Brown's election may ending up being a positive for health-care reform

By Shailagh Murray
Washington Post Staff Writer
Sunday, March 7, 2010

Remember how Republican Scott P. Brown's victory in January's Senate race in Massachusetts was supposed to represent a mortal blow to health-care reform?

"Probably back to the drawing board," Sen. Russell Feingold (D-Wis.) declared the next day. "Might be dead," Rep. Anthony Weiner (D-N.Y.) surmised. "We're back to where we were maybe even years ago," concluded Rep. Barney Frank (D-Mass.).

But rather than dooming the effort, Brown's win appears to have helped Democrats refocus the legislation and their strategy for selling it. Once on track to produce a bill that Republicans were prepared to depict as partisan and laden with special-interest perks, Democrats now expect to unveil legislation that costs less and more aggressively tackles health-care inflation -- a package they say could leave them less vulnerable in November. It drops the "Cornhusker Kickback" that so infuriated voters, and includes a few Republican ideas tacked on by President Obama.

"There's no government takeover of health care; there's an expansion of the private market, subsidies, more choice -- I mean, it's so much of what many of us had hoped for from the very beginning," said Sen. Mary Landrieu (D-La.), a moderate and reluctant supporter of the original Senate bill.

The House and Senate will launch the final legislative phase this week, with the aim of holding votes before the end of the month. The action will come in two phases. First the House will vote on the bill the Senate approved on Christmas Eve. Then each chamber is expected to consider a package of "fixes" offered under a budget rule known as reconciliation that will protect it from a GOP filibuster in the Senate.

Democrats could still fail to pass the overhaul for any number of reasons, and Republicans are vowing an epic showdown on the Senate floor to derail the reconciliation package. Sen. Judd Gregg (N.H.), the senior Republican on the Senate Budget Committee, which holds jurisdiction over reconciliation bills, has called the legislation "a giant asteroid headed at the Earth." He has pledged to block it.

Democratic pragmatism

But since Brown's election cost them their filibuster-proof supermajority in the Senate, Democrats have been in a more pragmatic mode. Though significant internal policy divisions remain, a new flexibility appears to have eased some ideological battles within the party.

The loss also forced Obama to engage more forcefully to save his top domestic policy goal by assuming the role of chief negotiator, which many Democrats had urged him to take on months ago. He has offered his own plan, in broad strokes, and convened a televised seven-hour summit in which he addressed major GOP criticisms. Both moves were key to restoring momentum, congressional Democrats said.

An attempt by a major California insurer to raise premiums by 39 percent also appears to have helped Democrats regain the political will to push health legislation to final passage without the cover of Republican support.

"The fog has lifted," Sen. Christopher J. Dodd (D-Conn.) said. "We have all had a chance to catch our breath. And I think people come to the conclusion that whatever the flaws, the status quo is not an option."

Brown's victory gave Republicans 41 Senate votes, enough to use the filibuster to block a final health-care bill from passing. To avoid that, Democrats will be forced to rely on the risky reconciliation process, allowing the legislation to clear the Senate on a simple majority vote, but under tight restrictions.

Although the Senate was the main obstacle to final passage, the primary burden of making reconciliation work will fall to House Speaker Nancy Pelosi (D-Calif). Senate Majority Leader Harry M. Reid (Nev.) can release up to nine Democrats who had voted for the original bill, and still retain the 50 votes he needs for passage. But because so many House Democrats dislike the Senate bill, Pelosi will probably need to gain converts among the 39 Democrats who opposed the original House legislation, which passed in November on a 220 to 215 vote.

House liberals oppose the Senate bill because it includes no government-run health plan. Socially conservative Democrats view the Senate's approach to abortion coverage as too permissive. Rust Belt Democrats oppose a new excise tax on high-value health plans that could hit union households. And Pelosi considers the Senate's subsidies for uninsured people to be insufficient.

Pelosi and Reid are expected to unveil the reconciliation package -- the fixes to the Senate bill sought by Obama and House Democrats -- early this week.

Obama weighs in

In the early days after Brown's win, many House Democrats refused even to discuss a vote on the Senate bill. But their resistance began to fade when Obama announced his own health-care proposal several days before the Feb. 25 White House summit.

"There's a limit to how much big, national legislation you can do without the president saying, 'I want this, I don't want this, I want this, I don't want this,' " said Weiner, who had voiced reluctance to vote for the Senate bill. "It had been a failure of the White House to engage in an important way."

House progressives may be prepared to make among the most significant concessions. Last summer, members of the group demanded that a public option be included in the bill. They have complained that the Senate bill's coverage of abortion is too restrictive, and they oppose the excise tax, preferring a surtax on wealthy households.

But Rep. Raul M. Grijalva (D-Ariz.), the caucus co-chairman, said after a meeting between Obama and progressives on Thursday that members of his bloc are likely to support the reconciliation strategy.

Grijalva said Obama "pledged his personal support" to continue working for a public option in future legislation, telling progressives that the current bill represented a "building block," as opposed to an endgame. Grijalva said Obama conceded that the bill wasn't perfect, but insisted the opportunity to enact an overhaul "won't come around again for a long time."

Progressives disavowed any suggestion that they had capitulated, especially on the public option. But some of their outside supporters suspect otherwise. Jane Hamsher, a prominent liberal blogger, called for Rep. Lynn Woolsey (Calif.) to resign as co-chair of the progressive caucus after Woolsey told a reporter she could vote for a bill without a public option.

The more moderate bill that is emerging may win support from fiscally conservative Democrats who rejected the House bill. That could help Pelosi offset progressive votes she could yet lose, along with Democrats who are dissatisfied by the Senate approach to abortion coverage, an issue that cannot be addressed in a reconciliation bill because it has no budget implications.

Rep. John Boccieri, a freshman Democrat from Ohio who voted against the House bill, signaled after the White House summit that he might support the legislation, saying that "we can finally move toward providing affordable, quality coverage for everyone."

Rep. Jason Altmire (D-Pa.) opposed the House bill because he viewed its approach to cost containment as insufficient, among other issues, but he said the Senate bill, combined with the reconciliation package, may prove more attractive. "I'm taking a fresh look, and we'll see," he said.

Even as Democrats are emboldened by their prospects, Republicans are convinced the majority party is walking into a political trap.

"There were a lot of discussions about what happened in Massachusetts and why," Senate Minority Leader Mitch McConnell (R-Ky.) said last week. He cited polls showing that the health-care bill was a major concern among voters in the Brown race, and warned that if Democrats manage to pass legislation, "it will be the issue in every race in America."

Gregg pledged to offer an exhaustive array of parliamentary challenges when the Senate considers the reconciliation package.

"It's going to be a very difficult exercise," he said. "House members who are relying on reconciliation to correct concerns with the Senate bill should think twice."