Health Care Update

Updated March 21, 2009

The House just passed the Senate health care bill by a vote of 219 - 212.

Echoing Sen. Jim DeMint's characterization of health care as Obama's "Waterloo," former Bush speech writer David Frum labels the passage of health care legislation today the "most crushing legislative defeat since the 1960s" for conservatives and Republicans.

Frum lays the blame for the defeat squarely on Republican party leadership:

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.

This time, when we went for all the marbles, we ended with none.

He also reserves a share of blame for what he calls "the conservative entertainment industry."

... overheated talk has made it impossible for representatives to represent and elected leaders to lead. The real leaders are on TV and radio, and they have very different imperatives from people in government. Talk radio thrives on confrontation and recrimination. When Rush Limbaugh said that he wanted President Obama to fail, he was intelligently explaining his own interests. What he omitted to say – but what is equally true – is that he also wants Republicans to fail. If Republicans succeed – if they govern successfully in office and negotiate attractive compromises out of office – Rush’s listeners get less angry. And if they are less angry, they listen to the radio less, and hear fewer ads for Sleepnumber beds.

Read the full commentary.

Hat tip to for the following:

  1. Pollster John Anzalone found that in Democratic congressional districts likely to be contested:
    • 60% of likely voters want health care reform and want it to pass this year, including 64% of swing voters.
    • As we've noted previously, once voters learn about the plan a majority supports it. Fourteen provisions were supported by more than 60% of those polled. Coverage of pre-existing conditions was the most popular provision.
    • Swing voters are as concerned about insurance companies as they are about any potentially negative consequence of reform.

    Anzalone also found that swing voters wanted more information about the reform bill before taking a firm position.

  2. Writing in American Enterprise Institute blog (yes, that American Enterprise Institute), Resident Scholar Norman Ornstein labels as "ridiculous" the "level of misinformation and disinformation over the use of reconciliation"

    and the self-executing rule that would permit the House to pass the Senate health-care bill without voting on it directly. Ornstein notes that between 2005 and 2006, then-House Rules Committee Chairman David Dreier used the self-executing rule 35 times, including a $40 billion deficit reduction package, "so that his fellow GOPers could avoid an embarrassing vote on immigration."

Earlier, we noted these two items from Nate Silver's

  1. Setting aside the issue that voters think they oppose the health care bill, but actually support its provisions, Silver observes that's summary of numerous polls on the popularity of the health care bill shows that public support now is virtually unchanged from what it was when the measure passed the House
  2. This from February that shows that both times Congress approved a health care bill (House and Senate), Democrats got a bounce in the polls from their own party voters "without suffering any further harm from Republicans and independents."


As the debate proceeds this evening leading up to the health care bill vote, Republicans are repeatedly claiming that it will increase the deficit and destroy Medicare, in direct contradiction of the Congressional Budget Office (CBO) analysis:

Comprehensive health care reform will cost the federal government $940 billion over a ten-year period, but will increase revenue and cut other costs by a greater amount, leading to a reduction of $138 billion in the federal deficit over the same period, according to an analysis by the Congressional Budget Office.... It will cut the deficit by $1.2 trillion over the second ten year period.

[The bill] also extends Medicare's solvency by at least nine years and reduces the rate of its growth by 1.4 percent, while closing the doughnut hole for seniors, meaning there will no longer be a gap in coverage of medication. The CBO also estimated it would extend coverage to 32 million additional people.

More here.