I have been skeptical that significant healthcare reform will pass, and I remain so. But I am less certain right now. Democrats are convinced that they suffered in 1994 because they failed to pass healthcare reform. If that conviction holds, they have enough votes to pass something like the Baucus bill and all the other bits of legislation working their way through Congress. The public option is not yet quite dead.
But it's far from certain that they can pull it off. The Congressional Budget Office scored the current version of the Baucus bill well, declaring that it will actually reduce the deficit in the first decade. But the CBO is an easy standard, as it takes the bill's promises at face value.
I see few big problems. One is that Baucus relies on huge cuts in the current Medicare program. It's very hard to take that seriously, and if the cuts don't happen, the bill will be much more expensive. The Baucus bill also turns on a trick: the revenue part kicks in a couple years before the benefits start. That reduces the cost over the first decade, but it's a onetime trick. It is also only part of the total legislation, and it is hard to imagine that the rest of the Senate bills that would be part of the finished product won't increase the cost.
The House by contrast has been much less disciplined on the fiscal side. Harry Reid and Nancy Pelosi came out of a meeting and addressed the press today. They acted like a couple heading toward a divorce, except that only one of them knew it. Reid kept telling the reporters about the things they agreed on, and Pelosi made little not really faces and exasperated sounds. The bill may yet unite both sides against the middle.
It occurs to me that the Democrat's basic premise may be wrong. Perhaps they lost the confidence of the electorate in 1994 not because they failed to pass anything, but because what they tried to pass was deeply unpopular. If that's true, what are we to make of the current polls on healthcare reform? It has been steadily losing support all year. Now comes the Pew Research poll.
Overall, support is 34% in favor/47% opposed. Public opinion is strongly weighted against Congress on this matter. Now some of the opposition may come from the left, which wants stronger reform than it thinks it will get. That part of the electorate will be pleased if the finished product is bigger and more expensive.
But the really alarming news for proponents of reform is the 20% very strong support vs. 35% very strong opposition. I am guessing that 35% is almost all opposed to the reform effort altogether.
Other bad news is that two key groups of voters, independents and the elderly, show very little support for reform. Are Democrats really going to pass a major overhaul of the American healthcare system with no Republican support and strong opposition from the public? That would require amazing courage.
Of course, that courage will be rewarded if the legislation passes and Americans find out, fast, that they like it. If, instead, they find out that they don't like it, the results will be catastrophic for the Democrats. This is genuinely exciting!
ps. Yuval Levin at NRO's The Corner, notes the skepticism expressed in the CBO scoring on the Baucus plan. Here is a passage from page 12 of the report:
These projections assume that the proposals are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation.
One of the reasons for public skepticism, I think, is precisely that no one has any confidence in Congressional promises of responsible behavior.
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