During the public option fight, I didn't focus much on the political ramifications of the health care bill. But now, with that fight seemingly over, and my attentions turning toward electing more Progressives / progressives in 2010, I give it a shot in the extended entry.
1. The health care bill is historically unpopular Back in August, I looked through polling data since 1993 to try and find the least popular pieces of legislation that passed into law. There were not many instances where Congress passed a law that was unpopular at the time of passage, but NAFTA and the Wall Street bailout were among the few examples I did find. The health insurance bill comes in at roughly the same level of unpopularity as those two bills:
2. Even if the bill is defeated, the bill is still unpopular, and the base is still demoralized Despite the bill's unpopularity, Democrats don't get to escape from it if they defeat it now. There is historical precedent for this: an unpopular health care reform didn't pass in 1994, and that defeat did not save Democrats at the ballot box that year. Quite the opposite, really.
If the bill goes down, it is because of Republican leadership. They get credit for it, while Dems are still the party that spent all of 2009 pushing an unpopular bill. Plus, Democrats look lame and ineffective, too. Defeating the bill does not improve the political picture for Democrats.
As far as the base goes, as I explain in point number four below, defeating a bill that is still very popular among Democrats is not going to rev up the rank and file.
3. The health care bill would have been unpopular even with a robust public option Even if the health care bill had a Medicare +5% public option, and a Medicare buy-in, and a 90% medical loss ratio, it still would have been unpopular. No matter the popularity of those individual provisions (see here for the public option, and here for the Medicare buy-in), whatever bills they were included in were still unpopular. Because of the general disconnect between the popularity of individual provisions in the bill and the popularity of the overall bill, progressive activists were looking to pass an historically unpopular bill, too.
4. The health care bill remains popular among Democrats, complicating the primary picture for Progressives If we want to use primary elections to elect more Progressives and progressives to Congress, having our candidates vote or argue against the health care bill would hurt our cause. While the exact numbers are quite varied, every poll still shows the health care bill to be very popular among Democrats. PPP shows (PDF, page 8) Dems favoring the bill 83-14, Gallup shows 76-17, and Quinnipiac shows 65-25. These numbers are even higher for self-identified liberals.
The primary rank and file is behind this bill. As such, if Progressive / progressive candidates break with the rank and file of the party on this, it will make our efforts to help those candidates win primary challenges much, much harder. More right-wing primary candidates would actually be able to use our opposition to the bill to outflank the Progressive / progressive candidates with the liberal rank and file.
Further, those right-wing candidates could very conceivably get White House support in the primary, as Rahm seeks payback for Progressives who crossed the White House. The ongoing popularity of President Obama among the primary rank and file would be further devastating to Progressives in primaries. All of this would mean that we not only get beaten on the public option, but that we end up getting beat in primary after primary, too.
5. Hard to see how we can defeat the health care bill Finally, I don't even think we can defeat this bill. And, after apparently losing the public option fight, I am not particularly eager to immediately turn around and lose another health care fight.
The Senate likely has 60 votes. Burris is preparing to justify his vote in favor. None of Feingold, Brown and Wyden have made any noise about defeating the bill. Expect Bernie Sanders to go along, too. 60 votes are locked in, from what I hear.
In the House, the Lieberman deal on the public option likely gained more votes from Blue Dogs than it lost from Progressives. The only thing that could still derail the bill would be Representative DeGette's anti-Stupak bloc. However, almost every member of that bloc already voted for the bill with Stupak language in it.
I don't intend to help this bill pass. If progressives get backstabbed by Lieberman and then ordered to cave at the finish line, then as far as I am concerned the White House has made its own bed with this. They can try and pass the bill, but they are going to have to do it on their own. I'm not helping. In fact, I kind of just want to hang out in the tall grass for a while and plot my revenge.
I am also not going to begrudge any progressive organization that works against this bill. Nor will I begrudge any member of Congress who is a co-sponsor of HR 676 and who votes against this bill. The last thing I am going to do is join in with the browbeating of Progressives. Again, if the White House wants Progressive votes and progressive support, then they have to do it on their own.
I strongly recommend to anyone who does work to defeat this bill make their calculations based entirely on policy, rather than on politics. If you oppose the bill because you think it is bad policy, then do what you feel you have to do. However, as far as the politics goes, because the bill would be unpopular even if we won our demands, because Democrats would still take a real hit from this bill even if it doesn't pass, because progressives probably can't actually defeat the bill, and because it would make winning Progressive / progressive primary challenges a lot more difficult, defeating this bill does not add up as a political calculation for progressives or Progressives.