Max Baucus unveiled his bill last week. His Senate Finance Committee begins its formal markup of the legislation on Tuesday. And still no Republicans have signed on. Despite the Montana Senator's unshakable confidence that his push for bipartisanship will bear fruit, it is looking increasingly likely that Democrats will have to go it alone on health care or at least virtually alone, with Maine Senator Olympia Snowe, the one moderate Republican who has remained open to supporting the bill. Walking down the corridors of the Senate on Sept. 17, I encountered a senior Senate Democratic aide whistling Simon & Garfunkel's classic "I Am a Rock," the lyrics to which, he noted bemusedly, Democrats should take heart.
But if Democrats end up passing this major piece of legislation essentially on their own, there's no guarantee that it will spare them pain. On the contrary, Republicans are betting that whatever does get passed exclusively by their opponents will come back to bite the Democrats in both 2010 and 2012. Even while some pundits say the GOP will end up looking obstructionist, Republicans are quick to point out that the bulk of the bill the exchange, which will help small businesses and the 47 million people who are uninsured buy affordable insurance, along with subsidies to help those who can't afford it and new regulations of insurers' practices wouldn't go into effect until 2013 (this is partly because of the complexity of setting up such a monumental enterprise and partly to help lessen the 10-year cost of the bill). Republicans daydream that Dems could be seen as passing a giant, expensive boondoggle with nothing to show for it. "People are already worried at the rate of spending going on," says Senator John Cornyn, a Texas Republican who heads the National Republican Senatorial Committee, which helps get Republican candidates elected to the Senate. "They see Democrats rush this thing through, strong-arming their way through, and that will make folks even more nervous."
To counter that kind of attack, there are significant provisions in the bill that would go into effect immediately, according to a White House aide. The practice of rescission (nixing policies for dubious reasons when sick people need them most) and annual and lifetime spending caps that insurers place on some policyholders would immediately be banned. For those who can't get insurance because of pre-existing conditions, a catastrophic-care fund would immediately be set up to provide coverage. And as part of an agreement with the pharmaceutical industry, seniors who fall into the so-called doughnut hole (after they spend their first $2,700) in the Medicare Prescription Drug Program would immediately start receiving 50% discounts.
"We, of course, prefer to work with Republicans to get this done. I'm not sure it's better for Democrats, but it's certainly better for the country," says Eric Schultz, a spokesman for the Democratic Senatorial Campaign Committee, which works to elect Democrats to the Senate. "But the bottom line is that Democrats were elected in 2006 and 2008 with a directive to change the direction of the country, and the health-care crisis was at the top of the list. We will not let political posturing get in the way of progress. It's this same posturing that is why we're in this mess today and it's also why the Republican Party is in such bad shape today."
Still, say Republicans, taking on such a monumental bill solo has almost never been done before: 16 Republicans voted for the 1935 Social Security Act and 13 voted to create Medicare, and they are quick to point out that 12 Democrats crossed the aisle to vote for the Medicare Prescription Drug Program in 2005. "I think the sheer act of passing it with Democratic-only votes would result in significant backlash, not just from Republicans though clearly it would gin up Republican intensity but I suspect from independents as well," says Whit Ayers, a GOP strategist.
Ayers, though, has a conveniently short memory: only two Democrats were involved in the negotiations surrounding the Medicare Prescription Drug measure. Once a bill like that gets to the floor, members have a much harder time voting down legislation that could help thousands, if not millions, of constituents. For that reason, Democrats are hoping the health-care bill will be a work of compromise so that, when they do get enough votes to bring it to the floor, it will be hard for Republicans to vote against it.
That may be a risky bet, but Democrats know, as Bill Clinton so bitterly learned, that the biggest risk could be passing nothing at all. If they don't get health care now, the fallout could kneecap the Obama Administration for the next three years, and would likely be felt at the polls. Of course, that reality creates its own complications; if the party has little choice but to pass the bill by itself, progressives have even less patience for producing the kind of centrist bill that Baucus has been pushing. But Dems will probably stick with a centrist bill because no one builds majorities from the extreme left or right, and the holy grail(s) are those independent voters who sit smack in the middle. A CNN poll earlier this month found that for the first time, a majority of independents, 53%, disapproved of Obama's handling of health care a 13-point drop since March.
Those same voters are what kept Republicans Senators Mike Enzi and Chuck Grassley at the bargaining table long after all expectations had died that they would ever sign on to a deal: as much as they would be happy to kill health-care reform, Republicans want to make the case that they gave bipartisanship their all. In fact, both cited "partisan deadlines" as reasons that they couldn't vote for the bill.
The Republicans need to avoid the perception of being the Party of No, and it's not clear that they are succeeding. A Bloomberg survey this month found that a majority of people were disapproving of the Republican scare tactics that were used over the summer: 63% said death panels weren't legit, 59% said they didn't believe health care would be rationed, and 52% said they didn't believe the oft-repeated GOP line that the Dems are putting the nation on a path to socialized medicine. And a Sept. 11-13 USA Today/Gallup poll found that 60% believe Obama is reaching out across the aisle, while only 33% say Republicans are reciprocating.