Posts Tagged ‘Sen. Scott Brown’

Land Ho!

Monday, March 15th, 2010

After a stormy voyage of more than a year, this Monday morning finds the good ship health reform within sight of a final vote. The tentative timetable has a CBO score out today or tomorrow, Rules Committee action on Wednesday and a vote before the end of the week.

Our understanding is that House leaders are leaning toward a single vote on the Obama fixes that will contain a clause passing the Senate bill passed upon passage of the amendments. That way, House members who are unhappy with the Senate bill will never actually have to vote on it. We do not expect House leadership to wait for all the votes to be locked down before going to the floor, but instead think they will schedule the vote once they are close and try to round up the last few yeses as the debate and vote are happening.

Deconstructing the Opposition Strategy: Be Very Afraid

The Republicans’ strategy at this point boils down to trying to scare the House Democrats into voting no. Their two main lines of attack are:

  1. The Senate won’t pass the fix-it bill, leaving the House stuck with the Senate bill.
  2. It will mean electoral trouble for Democrats in the fall.

Let’s break down each argument:

The first argument has shifted in recent weeks. Originally, the Republicans tried to play on the institutional distrust between House and Senate, suggesting that if House members “took the plunge,” Senate Democrats would leave them high and dry. But as more and more Senate Democrats committed to voting yes on a package of amendments (at least the necessary 50 have done so) the power of this scare tactic has waned, and so Republicans now threaten instead to gum up the works, making passage as hard as possible.

As we observed before, the bill that comes to the Senate will be small and will contain things that are easy to support—e.g. closing the Medicare doughnut hole, increasing federal funding for Medicaid, taking out special deals. Though Republicans certainly might play obstruction games, such parliamentary delay tactics may not play out the way they hope—think of the way Gingrich shutting down government in the 90s backfired with the public.

The second line of attack is that if Congressional Democrats vote yes, it will cost them their jobs. Republicans recently put out a poll from districts of swing members purporting to show that vote for reform would hurt their electoral chances. Whether a coordinated part of the strategy or on their own initiative, two former Democratic pollsters made the same argument in a Washington Post op-ed.

What makes the piece fishy is that a) the only polling they cite is from Rassmussen, a polling company with a well-known “house effect” in favor of conservatives and Republicans  and b) they conclude that what the Democrats should do is essentially pass the House Republican health care proposal (you can compare the GOP proposal to Obama’s plan here).

A more fair reading of the polling:

  • People want major change
  • The main elements of the reform bill are popular, and some are very popular.
  • People don’t know what’s in the bill. As Jon Stewart pointed out (watch at 4:05), there have been not a few misinformation campaigns to take the credit there. But once they learn what’s actually in the bill, they like it a whole lot better.

As the President has become more active in the debate and pushed out a clearer message about what reform does—eliminate insurance company abuses, provide people with security of never losing their coverage, provide tax credits to small business to help them afford insurance—public support has trended up.

Not to say that there aren’t some fundamental glitches in public opinion. Voters think a bipartisan bill is important, and that Democrats should keep working with Republicans until they get it. What the media have failed to convey is that

  1. the bill is supported by Republicans, including governors, former Senate leaders and former administration officials and
  2. the bill is essentially what Republican Senators proposed as an alternative to the Clinton plan in the 90s.

Finally, what should be clear after the Blair House summit is that there is no hope of getting any kind of bipartisan agreement, short of giving up and passing the Republican plan. It would be much more meaningful if pollsters confined their questions to the real choices that are available instead of setting up straw men.

Polls aside, there’s no doubt Democrats are sailing into a stiff headwind right now. The President’s party usually loses seats in the midterm, and this year the persistently high unemployment is fueling voter discontent. Discontent is aimed at incumbents generally, but with a large number of House seats to defend in historically Republican-voting districts, and with incumbent Senate Democrats from conservative states like North Dakota and Indiana retiring, the GOP could see substantial pick-ups. Add in the expected flood of corporate cash into the elections courtesy of the Supreme Court and it is shaping up to be a tough year for Democrats, indeed.

But the fundamental political question persists: are Democrats helped or hurt by failure to pass health reform? They are already on the hook for voting yes and attack ads are already being produced. Flip-flopping is famously unpopular in politics and is unlikely to win a pass from reform opponents in the election. Passing reform gives House Democrats a concrete historic accomplishment with which to fight back.

It don’t come easy: Math in the House
In November, the House health care reform bill passed with  220 votes. Currently with vacancies, 216 are needed to win.  If everyone who voted yes last time votes yes again, reform passes. But House leaders can’t count on every yes vote remaining in place, so every yes-to-no vote must be offset by finding a no-to-yes.

Here are three places where votes are at risk:

Abortion
The number of Democrats willing to ‘vote off’ because of abortion seems to be declining.  A recent letter from pro-life clerics and theologians looked at the abortion provisions in the Senate bill, chapter and verse, and concludes that the bill does not provide federal funding for abortion.  Several members who voted for the Stupak amendment have publicly reached the same conclusion. And although Stupak claimed that he has about 12 members who will stick with him in voting off, his camp seems to be shrinking as the reality that the Senate bill does not allow federal funds for abortion has begun to sink in. Most analysts put the total number of no votes on account of abortion at five or six.

Immigration
The Senate bill bars undocumented immigrants from purchasing health insurance through the new insurance Exchanges even if they use their own money. It also fails to provide equal coverage to legal immigrants, continuing a ban on federal matching funds for state Medicaid coverage and offering instead less comprehensive and more costly coverage in the Exchange. As a result, a number of lawmakers in the Congressional Hispanic Caucus have said that they were leaning toward a no vote.  The issue is further complicated by the fact that the provision relating to undocumented individuals cannot be addressed via budget reconciliation.

But a Medicaid provision that gives states at least the option to cover legal immigrants could be addressed in reconciliation.  While most states would probably not take up the option, the measure could at least provide fiscal relief and perhaps better coverage in those states who now cover legal immigrants with 100 percent of state dollars.

How possible is this? Remember that in the initial House vote in November, there was an 11th hour change on abortion. It’s still possible that House leaders and the President will see the light on Medicaid for immigrants, especially if it is the only remaining obstacle to passage. However, even if this last-minute adjustment is made, the legislation does not go far enough in providing equal access to coverage for immigrants, which only underscores the importance of comprehensive immigration reform (check out this weekend’s march here).

The Scott Brown effect
In the wake of the election of Republican Senator Scott Brown, the Massachusetts delegation has become visibly uneasy about reform. Despite compelling evidence that the Brown election did not turn on the candidates’ positions on health care,  some members of the normally solidly liberal Massachusetts delegation have indicated concern about moving forward, though not all have given the same reasons.  It’s hard to imagine that Massachusetts Democrats would actually sink national health care reform. But as the Brown election proved, nothing can be taken for granted—even in Massachusetts.

Coming soon

Stay tuned for updates this week as the CBO score becomes available and we get more clarity about the vote schedule.

-Michael Miller, director of strategic policy

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What we talk about when we talk about Massachusetts

Friday, February 12th, 2010

Scott_P._BrownAs we’ve said here before, the Senate special election in Massachusetts was a lot of things. One can probably find a hundred different explanations for why Scott Brown won in a hundred different bars on a given five o’clock (though we’re not advocating this polling method.)

But there’s hard evidence that whatever else Massachusetts voters were saying, they weren’t saying stop national health reform. Despite our convincing case, the national media kept saying the election was a referendum on health care reform. We kept looking at the polls, which said otherwise. So we’re taking the old statistician’s route: Say it again, with numbers.

The Massachusetts special election was not about health reform.

For voters, the economy came first. Seventy-nine percent of voters said their first priority was to “strengthen the economy and create more good jobs.”

And though 82 percent of voters said they knew of Scott Brown’s position to oppose national reform, this was a wash — just as many said this made them more likely to vote for him, as said it made them less likely to vote for him. (No one said Bay Staters were an easy crowd to figure out.)

And perhaps most tellingly, a majority of both overall voters Brown supporters (including Brown himself) supported Massachusetts health reform – a law that has achieved 98 percent health insurance coverage and served as a model for the national bills passed by the House and Senate. That’s powerful stuff: Opposed to many commentators who have the freedom/burden of conjecturing what reform might do, Massachusetts residents are living with the changes reform made and is making everyday – and they’re pleased.

Hungry for more proof? Check out our fact sheet.

–Kate Petersen, Health Policy Hub

photo credit: Wikimedia Commons

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Insider Baseball: The Curse of the Bambino?

Monday, January 25th, 2010

In Massachusetts, baseball and politics are both blood sports. On Tuesday, as the election results came in on who would fill the seat of the late Senator Kennedy, Red Sox fans who are also health reformers got that old unpleasant feeling they had back to 1986 when the ball went through the legs of Sox first baseman Bill Buckner to give the New York Mets a victory in Game 6 and, ultimately, the World Series.

The latest twist in the health reform saga is so improbable that if you submitted the plotline of to-date as a work of fiction, it would be dismissed as too unbelievable.

After the passage of groundbreaking health care reform legislation in Massachusetts helps spark a renewed drive for national reform, the Senator who championed the cause of health care for all throughout is career is struck with terminal cancer. He is temporarily replaced by a friend and former staffer, who gives the Senate Democrats a crucial 60th vote to advance reform, while a longer-term replacement is selected in a special election –a process pursuant to a law that was passed in 2004 to prevent a then-Republican governor from appointing a Republican to replace the other Senator from Massachusetts, who was then running for President.  Starting to sound familiar? But, then, a virtually unknown Republican state senator (who voted for Massachusetts reform) triumphs in the special election process created to safeguard the seat for Democrats, giving Republicans a 41st vote in the Senate and potentially undermining passage of the very reform his predecessor fought for.

Really, you can’t make stuff like this up.

The question now is whether the upset victory of State Senator Scott Brown over Massachusetts Attorney General Martha Coakley (whose name has become, in some quarters, as unpronounceable as Lord Voldemort) will cause health reform to go the way of the 1986 Red Sox, or the 2004 team, with reformers playing the band of rag-tag Sox that saw an 0-3 record as just four wins short of the Pennant. (And were right.)

Were we there yet?
To understand what the Brown election does and doesn’t mean for the chances of passing health reform, it is useful to pause to assess where the political process stood on the eve of Tuesday’s election.

Last week, House and Senate leaders and the Obama administration had nearly concluded negotiations over merging the two chambers’ bills. Although not all the details of that agreement are available, most observers believe that in addition to a publicly reported compromise on the tax-treatment of health benefits, the proposal would also close the Medicare Part D prescription drug “doughnut hole,” improve premium and cost-sharing subsidies for low- and moderate-income people, provide stricter federal oversight of insurance Exchanges, and alter the special Medicaid deal given to the state of Nebraska.

The content of this deal had not yet been presented to members of either chamber and one issue that remained problematic was the language prohibiting federal funding from being used to pay for abortions. Anywhere from 3 to 15 House members who had voted yes on the original House bill were expected to vote no on the House-Senate merger because they did not accept the Senate language on segregating federal funds. This meant that the House leadership needed to turn as many as a dozen votes that had been no the first time into yes on the final bill.

What the election meant (and didn’t mean)
Many pundits and politicians are spinning the Massachusetts election as a referendum on national health care reform, but that greatly oversimplifies what is a complex and not-at-all clear correlation. While it is true that Scott Brown won and that a majority of Massachusetts voters have a negative view of national reform, it does not follow that Brown won because of health care reform.

First, health care reform closely in line with the federal bills is already up and running in Massachusetts, so the benefits of passing federal reform were less clear to Massachusetts voters. Indeed, Sen. Brown voted for health reform in Massachusetts in 2006 and did not repudiate his support during the election. Why would he?: Mass health reform enjoys public approval of more than 70 percent.

Instead, he attacked the taxes and health spending cuts that finance federal reform, asking why Massachusetts voters should pay more taxes to finance the cost of covering health insurance for people in other states. Brown ignored, and Coakley failed to make the case,  that national reform would actually help Massachusetts (a case I made to Jon Cohn at The Treatment last week.)

To listen to the talking heads, you’d think voters picked Brown as an anti-health-reform message. But, in fact, the opposite is true: Polls show that the majority of Massachusetts voters who care about health care cast their ballot for Attorney General Coakley.

Obstacle course
Although the legislative path must be altered, the Brown victory does not prevent Congress from concluding its work along the lines that were negotiated by leadership just prior to election.  Instead of the House amending the Senate bill and sending it back for concurrence, the House can simply pass the Senate bill as is and then send over a package of amendments that can be incorporated via budget reconciliation, a process that requires only a simple majority in the Senate, rather than 60 votes.

That being the case, why have so many—including some prominent House progressives—suggested that the Brown election heralds the death of comprehensive health reform?

The short answer is: the elections’ psychological impact. The Democrats, having recently lost two governorships and with a number of prominent lawmakers facing uncertain electoral prospects in 2010 and now losing what was expected to be an easy race for them, are spooked. To get over the finish line, House leaders must reassure nervous members of their caucus, hold defections to a minimum and still move as many as a dozen members from the No to the Yes column. At the same time, the House and Senate need to finalize agreement on a package of reforms that can meet the technical requirements of a budget reconciliation bill.

Reversing the Curse
While all of this is difficult, it is by no means impossible. And failing to pass major reform legislation (as Five Thirty-Eight and The Treatment have pointed out) is unlikely to improve the electoral prospects of Democrats. Failure also means the continuation of the status quo in health care, with rising premiums forcing more people to go without care or lose coverage entirely, higher rates of medical debt and personal bankruptcy, unchecked increases in federal health spending and an eroding base of paying customers for doctors, hospitals and drug makers (not to mention health insurers who nonetheless continue to oppose reform).

In fact, the only way to blunt political attacks on health care is to actually pass and implement the best possible reform so that voters can see for themselves that the attacks on the bill are baseless and begin to recognize the benefits.

In addition, the alternatives that have been floated—passing an entire bill through budget reconciliation or starting over in negotiation with Republicans—are, as ideas go, also rans for two reasons: Both are time-consuming propositions at a moment when most members are anxious to move on to other issues, and they offer no certainty of either substantive or political success.  With this in mind, a strong grassroots movement to shore up support for reform has helped to stem the initial post-election panic that seemed to first take hold.

While it’s too early to say for certain that the House and Senate will be able to conclude their negotiations with a package that will win the support of 218 House members, it is far too early to count reform out.  Remember, “the curse” was ultimately reversed.

–Michael Miller, director of strategic policy


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