Sunday, March 21, 2010

House passes health care reform, Obama to sign.

I've been busy with a number of things, but I've been watching the events taking place on the health care debate. After the Senate passed the health care reform bill in December, the bill went into a torturous reconciliation process, where a number of House Democrats did not like the Senate version of the bill. There was a lot of back-and-forth going on between the two chambers, topped with Republican congress-critters tossing threats and temper tantrums at the Democrats for trying to reconcile the two bills. Even President Barack Obama canceled his East Asian trip to perform some last-minute arm twisting on House Democrats to vote for the health reform package.

So today was the big day for the House to debate and approve the Senate version of the health care reform bill.

The House approved the Senate's health care reform bill 219-212. From ABC News:

The House of Representatives passed the sweeping health care bill with a narrow margin, securing a significant victory for President Obama, who lobbied hard this week for the controversial legislation.

The vote was certain after the House Democratic leadership finalized a deal this afternoon with anti-abortion Democrats to vote for the health care bill in exchange for an executive order from Obama affirming no federal funding for abortion.

The House today voted on two separate pieces of legislation. One, the Senate health care bill and second, the amendments to that bill made by House members and Obama.

The bill now goes to the president's desk to sign, after which it will become law. The White House has not yet decided where or when Obama will sign the Senate health care bill, which he needs to do before the "fixes" to that bill begin to be debated in the Senate, though White House officials say it will not be this evening.

As the last speaker before the vote, House Speaker Nancy Pelosi of California said that by passing the bill, Congress would be taking a historic step.

"We will be joining those who established Social Security, Medicare and now, tonight, health care for all Americans," Pelosi said.

The bill still has to go back to the Senate for approval of reconciliation "fixes" that House Democrats have proposed. Senate Majority Leader Harry Reid assured the House, Saturday, that he has the 51 majority vote needed to pass the fixes, with the Senate expected to pick up the bill on Tuesday. Health care reform will be law.

Watching this debate unfold, what really interested me here is a couple of factors. The big factor has been the Republican response to the entire health care debate. The GOP never wanted any such health care reform passed--be it a Democratic health care reform or a Republican health care reform. In fact, I don't think the Republicans had a health care reform package they could sell to the American public. They never bothered taking up the mantle of health care reform, at least since President Richard Nixon looked at reforming a national health insurance plan for Americans. The GOP and the health insurance industry completely shot down President Bill Clinton's health care plan in 1994. Even when the Republicans controlled both houses of Congress under George W. Bush, they never bothered looking at health care, with the exception of passing the Medicare Prescription Drug, Improvement, and Modernization Act in 2003. But the prescription drug act is not passing a comprehensive health care bill for all Americans, but rather overhauling Medicare to provide prescription drugs to its recipients. But when you get Blue Cross raising health insurance premiums to its customers by 39 percent this month, and around 45 million Americans are uninsured, the Republicans have turned a blind eye to this growing problem. For the past two years, the GOP refused to join the Democrats in a bipartisan attempt to reform health care, using obstructionism, threats, lies, and deceit as a means to kill health care reform--Death panels anyone? The Republicans thought that by playing the obstructionist game, then Americans would suffer so much under a crushing health care system, job losses, a recessionary economy, and all sorts of other problems, that they would vote the Democrats out of Congress, and bring the Republicans back into the majority. Then the Republicans could play even more obstructionism against President Obama until 2012, when Sarah Palin will be elected into the Oval Office? So the Republicans were united in opposing health care reform. The vote even shows such opposition, since not one Republican House member voted for the health reform bill tonight.

That has all changed. Republican obstructionism failed. It brings me to a second factor in that the passage of this health care bill was a victory that President Obama really needed to re-energize his presidential agenda. Health care reform was a major Obama campaign promise during the 2008 presidential election. When President Obama stepped into the Oval Office, he tried to fulfill his promise of health care reform, but made some serious mistakes. The first mistake Obama made was that he never took the bully pulpit and tell Congress, "This is what I want from health care reform. Here are my proposals, now let us work together in creating real reform." I got the impression that Obama administration took a hands off approach to health care reform, instead saying, "Okay Congress, pass some health care legislation so I can sign it." Talk about a near recipe for disaster. Both congressional houses passed their own versions of health care reform bill which neither house liked the other chamber's bill. I am actually amazed at how close the bill passed tonight. The second mistake the Obama administration made in health care was really allowing the Republicans to control the message on health care for the past couple of years. Think about it--what do you remember of the message on health care reform? I remember death panels, Obamacare killing grandma, Obamacare reducing your Medicare benefits, Obamacare raising taxes, and Obamacare. I remember Tea Party protests, town hall disruptions organized by conservative groups, and even health insurance industry urging their employees to attend protest groups against health care reform. Looking back at the debate in 2009, it seemed like the message pounded into the American public was that health care reform was a terrible bill--look at all these Americans who are afraid of the evils of health care reform. Health care reform should be stopped. That was the message, brought to you by the Republican Party. I never heard much from the Obama administration to counter the Republican spin on health care. And yet, I look at the polls on the health care debate, Americans are split on whether they approve or disapprove of health care reform--it actually depends on how the question is phrased to shift Americans' opinions for either approval or disapproval on the issue. So President Obama lost the message on health care reform to the Republicans. That should have been enough to kill the issue, but it didn't.

Health care reform passed. I think in the last three months, President Obama and the Democrats woke up to the possibility that this reform bill will not pass. The turning point may have been when Massachusetts Republican state senator Scott Brown won a huge victory over Democratic Attorney General Martha Coakley for the late Ted Kennedy's vacant Senate seat in late January. Republicans thought that this was the American voters' repudiation of President Obama, and the congressional Democrats, agenda. I think it is a voter's anger over incumbents--both Democrat and Republican. Either way, this was a wake-up call for both President Obama and the Democrats. They needed to pass health care soon, and show a major legislative achievement for the Democrats, and a political victory for President Obama. President Obama needed to show the American people that he could deliver a campaign promise--especially during a troubled economic time, where Americans are worried about their jobs, their financial situation, the housing crisis, and the health care crisis.

Not only that, but 2010 is a midterm election year, where the president's party usually loses seats. If the health care reform debate was dragged out into the late summer/early fall, the Republicans would use health care in attack ads against Democrats in conservative-leaning states and districts. Those Democratic lawmakers would be more worried about their jobs, rather than about passing legislation. Health care would never have passed. And if the Republicans did take control of at least one house, we'll say the Senate, then the GOP majority leadership would simply throw the health care reform bill in the trash. Of course, the Republicans will obviously use this passage of health care reform in attack ads against the Democrats, but President Obama can also tell American voters that he fulfilled his campaign promise to deliver health care reform. This is huge. If President Obama failed at passing health care reform, I think it would have emboldened the Republicans, and conservative constituents, into greater attacks against the Democrats, and the president, for control of Congress. Such emboldened conservative constituents may have gone out of their way to vote Republican candidates in. The Democrats failure at passing health care reform would have also angered their liberal constituents. Would liberal Democrats have gone out of their way to vote for Democratic candidates that failed to deliver on health care reform? I'm sure there are plenty of liberal activists that are speculating on whether to replace those Democratic House members that have voted against the health care reform bill.

Finally, there is President Obama. This could have been a huge failure for the President, who was elected into office on a campaign promise of hope and change. Americans wanted change. If President Obama failed to pressure the Democrats into passing health care reform, he would have been seen by Americans as a president who could not deliver on his campaign promise of hope and change. President Obama would certainly have been a lame duck in the final two years of his first term in office--especially if an emboldened GOP gained control of the Senate. But now, the midterm elections have been changed. President Obama can sell his health care campaign promise to the American voters. The Democrats can attack the Republicans as being against providing affordable health care to Americans. The Republicans can still still play obstructionism and use fear attacks against the president and the Democrats on health care, however, I think the fear factor will be greatly diminished against the moderates and independents (the hard-lined conservatives will still believe in Obamacare's death panels).

This midterm election will still be about the issue of health care. But now the focus will shift to what will this new health care law do for the American voter? Instead of fear-mongering, the issue will be on legal specifics of this law. I think that will be more difficult for Republicans to raise with their fear-mongering, which they will still engage in. Finally, this huge hurdle is over for the Democrats and President Obama--they can now concentrate on other issues, such as financial reform, or jobs. President Obama and the congressional Democrats can work on passing more legislation, against Republican obstructionism, that they can also sell to the American voters. With the health care reform bill passed, American voters can now decide if this is the direction that they want to see their country heading towards, and vote accordingly. This is a whole new midterm election.

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