Being into the whole history thing enough to have written a book on it, I tend to take a long view on the big policy battles we fight today. As I wrote the other day, no piece of legislation ever gets to perfection, and on plenty of them you can have a perfectly legitimate debate even over the most well-intentioned bill over whether it does more harm than good. In addition to the actual policy particulars, lawmakers have to weigh (if they care about political survival) a wide range of other factors, including the political implications both nationally and in their home districts, the symbolism of what they are doing, how the interest groups and donors that matter the most to them are impacted, and how the media nationally and back home are treating the issue. Trying to factor in all these things is intense, and it is understandable that politicians sometimes have trouble making up their minds.
For reasonably progressive-minded advocates and lawmakers on a huge issue like health care, after you factor in all of the above, at the end of the day you also have to ask yourself two very big questions. The first is whether the passage of this legislation sets the stage on other issues for better or worse things to come. The second is whether the legislation, even with all of its flaws and compromises, creates a platform to build on in the future.
Forbes Magazine, which has never been called a liberal rag by the Right, recently published a 2009 national survey by the United Health Foundation entitled: "The Healthiest And Unhealthiest States". The funder for this foundation is none other than insurer UnitedHealth Group. In their most recent quarterly earnings report (October 2009) UnitedHealth Group cited revenues of $21.7 Billion, an 8% Year-Over-Year increase, and healthy profits. So no one can rationally accuse this health survey of being a hit job on the insurance industry. In truth it is chock full of interesting and useful health data, and worthy of close study, but what jumped out for me immediately are some bold political implications that it also documents. They are far from friendly to opponents of health care legislation currently before Congress.
Interest groups, too, deserve opportunities to make their cases, Stark said. He singled out the American Medical Association, the American Hospital Association and the Pharmaceutical Research and Manufacturers of America.
The health insurance industry, Stark predicted, would never support a Democratic health reform effort, but he said they could be easily overcome.
"They're going to be easy to roll because nobody likes insurance companies," he said.
Hmm. That one didn't quite work out.
As you might have noticed lately, I am big on accountability, learning from our mistakes, and improving tactics. What is interesting to me about health care reform in the case of insurance companies is whether the game was fixed, or an opportunity was missed.
On the one hand, you could make the game was fixed argument that insurance companies are more moneyed and powerful, have more lobbyists and connections, etc. I've also heard the campaign finance argument, which is we'll never achieve fundamental reform not just on health care but on lots of other issues until we have fundamental campaign finance and lobbying reform to establish public financing of elections, eliminate the revolving doors between members of Congress and K Street, and so forth. Therefore Pete Stark is wrong that they could be easily overcome because he forgets that issue.
On the other hand, I recall that when Obama gave his late October radio address ripping insurance companies, the first thought in my head was "it's about time". Other friends said that with his cutting of all these side deals with pharmaceutical companies, hospitals, insurance companies to find cost savings, he in turn agreed to shy away from such rhetoric, which was a mistake. Therefore Pete Stark was right that insurance companies are easy to demonize, it's just that our side never took advantage of it.
I tend to think it's actually something of both, but it's worth thinking about for future fights.
I thought it might be useful to summarize the big battles ahead, as well as the list of things that are good policy changes that seem likely to be in the final legislation. I have two lists of both in the extended entry.
I was at a retreat over the weekend with musicians and managers of musicians re how to best involve musicians in making social change, and the organizer of the event asked me to do a brief overview of what public policy advocacy actually means, so I drew some lines on four different pieces of posterboard to show people. Given that these simplistic, dumb-looking charts seemed to put advocacy into perspective for folks, and given the intensity of emotion we all feel about what is going on in the health care fight, I thought it would be worth reproducing them for a blog post.
Before I show them to you, I wanted to say a couple of things re this health care fight, and all other policy fights for that matter.
Last week, House Democrats killed two provisions that could have given us the best health care in the world: single-payer. But we've still got a chance in the U.S. Senate.
Single-payer health care is the only kind that would both control costs and cover all Americans.
House Speaker Nancy Pelosi had pledged to hold a House vote on single-payer, but she broke her promise, and did not allow the vote.
Even worse, Speaker Pelosi stripped a provision from the health care bill that would have allowed states to try single-payer.
As a final insult, the House approved an anti-choice amendment that will remove abortion coverage from millions of health insurance policies.
That's just not good enough.
Americans deserve a healthcare system that will cover everyone and won't bankrupt anyone.
Let's make our voices heard for real health care reform. Sen. Bernie Sanders has introduced S. 703, a bill that would create single-payer systems in every state to cover all Americans.
Last week, Rep. Dennis Moore published an editorial in newspapers across the third Congressional district announcing his support for the House health insurance reform bill. As he explained last week:
I will be voting for this bill because it addresses the issues of affordability, fiscal responsibility, quality and choice. We can no longer afford to do nothing. We must meet this challenge head-on.
This bill will not only dramatically improve the health care system for those who already have insurance they like and want to keep, it benefits those who don't have insurance...
Congressman Moore delivered on that pledge by voting for the bill Saturday.
For some perspective on the wisdom of the Democrats who are opposing health care reform, let's go the elections last Tuesday. New polling analysis from Greenberg Quinlan Rosner and Women's Voices Women's Vote is pretty powerful, and I recommend it to all the Democrats who voted no on the health care bill and every single one of their political consultants: the bottom line, friends, is that everything you do to depress Democratic voter turnout in your district is another nail in your coffin.
Health care reform was always going to be tough as hell, as difficult as any issue that could ever be tackled. As I learned from the agony of the 1993-94 Clinton attempt at health care reform, this issue is so massive, so complicated, so unwieldy that it is prone to be derailed by lobbyists pulling on any one of the hundred hanging threads and unraveling the whole thing. Culture war issues like abortion and immigration combine with issues peculiar to individual districts like having a medical device manufacturer based in a congressperson's district, and all of those things combine with bigger worries about overall ideological and political concerns back home.
When people over the weekend would ask why getting the votes for the health care bill was so hard, I would have to say: it just is - it is the nature of the beast. Every step along the way will be tough and painful and decidedly not easy. Every time we complete a step, like we did on Saturday night, it is easy to look at how hard it was and say, "Oh my God, the next step is even harder, how we will ever get there?"
Determined leadership can find a way through. In the 1993 budget fight, every step of the way was complete torture, and at numerous times it looked like we were completely done for. But we kept battling, took on one step at a time, and we got it done.
Speaking of determined leadership, Nancy Pelosi deserves enormous credit for finding a way to get this done. Like all progressives, I am deeply unhappy with the abortion language that was allowed to be voted into this bill. That language is unacceptable and has to be changed in conference committee. But I was looking at the vote count on Friday night too, and we really were done unless that vote was allowed. There were literally no good choices at that moment, because to let the bill fail or pull the bill from being voted on would have caused everything to get unraveled. We still have a very good chance at stripping this terribly restrictive anti-abortion language in conference committee, and need to keep fighting to do that.
On the final vote, the whipping process was intense and impressive. Democratic leaders I have known in the past have rarely played this kind of hardball, but some kneecaps were broken Saturday night to get these votes, and the Speaker did a masterful job of doing every little thing that needed to be done. She gave no passes to people, and she was very clear there would have been consequences to all who voted no. She got the job done.
I also wanted to commend the congresspeople from tough districts likely facing very competitive races who did the right thing on this vote. It was a good political move on balance because it will help them turn out the base in the 2010 election, but when you are getting hammered by the big money forces against this bill, it never feels like a tough vote like this is going to help you. As a strong progressive, I give more conservative members of the Democratic caucus a lot of flack sometimes, but these Democrats from tough districts deserve a lot of thanks:
AZ-01 Kirkpatrick, Ann R+6
AZ-05 Mitchell, Harry R+5
AZ-08 Giffords, Gabby R+4
CA-11 McNerney, Jerry R+1
CT-04 Himes, Jim D+5
FL-08 Grayson, Alan R+2
IL-08 Bean, Melissa R+1
IL-11 Halvorson, Debbie R+1
IL-14 Foster, Bill R+1
IN-8 Ellsworth, Brad R+8
KS-03 Moore, Dennis R+3
MI-07 Schauer, Mark R+2
MI-09 Peters, Gary D+2
MN-01 Walz, Tim R+1
NH-01 Shea-Porter, Carol R+0
NV-3 Titus, Dina D+2
NY-01 Bishop, Timothy R+0
NY-19 Hall, John R+3
NY-24 Arcuri, Mike R+2
NY-25 Maffei, Dan D+3
OH-15 Kilroy, Mary D+1
OR-5 Schrader, Kurt D+1
PA-3 Dahlkemper, Kathy R+3
VA-5 Perriello, Tom R+5
WI-08 Kagen, Steve R+2
On the other hand, there are some Democrats I am appalled by. As a 30-year supporter of single-payer, and with full knowledge of the imperfections in this bill, I am angry that single-payer supporters Kucinich and Massa were happy to let any hope of health care reform for a generation die because the bill wasn't everything we hoped it would be. To let another generation go by where tens of thousands of people die every year from being under-insured, and have the insurance companies continue to be allowed to screw people over pre-existing conditions, lifetime caps, and recessions is just wrong.
Then there is the large collection of Blue Dogs who care nothing about the President or the Democratic Party's top priority, let alone all those people without insurance. After all that Rahm Emanuel and Nancy Pelosi did for these reps in the 2006 and 2008 elections, all the money and time and staff and consultant help they gave them, for those Blue Dogs to walk away on the biggest issue, when they were needed the most, is a sign of their selfishness. These are Rahm's people, recruited by him and supported by him at every step of the way, and they don't care that they are making him look terrible by leaving him out to dry. They are also dumb about their own political fate: if Democrats don't deliver, Democratic base voters will walk away in massive numbers, and it will be the people in marginal districts that will suffer the most.
The health care debate was always going to be a knock-down, drag-out fight, with every stage a harrowing journey to get through. But we survived another big step on Saturday night, and are alive to fight for another round. We will figure out how to win this one way or the other, making history when we do.
In the earlier diaries I posted today a number of issues have come up that I think deeserve further reflection and response. So I'm going to deal with several of them.
First up, some folks argued that the Stupak Amendment was no big deal, really, or at best overblown as an issue, even a red herring. But Digby had is exactly right --the Stupak Amendment is establishment payback for getting uppity [emphasis added]:
One of the things that those of us who follow politics from afar tend to see that those who are involved in the minutia often understandably miss, is the over arching themes that guide the politicians and the villagers. I don't suppose that they are necessarily aware of it, although some of the influential strategists may be, but it's there nonetheless.
I knew that after all the sturm and drang over the past few months over the public option, the number one liberal priority in the health care debate, there would be a price for its success. The ruling elite could never allow an unambiguous liberal victory. It would endanger their narrative that says fealty to business, religion, military and other authoritarian structures is democratically inspired. They have to maintain the fiction that the people prefer to be subjects. If politicians aren't convinced that there will be a price for being liberals, they might get the idea that they can actually govern liberally.
Second, another major issuse concerned the efficacy of challenging and defeating reactionary Democrats. For the most part, this concern is either born out of chronic cynicism (in which case, I have to ask, why are you posting at Open Left?) or misunderstanding. Challenging and defeating reactionary Democrats is not a silver bullet. It's just one task among many. In Digby's post just referred to she essentially talks about hegemonic struggle, and about why the establishment can't tolerate allowing a clean liberal victory. Extracting a penalty in response to their penalty is just one part of the larger struggle we need to be engaged in. And even if candidates do lose, their campaigns represent an opportunity to educate voters. As I wrote in one of my comments, this is precisely how Bernie Sanders moved, over time, from getting 1% of the vote in his election to being a US Senator.
Third, some have complained that this is bad strategy. That (a) it's already too late in the cycle, (b) we should be targetting other issues--such as economic ones, (c) we should be postitively supporting existing progressive challengers instead. Both (a) and (b) have some truth in them--but this simply reflects the numerous ways in which the system protects itself. The point is that this pair of votes--the Stupak Amendment and final House passage--have provided a rare opportunity in which points that are usually intentionally muddied for the general electorate have become strikingly clear. And just because the timing is not optimal, and issue is not squarely in the middle of where voters are suffering most does not mean we should ignore this opportunity. Sieze whatever opportunity you can grab hold of--especially the opportunity to strike back at the sort of move that Digby describes. As for (c), it's most certainly true, but a case of walking and chewing gum at the same time.
This is a followup to my earlier diary, "Targetting Dems In 2010", which featured three different sorts of a spreadsheet of Democrats who voted for the Stupak Amendment. In this diary, I want to clarify my proposed overall approach, discuss some options within that framework, and encourage discussion of some particular points that need to be further clarified.
First, The Overall Approach:
(1) My intention here is to develop a methodology for supporting a plurality of strategies for building progressive power and getting rid of bad Democrats. While different people may feel strongly about different aspects of strategy (for example, "don't target Dems in GOP districts, because you can't expect better"), I think it's important to realize that it's impossible to expect everyone to agree on strategy. So we should support a plurality of strategies, looking for the best targets for each strategy.
(2) My use of spreadsheets is heuristic, not determinative. It's mean to guide our decisionmaking toward the best targets and away from the less promising ones, so that we can better focus our resources. But it's meant to assist us in reasoning consistently, and making reality-based decisions as much as possible. It's not meant to do our thinking for us, or to rule out the role of passion or of intangibles. It's a tool, nothing more, nothing less.
(3) I am not wedded to restricting ourselves to those who voted for the Stupak Amendment. It simply represented a very good pool of portential targets to start with. Another such pool would be all those who voted against the final bill (though I certainly do not support targetting progressives like Dennis Kucinich for voting against it becauseit was too weak.)
Second, Additional Factors To Consider:
(1) Add a category to identify leadership positions, such as committee or subcommittee chair.
(2) Add a category to indicate length of tenure.
(3) Add a catetgory to identify those who may be running for higher office.
(4) Add a category for those who seat is likely to be redistricted in 2012.
(5) Add categories for specific issue area Progressive Punch scores.
(6) Add a free-form note column for noting particularly eggregious actions.
(7) Add free-form note columns for recording on-the-ground attitudes and perceptions.
(8) Add columns with the filing date, primary date, and filing date for a general election challenge.
Comments are welcome regarding other factors we should track.
Third, Potential Options--With Rationales:
(1) Focus on those who won with a very small margin, as these are easiest to defeat with an independent progressive candidate in the general election, should a primary effort fall short.
(2) Focus on those in Dem districts, as a successful primary will almost certainly be elected in the general election.
(3) Focus on those with leadership positions, as this will strike at the organization heart of the conservadems.
(4) Focus on those recently elected (such as last 2 cycles), as these will be more easy to defeat.
Comments are welcome regarding other rationales--they need not be single-factor rationales such as those above.
To begin the process of focusing our anger toward productive corrective action in next year's elections, I've compiled a table with some relevant information about Democrats who voted for the Stupak Amendment.
In the wake of House passage of the health care bill & the Stupak Amendment, we clearly have our work cut out for us. Yet, at the same time, we have a tremendous opportunity: a very sizeable number of bad Dems have very publicly identified themselves in a way that average voters can readily grasp. Whether or not they can be defeated in primaries next year, they can clearly be organized against, and that means that progressive infrastructure can be built in their districts, to increase pressure on them in the future. And in some cases--where their general election margins are small--independent progressive candidates in the general election can be enough to defeat them. Newly drawn districts in 2012 will mean that more progressive replacement candidates will have a much better shot as a result. It's quite clear that we need to do this. There is really no other way to ensure that House members will show any loyalty whatsoever to those who elected them. And so here is a preliminary list of those who voted for the Stupak Amendment, along with some pertinent information for gauging who might be the highest priority to concentrate on getting rid of.
Some of these people--such as Stupak himself--have designs on higher office next year. Making sure that they fail should be a top priority for us. Narrow general election victories and low Progressive Punch scores indicate vulnerability to general election challenges and disappointed core constituencies, respectively. Crucial vote scores for this current session are particularly salient in terms of potential for recruiting activists to work against them. Another re-sort according to general election percentages is presented on the flip.
Jon Walker and David Dayen, both of Firedog Lake, are reporting that the Stupak Amendment which virtually bars BOTH Private Companies AND the Public Option from providing coverage for Reproductive Health Care for Women will receive a Floor Vote today in the House.
As Jon explains-
Stupak's amendment, by not allowing a private insurance company to sell a policy to anyone if they receive any amount of affordability tax credits, would make it impossible for a private insurance plan that covers abortion to survive on the individual and small group market. Stupak has threatened to bring down the entire bill if he does not get his amendment. Rep. Stupak called all previous "compromises" that had been offered "unacceptable."
As David reports-
The Democratic leadership is making a bet that, if it doesn't pass, Stupak and his cadres will sign on to the bill (I highly doubt it; most of them are no votes on health care entirely); and if it does pass, pro-choice Democrats won't sink the bill entirely (also, I highly doubt it). I'm a bit surprised that it's come to this. Also, Stupak appeared to have lied in the Rules Committee about how the deal "fell apart," since he got what he wanted.
This is an enormous bet, and not a well-designed one either, in my view. The Democratic Party will tomorrow give a minority of their caucus an opportunity to amend a large health care bill that would effectively ban abortion services coverage in the individual and small group insurance market, essentially telling private insurance companies what they cannot cover.
The amendment is expected to pass with the combined support of more than 40 anti-abortion Democrats and virtually every House Republican. That likelihood meant that leaders of the much larger group of Democrats who support abortion rights were not happy to learn of the deal.
"There will be no abortion, not just with public funds, but with private funds under the public option, and that's not acceptable," said Rep. Diana DeGette (D-Colo.).
House leaders met with that bloc of Democrats late Friday to try to quell their frustration., but the agreement makes clear that they believe abortion-rights Democrats will find it difficult to vote against the health-care bill even with such a restriction attached to it.
As far as I'm concerned this is a flat out deal breaker.
Health Care Reform with the Stupak Amendment is not worth passing and I intend to call the House Leadership and my Congressperson today to express that opinion.
Put yourself in Ian Pearl's position. You were diagnosed with muscular dystrophy shortly after your birth and have been confined to a wheelchair since you were six years old. Even though you were physically disabled, your brain is fully functional and you are striving to be the best you can be.
But then it happens. At 19 years old, you have a life-threatening complication that leaves you with one option: If you are to live, you must breathe with the help of a ventilator.
And through it all, through the life-threatening complications you had to endure along the way and through everything you have been through since you were born, who would have thought that it was a health insurance company that could be the thing that kills you.
Ian's story is better told by him, but here's the summary: Guardian decided that they were sick of covering Ian. At first, they pulled the health care plan that covered everyone in his dad's company in New York. That could be seen as a general move not targeted at Ian, but with some digging, Ian found that it was because of him and others with serious medical issues that Guardian made this decision. According to Ian's account on Huffington Post, Guardian created a "hit list" of their insured customers who were costing them the most to cover. These members were referred to by Guardian's top officials as "dogs" and "trainwrecks" because of their health conditions and their cost to insure. Ian was one of many targeted by Guardian, a process that included certain members like Ian having private investigators look for anything to cancel the plan so Guardian could save money.
It's not like Guardian couldn't afford to cover Ian and others in similar situations (from Ian's post):
While all this was going on, Guardian reported $7.5 billion revenue, net income of $437 million, and available capital of $4.3 billion in 2008. Unlike small businesses, Guardian's financial strength remained unscathed by the economic downturn.
What Guardian did was remove a plan they offered from an entire state all because of a select few of their insured who were seen as too costly.
Enter Senator Eric Schneiderman, who introduced S6263 or "Ian's Law" in the New York State Senate. The bill "provides enhanced consumer protections in the event of an insurer's discontinuance of coverage, including requiring approval of the superintendent and notice to policyholders." Specifically, it would prohibit insurance companies from doing what Guardian did: Canceling a whole class of a policy they were offering. With Ian's Law, the insurance company could not cancel this plan unless they received approval from the state Insurance Department.
How is this law different from current law? Currently, it is illegal to cancel someone's insurance because they have chronic health problems like muscular dystrophy. Thus, it would have been (or perhaps IS) illegal for Guardian to cancel Ian's policy. But nothing prevents them from pulling a whole class of insurance. Of course, if they did so because of those who they insure that have chronic health conditions, that IS illegal and should be dealt with and the individuals responsible should not just be held liable via civil action, they should also face criminal charges. Because in the case of Ian Pearl, this is life and death. And when insurance companies are playing games with people's lives, they should face serious punishment.
For more on this story, watch the video below from yesterday's press conference introducing Ian's Law. The full text of the bill is below the fold.
This bill would prevent health insurance companies from doing what Guardian did: Pulling coverage in the name of profit. That was the motive in the case of Ian and others. They were seen as "dogs" and "trainwrecks" because they were actually in need of their insurance and thus costing Guardian. Not that Guardian was hurting for the money. They still have their billions. But they wanted more. So they put Ian in a situation where he is now fighting for his life.
Ian's Law is important and while it would only apply to New York, it should be a law that every state introduces and passes and should become a federal law so that we can prevent insurance companies from deciding who they want to cover and who will be the cheapest to cover.
With a vote looming on Saturday night, the whip in the House for the health care bill remains very close. According to the whip count at The Hill, 43 Democrats are no, leaning no, or undecided. With 258 House Democrats, if every Republican votes "no" then 41 Democratic defections will defeat the bill.
One new "no" vote that just appeared, and is not on the list at The Hill, is freshmen Democrat Larry Kissell. This is noteworthy, given that in 2006 and 2008, Larry Kissell raised $485,795 on Act Blue. Some of that was raised directly by the campaign, but most of it came in through blog-organized fundraising pages.
Larry Kissell is a terrible fundraiser, and has always struggled with it. His Republican challenger already has more cash on hand than he does, which is a real rarity for Democratic incumbents. It might be a nice bit of pressure tomorrow to call his campaign office tomorrow, letting him know that a vote against the health care bill will not only slow donations, but will result in thousands of people asking for refunds.
If you happen to have given money to Larry Kissell in the past, go ahead and contact his campaign office tonight, letting him know how you feel about his opposition to health care reform with a public option. The number is 1-877-428-4048, and the email is info@larrykissell.com.
Under the bill insurance can be sold across state lines. But what this means is that the INSURER can pick his 'primary state' and be in almost all instances governed by its laws. Think credit cards and South Dakota. Except the bill defines 'State' as including all territories including Jack Abramoff's favorite client the Northern Marianas.
Like those 'Made in the USA' t-shirts actually produced by foreign workers in Chinese-owned sweat-shops in the N. Marianas? Well you are going to love your health insurance plan that is solely governed by the Northern Marianas Insurance Commissioner. More in the extended entry.
Probably the most visible proponents of H.R.676, the Single Payer/Medicare for All proposal currently being set forth as an alternative to H.R.3962 are Physicians for a National Health Program or PNHP. They are the last people you would expect to spoof the bill and so I invite everyone to actually visit their H.R.676 web-page and link to the PDF of the bill that they supply so that you can double-check every single claim I am going to make here.
Because I am going to be making some very harsh judgements on this bill. So before people start hating on me please do some homework.
This bill is not a serious attempt to present a policy proposal that could actually be passed. In fact in its current form it could not even be scored by CBO. It is instead a manifesto that tosses some red meat to gullible progressives. I support an ultimate transition to universal single payer, but we have a snowball's chance in hell of getting there by this road. Single Payer Now! people who don't want their bubble bursted should just pass this diary by, because you are not going to like what I have to say. Trust me on this one.
Extended entry text cross-posted at Angry Bear and MyDD
If you're confused about health care reform, we don't blame you. With all that's being said on the news and on the internet, it's hard to decipher the real message, the real truth about what reform means to us as a country and as individuals. As we've noted in earlier posts, there are many myths circulating with the intention of dissuading Americans from believing that a change in our current health care system would be a positive one. Whatever the motivation, let's focus on what is happening now.
With the Republicans becoming locked into being the party of No/Hell, No/Not Ever/Nada/Absolutely Not/Never Ever, Democrats are going to need to seriously consider revising the rules of the Senate at the beginning of next term. The gritty reality of the Senate rules minefield is making the passage of health care reform way too complicated. But it's virtually impossible to change the Senate rules in the middle of a term, so we are stuck with getting this thing done with the rules we have.
Fortunately, the Democratic leadership on Capitol Hill and at the White House are completely bound and determined that they will pass a health care reform bill by any means necessary. We have come too far, spent too much time and political capital, to turn back now. I think almost everyone in the party (except maybe 3 or 4 Senators) understand the disastrous consequences of not getting a bill passed.
There are, however, two realities that in combination make getting the deal done really complicated.
The first is that the progressive wing of the party is as dug in as I have ever seen them on having some form of a public option in this bill. This reality, which has been building for months now because of stronger progressive leadership in Congress and a powerful grassroots campaign to push for the public option, has been slow to dawn on the Washington elite, but my sense is that progressives are getting more determined on the issue every day , not less, and that with their rhetoric, their promises to activists, their signatures on letters promising to oppose anything without a public option, that their willingness to give on the issue has gone out the door.
The other reality is that getting the final four or five moderate Senators to vote to let this bill get passed at the end of the process- whether to take it to conference committee or for final passage- is extremely difficult. Between a range of factors including genuine policy and ideological concerns, worries about conservative home state politics, fears about money being cut off from the insurance industry for their campaigns, desire to extract every possible concession on every possible subject, and the egos of being a Senator, getting every last Democratic Senator is a massive challenge. This would be true, by the way, with or without the public option, but the high-profile symbolism of the public option just raises the degree of difficulty with some of these Senators.
I actually think Harry Reid is doing a remarkable job working with the holdouts. He has gotten a lot of criticism over the past few months, but given the Senate rules, he is doing a remarkable job working every last angle to get this bill moving (beginning of next term, you gotta get the rules changed, though, Senator). He is now really close to getting the 60 votes to get this bill to the floor for debate, and I think that will happen.
The biggest question, though, is what happens next. No one wants to go the reconciliation route because given those ugly Senate rules, it is just a convoluted mess to do things that way. It would take more time, create enormous logistical hassles and tie-ups, and almost certainly force the bill to be broken into two parts, one that would go through the reconciliation process and one that could not because its provisions aren't directly related to the budget. I can understand why Reid and the White House would rather not go down that path unless they absolutely must.
Unless all 60 Democrats stick with Harry Reid, though, that's what they will have to do. Getting this omelet done may require breaking a few Senatorial eggs. Having talked with some Senate staffers, I know they are preparing for every contingency, including reconciliation, and that's a very good thing, because I think that's what this will probably come down to in the end. I know it's a messy, irritating, uncomfortable way to get the deal done. But if any of those Senators decide they want to say no, and don't want to be players on the most important piece of legislation in at least 50 years, so be it. This legislation is too important not to pass.
Anti-immigration groups and pundits cling to phrases like "Illegal Alien" because they only focus on foreignness and danger. These extreme factions are all about casting immigrants as what ails our society, conjuring up demons upon which to focus national ire, and perpetuating a subhuman category of being. It's a convenient distraction from things that are actually endangering our nation. A new web-only series from ColorLines called "Torn Apart by Deportation"is the perfect antidote to people like CNN's Lou Dobbs.
