Showing Some Spine

After Scott Brown's victory in the special Massachusetts Senate election nearly a month ago, many in the mainstream media sounded the death knell for Barack Obama's health care reform. Brown's victory stripped the Democrats of their 60-vote supermajority. Without the numbers, it was said, Democratic senators had no chance of blocking Senate Republicans from filibustering health care reform, and the bill would not pass unless it was watered down to attract at least some Republican support. However, after Harry Reid's recent announcement that Democrats will push health care reform through the Senate using a congressional procedure known as budget reconciliation, it seems as if the bill may indeed have a chance of passing without any Republican support.

The reconciliation process is an obscure and complex one that can be used to streamline the passage of any measures that affect the federal budget and reduce the deficit. Essentially, when a bill is brought to Congress under the reconciliation procedure, debate in either house is limited, and, in the Senate, the use of the filibuster is forbidden. As a result, only a simple majority of 51 votes—rather than the traditional supermajority of 60—is needed to pass the bill in the upper chamber. This would solve the Democrats’ 60-vote problem, and enable them to include particularily divisive provisions—such as a public option—which conservative members of their own caucus (Joe Lieberman, Blanche Lincoln, Mary Landrieu, and Ben Nelson) oppose.

The Democrats have long had the reconciliation option on the table, and the progressive wing of the party (yours truly included) has for some time been urging the president and congressional leadership to use it. However, as a result of President Obama's desire to pass the health care bill under the guise of bipartisanship, the procedure had been put on the back burner.

Reid's announcement—and the support the President seems to be offering for the use of reconciliation—represents a welcome shift in Democratic strategy on the health care issue. Ever since President Obama made health care reform the centerpiece of his domestic agenda last year, the reconciliation procedure has been available for him to pass meaningful health care reform. But by not taking advantage of this opportunity and instead caving in to Republicans and Democratic moderates, the president has capitulated on one of the most crucial issues to come before the United States Congress in the history the Union.

What the president has termed “bipartisanship” has devolved into outright appeasement of Republican demands, and it has come at the expense of the American taxpayer and the American economy. Soaring health care costs are a significant strain on not only individuals and families across America, but also upon the federal budget. If spending on Medicaid and Medicare continues at the current rate, these programs will increase in cost from 5% of our national GDP today to 20% of GDP in 2050. Rising health care costs are breaking the federal budget and contributing greatly to the already formidable federal deficit. Clearly, this is not an issue on which he can afford to compromise.

If the Massachusetts election has taught the president anything, it's that ordinary voters are worried about the desperate financial plight of many individual Americans and about the enormity federal deficit. It is these voters—not the Republicans—the president needs to appease, and he can do this by implementing real, substantive health care reform to reduce the burden of health care costs on American families and the American government. In order to do so, however, he needs to play some hardball politics.

There are promising indications that the president is ready to dig his heels in for a fight; he has written his own version of the bill—to be unveiled in a public brainstorming session on health care with the GOP next week—and seems prepared to move forward with it under the reconciliation procedure. Despite claims from the right wing that such a move represents an unprecedented and extremist “nuclear option,” there is strong precedent for such action, especially with regard to health care: in 1985, Congress used the reconciliation procedure to pass the Consolidated Omnibus Budget Reconciliation Act (COBRA), which allowed employees leaving a firm to remain enrolled in their employer’s health care plan if they continued to pay premiums. Again in 1997, reconciliation was used to pass the State Children's Health Insurance Program (CHIP) and Medicare advantage, two programs which now provide benefits to more than 17 million Americans.

Had the president and Congress employed this policy months ago, they would have saved themselves a lot of time, energy and political capital. Had the President acted with dispatch in passing the health care reform bill, the Republicans would have had no opportunity to take control of the debate, defame the president and his allies, and push the Democratic Party into such disfavor with voters. However, the Democratic “bipartisan” strategy lent itself to delay, and over time, the President and his party simply lost control of the message.

But what's done is done. We can only hope that, this time, the president will have learned from his previous mistakes and will take swift action to pass a meaningful reform bill. To act in any other way would result in absolute disaster.

DAVID ZOPPO