Today, the President signed the Senate health care reform bill into law. The reconciliation bill is still pending and will likely be completed by next week, bringing a long, tortuous and messy process to a close.
Just when the legislation appeared ready to fail at many points, some deft sausage-making kept things moving:
- Nancy Pelosi wouldn’t have had enough votes to pass the bill last fall if she hadn’t adopted the “Stupak Amendment” regarding federal funding of abortion.
- The “Cornhusker Kickback” and other special deals were necessary to get the sixty votes required to pass the Senate bill on Christmas Eve. No deals – no health care bill.
- If Senate Democrats didn’t have sixty-votes, it’s unlikely there would be comprehensive health care reform. Republicans tried to kill the bill as a matter of political strategy. Important regulatory and other changes couldn’t have been adopted via reconciliation.
- The election of Scott Brown was essential to uniting Democrats. There were never enough Democratic votes in the House or the Senate to adopt single payer, the public option or medicare buy-in, but the “progressive” base of the party kept pushing for it. The Brown election helped Democrats get realistic about what was possible, and that helped Democrats recognize that while the health care bill wasn’t perfect, it was a good foundation that also represented historic change.
- When the Brown election had demoralized Democrats declaring health care reform dead (oh ye little faith, Barney Frank!), Obama created a new intermediate distraction (the Summit) to buy some time to adjust to the new situation. He used the summit to make it clear to everyone that Republicans were simply trying to delay, and to make it clear that he was going to push forward.
Ultimately, there’s nothing like a good external (existential?) threat. Democratic legislators, faced with potentially catastrophic election prospects in November, finally figured out their best course of action was to finish the job.
Great legislation requires some core principles, a strategy, good people working hard to execute, great internal and external communications, etc. But it also requires an ability to improvise and to change as required. There’s always a risk of failure, but you make the decisions you have to make to keep things moving forward. And if you’re lucky, well:
