When thinking about how to make the health care bill better, at this point there are two main questions:
What can be done to make either Lieberman or Snowe support better legislation? At this point, it appears we only need either Lieberman or Snowe to achieve a health care deal with vast Medicaid expansion, smallish Medicare buy-in, moderate subsidies, and a new regulatory regime. Keeping in mind that there are many fights left to be had, and Mike's warning that no deal is final until it lands on the President's desk, for all intents and purposes only one more vote is needed to pass this bill. That vote, unfortunately, needs to come from either Lieberman or Snowe.
OR, if that fails
What can be done to circumvent the need for 60 votes altogether? If the current framework of the Senate compromise is not good enough for you, and you would only be willing to support something better, then you need to figure out a way to circumvent the need for 60 votes altogether. A 51-vote Senate would produce a bill comparable, and perhaps even better, than the one produced by the House. Achieving a 51-vote Senate requires either reconciliation or nuking the filibuster entirely.
Of all the critics of the various campaigns for better health legislation, they don't advance the campaign unless they offer solutions for the current predicament we face. We can save the broader post-mortems on how the fight could have been waged differently from the beginning for later. Right now, we need to deal with the problem at hand, rather than look into the past.
I personally don't have particularly comprehensive answers to either of those two questions. In the extended entry, I describe what strategies I can think of for getting to 51 votes, and for pressuring Lieberman and Snowe. Hopefully, the discussion that ensues can lead to something more comprehensive.
On Lieberman. Given that we have already defeated him in a Democratic primary, and that he currently has a 2-1 disapproval rate among Connecticut Democrats, it is difficult to imagine what further electoral pressure progressive activists can directly place on Lieberman. Any further pressure must be applied from the Senate Democratic Caucus itself, which could strip Lieberman of his chairmanship.
We could take action against the overall caucus for not taking any action on Lieberman, given that the overwhelming majority of Democratic Senators refuse to threaten any punitive action against Lieberman whatsoever. Such pressure could involved an organized donor strike to not donate to any incumbent Democratic Senate campaigns at all in 2010, until action is taken against Lieberman.
Then again, even if that strike did actually pressure Senate Dems into taking action against Lieberman, it still isn't a guarantee that he would sign onto the health care bill. With most of his base of support now coming from Republicans, he might just take his business and switch parties altogether, while still opposing the health care bill.
On Snowe One problem we face with Snowe is that Republicans actually have more leverage over her than Democrats. For one thing, she is more vulnerable to a Republican primary challenge than she is to a Democratic challenge in the general election. Also, Republicans can remove her committee seats and / or seniority, while Democrats cannot.
One thing Snowe does like is the power she gains from playing both sides. As such, perhaps threatening to cut her out of any dealmaking with Democrats in the future is the right way to approach her. It strikes me as doubtful that either the White House or Senate Democratic leadership would make such a threat, but it is the best pressure point I can think of on Snowe.
We could also push to get a small group of Senators who just defeat the whole bill, and say it is reconciliation or nothing. The best bets on that front are Burris and Sanders (Russ Feingold is opposed to using reconciliation), given that Burris has nothing to lose and Sanders tends to be a progressive iconoclast.
To pull this off, you probably need both Sanders and Burris. Otherwise, the Democratic leadership and the White House will just cut whatever deal they can get with both Lieberman and Snowe, triggering a conference committee (or even just going straight to the President's desk). Problem is, Bernie Sanders actually likes the new Senate deal with a Medicare buy-in more than he liked the opt-out public option. So, for this strategy to even get off the ground, you need Lieberman to state that he will filibuster a bill with a Medicare buy-in. That hasn't happened yet, although it might soon.
House Progressives: If all that fails, then House Progressives could threaten to kill the bill in conference committee, and then demand reconciliation. Raul Grijalva has indicated that he might vote against the Senate deal, so this is a possibility. Then again, Dennis Kucinich likes the deal (because of the Medicare buy-in), so it isn't clear that there has been a net loss of Progressive votes so far.
Further, as I mentioned yesterday, it would be extremely difficult for most House Progressives to vote against the Medicaid expansion in the bill. Doing so would actually open them up to primary challenges in their district, where more right-wing candidates could easily outflank them. There are a lot of people in all Progressive districts who would be helped by the Medicaid expansion, and the health care bill still has its highest level of support in Progressive districts.
Finally, the Senate deal is likely to have won over some "no" votes in the House. So, even if a handful of Progressives threaten to sink it, that probably won't be enough to block final passage anyway.
Perhaps I am not creative enough, but those are the best ideas I can come up with right now. The best one, I think, is using Sanders and Burris to cancel out Lieberman and Snowe if Lieberman opposes the Medicare buy-in.
If you have other ideas on how to pressure either Lieberman or Snowe, or on how to get to reconciliation, I'd love to hear it.
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