Numbers Not Adding Up for Senate Democrats on Health Care Reform

Anxious Democratic senators are awaiting the scoring by the Congressional Budget Office (CBO) of their latest tweak to the Senate health care reform bill. The new compromise proposal abandons the “public option" but allows individuals aged 55-64 to obtain coverage through Medicare. It also expands the Medicaid program to include adults with incomes up to 150% of the poverty level.

But the real numbers that the Democrats in the Senate have to chew on while they wait matter more to them than whether the latest scoring will add $50 billion or $100 billion to the ten-year cost of the bill. They are the numbers that politicians always follow: presidential approval ratings, congressional approval ratings, polls for the upcoming midterm elections, and polls on the level of support for the health care bill itself. These numbers are falling off a cliff for the president, the Congress, individual Democratic senators and House members facing re-election, and the bill itself.

And they now may place the passage of the bill in jeopardy, regardless of the measures designed to get 60 votes in the Senate or the CBO scoring.

The conventional wisdom is that the Democrats have to pass a bill; they have to find 60 votes in the Senate to pass some multi-trillion dollar concoction or version of “reform." The president has made health care reform the centerpiece of his “change” agenda. The bill, in different forms, passed three committees in the House and two in the Senate. A version has now passed the entire House. The momentum for passage in the Senate is strong.

The Democrats are now closer than they have been since the creation of Medicare and Medicaid during the Johnson years to vastly expanding the government’s health care entitlement programs and cutting the number of uninsured Americans by about two-thirds. If the Senate can get to 60 votes, close off debate, and pass a final bill, it is likely the House will cave and follow the Senate’s lead.

I have been arguing for months that the liberals in both the House and Senate will be the ones who move to appease the moderates in order to get something passed. The House progressives allowed a tough anti-abortion amendment to pass in order to secure the votes needed for final passage of the measure in the House and “kick the ball down the field" hoping they could get rid of this provision at a later date in the process. The moderate Democrats in both the House and the Senate by and large come from swing districts or purple states, while the more ideologically driven progressives hail from safer House districts and bluer states. In order to get a health reform bill passed, the progressives will settle for half or three-fourths of a loaf and protect their less leftist colleagues, giving them a bill they can tolerate, if not warmly endorse, thereby shielding them in future election cycles.

The evidence that Harry Reid’s effort may be cratering can be seen in the few days since the latest compromise package was reached by “the gang of ten Democrats” -- five moderates and five liberals. The senators who are taking to the airwaves to express concern or offer new amendments (allowing importation of drugs from Canada is the latest amendment that is gumming up the works) has expanded beyond the core group of holdouts Harry Reid had been cajoling on the public option -- Joe Lieberman, Ben Nelson, Blanche Lincoln, and Mary Landrieu. Now, Bill Nelson of Florida, Byron Dorgan of North Dakota, and Jim Webb of Virginia are among a larger group who have become skeptics and are suggesting fixes.