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Today in Health Care Reform

Laying the New Foundation, brick by brick.

9:40 AM, Mar 18, 2010 • By MATTHEW CONTINETTI
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The Democrats' race to pass health care reform is getting exhausting. It's not only the constant rush of developments to the story. The poor undecided congressmen are also tuckered out:

Rep. Jason Altmire has met with President Obama twice this month and received a phone call from Air Force One. Two planes circled his western Pennsylvania district, trailing banners urging him to vote against the health-care bill. And conservative "tea party" activists confronted him at his office, trying to force him to answer: "Are you for or against the bill?"

The pressure has been extreme over the past two weeks on Altmire and the few dozen House Democrats who say they still have not decidedhow they will vote on ambitious legislation designed to remake the nation's health-care system.

Says Bart Stupak: “All the phones are unplugged at our house — tired of the obscene calls and threats. [My wife] won’t watch TV,” Stupak said during an hourlong interview with The Hill in his Rayburn office. “People saying they’re going to spit on you and all this. That’s just not fun.”

No, it's not. It's a do-or-die moment and one of the most significant (and costly) social reforms in American history is at stake. The president isn't exactly kidding when he says his presidency is on the line. If health care fails, he'd surely have time to recover. But his credibility would take a huge blow and Democrats would run away screaming from his agenda. At least I think that's the point Jacob Hacker makes here.

Not that passing the bill would make things any better. Grover Norquist points out that, if health care reform passes, Obama would break his pledge not to raise middle-class taxes -- and thus doom his reelection bid. It's a bad idea to make predictions about an election that is several geologic ages away. But the no-new-middle-class-taxes pledge is going to come back to Obama for sure.

Where does the bill stand? The Kucinich flip helps Pelosi. But he's still the only No Democrat to announce he's a Yes this time around. Still to come: the heretofore mythical CBO score and the introduction of the rule, which will include the final reconciliation language. At this point the earliest a vote can be called is Sunday morning. Don't be surprised if Obama postpones his Pacific trip once more.

G.B. Shaw famously said you could lay a thousand economists end to end and they would not reach a conclusion. Even so, today a group of 100 economists sent a letter to Obama and Pelosi explaining how the Senate bill will saddle the economy with tax increases, increased health costs, and burdensome public debt.

Also, set some time aside to read Fred Barnes's Wall Street Journal op-ed today. He makes a crucial point: Whatever happens this week is the beginning, not the end, of the health care debate. If the bill passes, it will reshape politics. The Democrats will move quickly to add a public option and more generous (i.e., expensive) subsidies and benefits. Legal challenges and the battle to change or repeal the law will begin. Every year, the parties will clash over spending. If wavering Democrats are tired now, just wait. Before long they'll be collapsing from fatigue.

Provided they still have a job, of course.

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