Even with Mass. Loss, Dems can still Pass Healthcare Reform

Even with the loss of the 60th vote in the Senate, the Dems have a couple possibilities to still pass the healthcare bill. One option is to try to work out a deal really quickly, before Scott Brown is seated - that's going to be a struggle, and passing the bill with an already-voted-out lame duck appointed Mass Senator is going to seem awfully illegitimate to a lot of people. Another option is to use the budget reconciliation process in the Senate to pass the final bill, which you can do with only 50 votes (more about this later this week). The third (and at the moment, most likely) plan is to have the House go ahead and pass the bill passed earlier by the Senate. That bill has a number of differences with the House bill, 2 of which are going to be difficult to finesse (other differences are listed here):

• The first is the means of paying for the healthcare subsidies which will allow lower-income folks to buy healthcare. The House bill pays for subsidies through a surtax on couples or individuals making more than $1m a year (the tax would only be on income above $1m). The Senate bill pays for subsidies through a 0.8% increase in the medicare tax on couples making over $250k, as well as a fee on insurance plans with premiums over $8,500 for individuals or $23k for families (this fee would be paid by insurance companies). The Senate's plan has been opposed by unions, whose members usually have pretty expensive healthcare plans. Prior to tonight's loss, unions had been negotiating to have their members (anyone whose healthcare is provided by an employee pursuant to a collective bargaining agreement) exempt from the fee for 2 years. I don't think that unions will allow the whole reform project to go under on this score.
• The second issue is the "Stupak amendment" passed by the House, under which nobody who gets a subsidy to help pay for health insurance can pick a plan that covers an abortion. The Senate's bill does not have this restriction. This is going to be a significant sticking point, because the House would have to back off the Stupak restrictions that they passed just a couple months ago. I think that there's some wiggle-room here, because I imagine that some of the people who voted for Stupak did so understanding that it might be removed by conference committee, and would be willing to vote for the Senate bill without those restrictions. I bet that pro-life organizations will be putting an enormous amount of pressure on those members of congress over the next couple weeks to try to keep them from voting for a "Stupak-free" bill.

The original House bill only passed by 5 votes, which has some commentators thinking that there's no way that, without the pro-life language or the pro-union financing provision, the Senate bill will get enough votes to pass the House. This argument fails to note that Nancy Pelosi gave permission to many House Dems in marginal districts to vote against the bill, knowing that their votes weren't necessary to pass it. These Dems aren't going to get that dispensation again.

They are going to have to look back to 1994 and recall what happened the last time Congress dropped the ball on major domestic policy legislation- it lead to a Republican tidal wave that swept a lot of folks out of office. If that happens again, the most vulnerable Dems will be the very people in those marginal seats. They need to realize that if they face a tea-party tidal wave, voting against the healthcare bill will not save them - it will only alienate progressives. Tea-party voters aren't going to vote for a Democrat under any circumstances, even one who voted against healthcare reform. The only hope for vulnerable House Dems is to nip the tidal-wave in the bud, by getting a big win for health care reform.