Well, it is done. Obama has signed the Senate bill into law. Americans now have a statutory right to health insurance, and in most if not all cases a right to have someone else pay for that insurance. I believe we have only the dimmest understanding of the full consequences of this legislation. It will raise taxes. Its cost-controls are unproven and trivial. The bill will increase demand for a fixed commodity and thus increase the overall price of that commodity. So health care spending will continue to rise as more people enter the system, the population gets older, and technology continues to improve. Susan Ferrechio runs through the various unintended consequences here.
Even when the exchanges become fully operational, not everyone will be insured. The penalty for violating the mandate is too small to coerce universal compliance. In fact, as Scott Gottlieb points out, it is quite likely that there will be more uninsured in the medium run as businesses fob off their employees to the exchanges and those employees who do not receive subsidies (43 percent of the individual market, according to CBO) cannot afford the higher premiums for government-mandated insurance. Liberals will respond to this crisis of their own making by calling for an increase to subsidies, a public option, or universal Medicare.
But leave all that aside for a moment. What I don't understand is the media compliance in the massive White House spin operation now underway. Yes, the health bill signing is a historic achievement -- the realization of a liberal dream that also puts us one step closer to national insolvency. And perhaps it is better for the Democrats to have something to run on in the fall rather than nothing. Even so, reading the accolades, you get the impression that the Democrats have just averted electoral disaster and the Republicans have committed a catastrophic political error in opposing a flawed and expensive big-government bill.
Please. All of this is partisan posturing. The truth is, we really don't know what will happen in November. But the underlying facts are these: The public and the GOP, and a not insignificant number of Democrats, oppose the Senate bill. The electorate is ideologically divided, with independents swinging right. Republicans are running even or better in the generic ballot. They need a 40-seat pickup to take back the House. The 49 House Democrats from districts who supported McCain are in real danger. The Congress is exhausted. Democrats must defend the legislation they passed by a slim, partisan margin. Unemployment remains high and the president's economic recovery program is not what you'd call a tremendous success.
Does the president have momentum? Of course. But memories are short. The momentum may not last. Michael Tomasky: "A mere forty-eight hours ago, Barack Obama was a struggling president, even a likely one-termer. Today, in the wake of the House’s narrow passage of the health-reform bill—which is to say, on the strength of a grand total of four votes, which if cast the other way would have ensured reform’s defeat—he’s suddenly once again a political mastermind and one of the most consequential presidents of the last half-century!"
Conservatives and Republicans may not be able to undo fully the damage this legislation does to government finances, insurance markets, and the American economy. But, as someone once said, the work goes on. The cause endures. The hope still lives. And the dream shall never die.
Sometime in the next hour, the House of Representatives of the United States of America will pass into law a health care reform that the people they represent oppose. In so doing, they will complete the decades-long project of American liberals to create an American welfare state along the lines you find in postwar Western Europe. Next comes immigration, cap-and-trade, a universal entitlement to higher education, and card-check legislation empowering unions. And after that come the tax hikes -- not just on the rich, but on everyone -- that will be required to pay for this drastic expansion of government. Never in modern congressional memory has so much been affected for so many by so few.
Do not believe anyone who tells you they understand the path American politics will take after this vote. It is truly unique. And yet a few things are clear. One, the idea of the "pro-life" Democrat should be tossed into the dust-heap along with such outmoded concepts as cold-fusion. Two, Obama will achieve a short-term bump in his political capital, and likely his poll ratings, because he will have achieved something that every Democratic president since Harry Truman has been unable to accomplish. And three, Obamacare is a testable proposition. The proponents of this legislation have made distinct claims regarding its costs and consequences that should not be forgotten -- especially when America encounters its first debt crisis some years from now.
Let's give the last word to Rep. Paul Ryan:
Liberals are right. America will never be the same.
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.”
Meanwhile, pundits are busily trying to figure out the Slaughter Rule, a procedural measure by which the House could "deem" the Senate health care bill passed without actually voting on it. If this sounds confusing, that's because it is.
Even liberal blogger Ezra Klein writes that "this is all about plausible deniability for House members who don't want to vote for the Senate bill, although I doubt many voters will find the denials plausible." Why doubt? A negative public reaction to the health care vote is a near certainty. The question is whether the reaction fades before November.
The House Democratic whip said yesterday he does not have the 216 votes necessary to pass the Senate health bill. In order to get there, he, Nancy Pelosi, and Steny Hoyer must flip some of the 39 House Democrats who voted No on the House bill last November to Yes. The latest whip count is here.
You'll note that not a single Democrat who voted No in November is counted under the "Lean Yes" or "Firm Yes" column. Meanwhile, there are 35 "Lean Nos" and "Firm Nos," and 72 "Undecided" members. The maximum number of Democratic defections is 37. The health care bill can be defeated.
President Obama has delayed his upcoming trip to the Pacific in order to pressure wavering House Democrats to back his health care reform. Obama was originally supposed to depart next Thursday, March 18. Now he'll leave Sunday the 21st. But that is still five days earlier than the Democrats' self-imposed deadline of March 26, when Congress is scheduled to begin its Easter Recess. At this point I wouldn't be surprised if Obama postpones the Asia trip until April. He and the leadership are engaged in a full-court press to win every vote.
Nancy Pelosi does not have the 216 votes necessary to pass the Senate health care bill. She's planning to go ahead without the votes of the Stupak 12. Today the Senate parliamentarian ruled the Senate bill must become law before "fixes" can be made via the parliamentary tactic known as reconciliation. The GOP Senate caucus will rigorously enforce the Byrd rule, limiting the reconciliation changes to budget matters and nothing more.
What's going on? The final push for Obamacare is about to begin. It starts on Monday, when the House Budget Committee will insert reconciliation instructions into the November House health care bill. By late Monday / early Tuesday, Budget will pass this bill and send it to the House Rules Committee, where Pelosi will change the language so that it matches the Senate bill. This is the final compromise legislation that may come to a vote on the House floor within weeks. "They're creating the shell," says Rep. Paul Ryan of Wisconsin.
In health care speech number 37, President Obama told his audience in St. Louis, Missouri, yesterday that "the time for talk is over." He's said this before, of course, and it wasn't any truer then than it is now. The talking won't stop until the bill is passed -- and even then, the talking won't stop, because disagreement is far more common than consensus. And even if the GOP doesn't repeal health care reform, it will seek to change the policy and shift it in a consumer-oriented, free-market direction over time.
The desire to stop talking reflects a deeper antagonism toward politics. Read George Will's column today: "Progressives are forever longing to replace the governance of people by the administration of things. Because they are entirely public-spirited, progressives volunteer to be the administrators, and to be as disinterested as the dickens."
In the umpteenth liberal column urging the president to "get tough" and "fight back" and "pass the damn bill," Richard Cohen writes: "What's wrong with the old belief -- a virtual childhood mantra -- that 'majority rules'?"
Good question! Let's take a moment for a basic civics lesson. The United States is not a unicameral majoritarian democracy. It is a bicameral constitutional republic with minority rights, checks and balances, and dispersed power. The majority does not rule. Why? Because the Founders sought to guard against what Tocqueville called the "tyranny of the majority." Liberals can bemoan this fact all they want. In order to change it, however, they would have to enact real change to the Constitution and the rules of the U.S. Senate. Good luck with that.
Thirty-five. Including today'sspeech, that's the number of times Obama has delivered major remarks on health care reform, according to the Washington Post. What has happened between number one and number 35? Tea parties, town hall protests, and rising public opposition to the legislation before Congress. Doctors in lab coats won't change the numbers: The public does not want this bill and does not think it will improve health care in America.
But of course that doesn't matter. What matters is whether Nancy Pelosi has 216 votes to pass the Senate health care bill and make Obamacare a reality. Three top Democrats tell The Hill she does. The numbers tell a slightly different story, however. With Rep. Michael Arcuri, Democrat of New York, switching from Yes to No, ABC News says Pelosi starts off with 215 -- one less than required.