There are currently dozens of lists floating around the internet about the many reasons why the health care reform bill should be killed or passed. Personally, when it comes to determining the value of the Senate health care reform bill, I have found those lists more useful than a dozen CBO scores.
Still, I will not be directly engaging in that wonky debate in this post. If you want to debate the policy of the bill, this is not an article for you. Instead, I am going to set policy aside for a moment and look at a list of the various political arguments for passing or defeating the bill. This is, after all, not just a policy debate, but a political debate, too.
To prevent this post from being a mystery novel, I conclude that the only major political difference between Progressives defeating this bill versus letting it pass will be to undermine the Progressive political position within the overall Democratic coalition. This is, I bet, a calculation many Progressives have already made, which is one of the reasons why they are signaling they could accept the bill.
Will passing the bill make future health care reform efforts easier or more difficult? Those progressives in favor of defeating the bill argue that passing it will make future legislative reform more difficult. The reasoning here is that this reform will strengthen the insurance industry, giving them more power to fight future reforms. Also, reform will be shelved for a while. After the massive struggle to pass this bill, the public will lose confidence in the legislative reform process, while those in the beltway will feel as though the problem has been solved.
Those in favor of passing the bill make pretty much the exact same argument. The opponents of reform, including the insurance industry, will have renewed strength if they defeat the bill. The public will grow extremely skeptical of a process that lasted for an entire year and produced nothing. People in D.C. will be loathe to once again tackle a process like this, which pushed down their approval ratings and clogged the rest of the legislative calendar to no end.
The truth is that both of these arguments are entirely speculative and unprovable. We know more health care legislation won't happen next year, because the House has declared it is "done" with legislation for now. Other than that, we don't know the future timetable for health care reform will be no matter what happens to this bill. We also don't know what the public desire for more reform will be, or the relative strength of the players in any future fight.
Bottom line: With so much speculation on both sides of this argument, it should be disregarded entirely when making any political decision on the bill. It is an argument over the unknowable.
Should Progressives defeat the bill to increase their influence in Congress? The idea behind the "Progressive Block" strategy is that Progressives can take a play from Blue Dogs, and increase their influence in Congress, by threatening to join with Republicans to block must-pass legislation unless the Democratic leadership meets Progressive demands. In this case, the theory would say that because the Progressive demand for a public option was not met, Progressives in the House and Senate should block the entire bill.
It is still a good idea in theory, but in this specific case it lacks a critical element I had not considered over the summer: sufficient popular support from the Democratic rank and file. While conservatives and their Blue Dog enablers can rely upon a plutocratic lobbyist, media and donation system for support no matter what they do, Progressive power must flow from popular support. As such, Progressives will not increase their influence within Congress if they defy the wishes of about three-quarters of Democratic voters and defeat the bill. Doing so would actually undermine their influence in Congress, leaving them without big money, big media, or rank and file backing. They would have no source of power left.
Bottom line: Progressives can't increase their influence in Congress by defying the will of a supermajority Democratic base. For this path to work, they need popular support among rank an file Democrats for their actions. Due in part to President Obama's popularity among the rank and file, that support does not exist for blocking the bill from the left.
Should the bill be delayed, rather than defeated, and passed through reconciliation? This is something which I agree we definitely should have done. With Senators becoming less progressive the deeper you dig into the bench, it is simple mathematics that a bill which only requires 51 votes can be made more progressive than a bill that requires 60 votes. Even if not every part of the bill can be passed through reconciliation, those parts that could have been passed through reconciliation would have been made stronger if they only required 51 votes. Further, more broadly speaking, we should be pushing to achieve a 51 vote Senate whenever possible.
Problem is, we did not put in the effort over the summer to round-up 51 votes for reconciliation. The Senate whip count which we helped conduct here on Open Left was focused on finding 51 votes for a public option, not on finding 51 votes for reconciliation. At this late date, reconciliation would require starting a new whip count campaign, even though the last one took five months. Further, progressive Senators like Feingold and Harkin start in opposition. Every Conservadem who wrung concessions in the bill would be opposed, too. Hard to imagine that the leadership would want to start over from the beginning, either.
Bottom line: Let's never make the mistake of not pushing for a 51 vote Senate, wherever possible, again. At this point, however, it is too late. Whether or not we push for reconciliation, it won't happen.
Will passing or defeating the bill have more negative electoral repercussions for Democrats in the short-term and long-term? Both sides are also arguing about the short-term and long-term electoral impact of defeating or passing the bill. On this front, I will simply reiterate my claim that every outcome sucks for Democrats in both the short-term and long-term:
The bill passes, without the individual mandate. In this extreme long-shot scenario, the bill is still unpopular. Public blowback anyway. Advocates of stronger health care reform still grow more dejected. Health care costs probably rise even faster, (and fewer people are covered) resulting in different, though still negative, long-term political consequences.
The bill is defeated by Republicans and conservative Democrats. If this happens, then ineffective Democrats were stopped from passing an unpopular bill by heroic conservatives. Democrats still have an unpopular bill hung around their neck anyway, but now people turn even harder to the teabaggers in the short term due to their heroic effort to defeat the bill. Advocates of stronger health care reform still grow more dejected. Democratic rank and file, which still largely likes the bill (despite some movement in the other direction) also grows even more dejected.
Bottom line: As with #1, although for different reasons, this argument doesn't matter. Every outcome is bad from a political perspective. It is a wash.
My overall conclusion is pretty much the same one I have been making all along: if Progressives defeat the bill, the only different political outcome they will experience from passing the bill will be to undermine their own political position within the Democratic coalition (#2 on this list). Electoral impacts for the entire party are negative no matter what, arguments over impact of this bill on future health care reform efforts are entirely speculative for both sides, and reconciliation simply isn't going to happen at this late date. All I see from a Progressive defeat of the health care bill is an even weaker position of Progressives in the overall caucus, largely because of the dominance President Obama retains over the progressive and Democratic rank and file.
At the same time, it remains vital for Progressives and progressives to maintain a public face of outrage at the bill, at least until the conference committee is over and the bill ends up on President Obama's desk. As soon as the progressive consensus becomes that this bill is teh awesome, the worse the bill will become. Any attempts to strengthen the bill requires people on the left making as much hay as possible over how much the bill sucks. This is a simple principle that even famed Third Way Presidents like Bill Clinton understand perfectly well:
Mike Lux once told me an anecdote about then-Representative Bernie Sanders and President Clinton during the signing ceremony for the fiscal year 1994 budget. Before the ceremony began, he heard President Clinton telling Representative Sanders that he and other progressive members of Congress should have attacked the budget from the left more vehemently. President Clinton's reasoning was that such attacks would have provided his administration more room to push the legislation to the left, and less justification to give into demands from the right.
Two months ago, President Clinton himself told me a similar story. He said that he had read a lot of people online calling him a sellout, or something similar, for any number of reasons. Rather than being upset with this criticism, he said that he wished that sort of progressive media had been around to broadcast that left-wing criticism during the 1993-1994 health care fight. Once again, if that criticism had been both prominent and backed up with real power in Congress, it would have given him a lot more room to work on health care.
You can't strengthen legislation from a progressive perspective unless people are demanding it be strengthened from a progressive perspective. As such, even if defeating the bill does not ultimately add up for Progressives in Congress, progressive outrage over the bill remains absolutely vital at least until the end of the conference committee.