CommonGround: Political news and analysis by Chuck Raasch, Gannett national writer

Decisions that got us to this moment in health care

By CHUCK RAASCH, Gannett National Writer
March 17. 2010 3:18PM

WASHINGTON — Thirteen months ago, when President Barack Obama launched his health care reform push, even he probably didn't realize how prescient he was when he declared, "I suffer no illusions that this will be an easy process."

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Since then, Democrats have suffered stinging voter rebukes in elections in Virginia, New Jersey and, especially, Massachusetts, where Scott Brown became a crucial 41st Republican vote in the Senate, in effect blocking Democrats' ability to prevent bill-killing filibusters.

Brown's election symbolized an important byproduct of this lengthy fight: a campaign-like re-engagement of activists, especially the newly aroused "tea party" movement on the political right.

Their protests around the country have raised the stakes and the uncertainty over the November congressional elections. Democrats have fueled their opposition with controversial legislative maneuvers to get a bill through, maneuvers Democrats correctly say that both sides have used in the past.

As the House of Representatives moves ever closer to a climactic vote that could put a highly partisan reform package on the president's desk, a glance back at the long road Democrats have taken reveals calculated political risks that could pay off in the long term but could also destroy their majority in the short term.

Meanwhile, Republicans have remained in lockstep throughout, convinced that the public would not accept a package of subsidies to help the uninsured get covered, higher taxes on higher-income workers, Medicare cuts and other measures likely to be in a final bill.

Looking back, the president, his allies and his foes made five crucial decisions that have largely brought us to where we are today:

1. Democrats pushed reform in one comprehensive legislative package, not break off parts that might have had easier roads to passage, such as eliminating pre-existing conditions as a reason to deny individual coverage.

Taking on health care in parts could have built bipartisan momentum and trust for later, tougher battles. But a piecemeal approach also might have allowed Republicans to pick off parts of the reforms that Obama and his Democratic allies deem essential for long-term budget and health care solvency, such as tax increases to help pay for insurance subsidies for low-income Americans.

2. Democrats continually tried to build the illusion of momentum by promising delivery of legislation by certain dates.

House Speaker Nancy Pelosi promised last May that a bill would be passed by the August recess, which did not happen. The succession of deadlines helped Republicans argue Democrats were trying to ram through legislation with huge consequences without giving them and the American people time to learn about it and try to make it better.

3. Democratic leaders attacked and tried to marginalize the opponents when pushback against the Democrats' reform ideas first appeared in raucous town hall meetings in August.

Pelosi said the protesters were the product of an "Astroturf" movement, implying they were drummed up by Washington interest groups, of which all clearly were not. On Aug. 10, when Pelosi and House Majority Leader Steny Hoyer wrote in USA Today that the more raucous protesters were "un-American," the opposition intensified — and took on a test-of-patriotism hue.

4. Congressional Republicans regained a foothold among fiscal conservatives by opposing Democrats' reform efforts on the basis of cost.

But some of their leaders demagogued their opposition to the plan and, in doing so, undermined Republicans' arguments that they wanted reform, just not Obama's brand of reform.

A leading example was 2008 vice presidential nominee Sarah Palin's assertion that the legislation would create "death panels" to ration care, which Democrats said was patently false.

The contretemps gave Obama an opening to counterattack Republicans as do-nothings, and at a rally in August he pounced. He said that while people can come to different conclusions based on the facts, "what you can't do — or what you shouldn't do — is start saying things like we 'want to set up death panels to pull the plug on Grandma.'"

5. Democrats failed to see until too late the real-time effects that health care politics were having.

Their Massachusetts Senate nominee, Martha Coakley, took time off in the month before the January special election, and by the time Democrats realized that Brown had surged ahead, it was too late for a comeback.

And so in arguably the most Democratic state in the country, Obama's party took a big hit, just one of many surprises on a long and unfinished road.

Contact Chuck Raasch at craasch@gannett.com, follow him on Twitter or join in the Facebook conversation.

 

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