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Health Care Moving in the Right Direction

posted by Christopher Hayes on 01/27/2010 @ 1:41pm

For the first time since the Massachusetts debacle, I'm cautiously optimistic about the fate of health care reform. Here's why: In the wake of Scott Brown's election, what was most dispiriting was the total leadership vacuum and chaotic, every-man-for-himself atmosphere among congressional Democrats. There didn't seem to be any hard consensus on what to do next. Some said: break it up into smaller pieces, radically pare down the bill, go back and find Republican support (ha!) or let the thing die. Every one of these options would actually spell the death of health care reform, and one of the most stunning legislative failures in recent memory. To even consider such a move seemed insane, and yet those of us paid to observe Congress have spent the last two weeks watching, with mouth agape, as congressional Democrats slowly raised a loaded gun to their collective mouths and volubly considered pulling the trigger.

But sanity has, tentatively, provisionally prevailed. After spending much of yesterday talking to folks on capitol hill, it's clear there is increasingly consensus on a path forward: As I explained last night on Rachel Maddow, it involves a few steps, but is relatively straightforward. The House has to come up with a list of changes to the Senate bill that will get them to 218 votes (and will also pass muster with the procedural constraints of "reconciliation". For more on that you can listen to last week's episode of The Breakdown.) They then send those changes to the Senate leadership, which can pass them through reconciliation, a process that requires a simple majority. Once that process has moved forward or (better!) is completed, the House can then pass in quick succession the Senate bill, and the amended fix.

Now that's it, clear reconciliation is the only real option forward, we're suddenly operating in this bizarre alien universe where majority rules. So when I read Ben Nelson this morning expressing his discomfort with reconciliation I took great satisfaction in the fact that his opinion on the matter was more or less meaningless. It was always the razor thin 60 vote majority in the Senate that produced the agonizingly slow process of death by a thousand cuts. But that is, in the world of reconciliation, no longer operative.

In fact, now that reconciliation is on the table, the public option has regained a pulse. After all: it already got 218 votes in the House, remains one of the most popular parts of healthcare reform and once upon a time enjoyed majority support in the Senate. Today, Ryan Grim reported that two House members were circulating a letter to their Senate colleagues telling them to put the public option into the reconciliation package, and the PCCC, DFA and Congressman Alan Grayson delivered 250,000 petition signatures to Harry Reid this morning calling for the same.

This does not mean, by any earthly means, this is a done deal. If ten Senate Democrats get scared and back away from reconciliation the bill is sunk. That would be a massive and stunning rebuke to leadership, so this is a true test of Harry Reid's ability to see this through. So far, there's still been a startling lack of leadership both within the Senate caucus and from the White House. (Ezra Klein has a run-down of the latter here). It will also probably be necessary, for procedural reasons, to get Budget Committee Chair Kent Conrad on board. So far he's been non-committal, but hasn't ruled out the idea of reconciliation.

So there are obstacles. [snip]

But there's a very doable path forward, and there are almost certainly the votes to get it done. It really is a question of political will and pressure at this point. [snip]
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