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RealClearPolitics HorseRaceBlog

By Jay Cost

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How Close are the Democrats on Health Care Reform?

Some commentators have suggested that the Democrats are pretty close to finalizing a comprehensive bill on health care. But like Mickey Kaus, I am not as certain. Last week, I listed several questions I had about the bill's progress. Here's an update on that post, plus a few extra considerations.

What Happens When an Unstoppable Force Meets an Immovable Object?

I saw this in the Huffington Post today:

The Blue Dog Coalition is engaged in a member-to-member whip operation in the House, beginning with a survey of its 52 lawmakers, to find out where they stand on critical health care issues. The principal focus is the public insurance option, but the canvass also touches on various tax and revenue increase proposals to pay for reform.

The pressure is being mounted after three House committees already passed reform bills and House Democratic leaders are working to merge them into a final floor package.

For the first time since they formed in 1995, the Blue Dogs have been out-organized by their liberal counterparts. The Congressional Progressive Caucus completed its first survey and began whipping back in the spring. They launched a final whip count last week that will be finished by Wednesday evening.

This does not seem like a beneficial development for reform efforts, in my opinion. You have one faction within the Democratic Party whipping in one direction, another whipping in the opposite direction. And we're supposed to be just six weeks out from a final bill? Importantly, I've not yet seen evidence that one side or the other is prepared to buckle. Until I do, I have to conclude that serious hurdles remain.

Relatedly, there are reports that Pelosi intends to push the House bill to the left. Is this a sign that the Congressional Progressive Caucus (CPC) holds the most sway in the chamber? Or is it a reflection of her policy preferences? Either way, what happens during the conference process if the CPC remains staunch in its support of a robust public option?

Also, I have seen a lot of Baucus-blasting on the progressive blogs over the last few weeks. There has also been fighting between DailyKos and FireDogLake, on the one hand, and Blue Dog leader Jim Cooper on the other. That is not a positive sign. If Democrats are prepared to come together around a single measure, I have not seen a heck of a lot of evidence of it. It is quite possible that not just Republicans - but some faction of the Democratic Party - is going to be on the outside looking in if a bill is passed.

Is There a Compromise Position?

I do not know of one yet. I've heard a lot of talk about "triggers" for a public option. This seems to work for approximately two people: Rahm Emanuel and Olympia Snow. That's not enough to pass a bill through the Congress! Nancy Pelosi sure does not like the trigger idea. Leaders might find common ground - heck, they might have found it just now, as I am writing this! - the point is that I have not seen anything yet that can unite these factions.

The public option is not the only thorny issue. Another one is whether they can produce a bill that does what the progressives want without alienating the budget hawks who will be needed for passage. This is also going to be a factor in any reconciliation process. Reconciliation bills that increase the budget deficit by even a small amount cannot get through.

What about time frames?

The Senate Finance Committee has blown deadline after deadline, and with more than 500 amendments on its table - it looks as though it is going to blow yet another one. Democrats are talking about a 6-week window for getting a bill through the process, and Mickey Kaus has a reasonable explanation for why:

"Orszag Sees Health Law in Six Weeks" (Bloomberg): OMB Director Peter Orszag didn't really predict a health care law in six weeks--he said "The goal would be, yes, over the next six weeks or so, maybe sooner,." We know all about "goals." But the 6-week frame is not an accident, because something happens in 6 weeks: elections. If Democrats lose big gubernatorial races in New Jersey and Virginia, that could produce a new wave of jitters among already skittish Congressional swing Democrats.

More delays will push the bills past these off-off-year elections, and Kaus is right. Bad results in those elections could make nervous Democrats all the more nervous.

Like Kaus, I am suspicious of these time estimates. The fact that Democratic leaders have still not made clear whether they are planning to use reconciliation or the normal legislative process suggests that (a) they still do not know who will support what and/or (b) they still do not know what will actually be in the bill. How then can they give us precise estimates?

What about seniors?

Last week I questioned how the public will react to these proposals, and what that will mean to the legislative process. Gallup has produced some data that helps us specify this question: what does it mean that senior citizens are opposed to this bill? As I have written before, seniors are a significant force in midterm elections. What happens if senior opposition stiffens?

Do we really know anything?

One of the problems with writing about Congressional policymaking as it happens is that a lot of the real meaty stuff happens behind closed doors, and leaders who give "progress reports" do not have an incentive to offer accurate assessments. Instead, they are better off giving overly bullish reports, i.e. spin. So, here is the trouble I find myself in. I suspect that most of the members who speak to the press are trying to spin me. I also do not trust the journalists producing the news stories that serve as my primary data set. I do not think they can differentiate the spin from the reality - and in fairness to them, I do not see how they could. So, like Descartes, I am in quite the epistemological quandary here. But unlike old René, I do not have an insightful axiom like "I think therefore I am" to build knowledge upon.

In other words, the conditions of uncertainty are severe, to say the least. That's why I still have nothing but questions. And as for my prediction for a comprehensive bill passing...how about this: I'll put it at 50% with a standard deviation of 25%, for a practical range of 25% to 75%.

That's what you might call a punt!

-Jay Cost