip Klein and The Washington Monthly's Steve Benen write for publications at opposite ends of the political spectrum, but both agree on one thing: passage is going to be a pain. "If the Senate leadership had 59 votes lined up for cloture," writes the liberal Benen, "finagling one lone holdout would be tricky enough. But as the bill currently stands, there are four holdouts who are all prepared to vote with Republicans to kill health care reform." Two of those seem to have little "wiggle room," he adds. Klein agrees: "Joe Lieberman and Blanche Lincoln--have unequivocally said that they would block any bill that still included a government plan at the end of the upcoming amendment process." He's not sure how Senator Reid (D-NE) is going to manage 60 votes when it comes to the public option and abortion.
  • It Only Gets Worse from Here Blogger Greg Sargent says from here on in it will be a steep uphill climb. It's not clear where the compromise on key issues is going to come from, or if one even exists.
The grueling miracle-work of assembling 60 votes--amid a flurry of debate and amendments--will have to be pulled off once again. But this time the circumstances will be even more difficult. Moderate Dems no longer have cover. They no longer can support moving the bill forward merely to improve it. Support for moving to a final majority vote, in practical terms, is inescapably support for the final bill, a point Republicans will amplify in the weeks ahead.
  • We Can't Watch This  Staunch health care reform supporter Mitchell Bard and The New Republic's Jonathan Cohn are bracing themselves to see their beloved legislation butchered. Cohn points out that the bill, as it stands, is imperfect, but any efforts to improve it are going to be more than balanced out by "an ongoing rearguard action, to fend off changes from the right." That means that "for progressives, victories are more likely to come in the form of ground not conceded than ground gained. Every day that legislation doesn't get worse is a day to cherish." Bard is even more pessimistic. "So what am I supposed to celebrate, exactly?" He asks. "That a health care bill will be debated? Even though, to get past a 60-vote cloture motion, it will have to be gutted even beyond the shadow of a bill it is now ... ?" He's not sure, "if it gets any weaker and cuts into the constitutional right of women to choose," whether the "good still outweigh[s] the bad."
  • Quiz Time: Which of These Will Prove Catastrophic? ABC's George Stephanopoulos turns the affair into a game. He asks readers to choose which issue will be "toughest ... to solve," which senator "will have to swallow hardest to vote yes," and which "outside issue" will be "most likely to iimperil passage." For the last question, he offers three options: Afghanistan, "debt limit extension," or a "second stimulus."
This article is from the archive of our partner The Wire.