Scant Agreement on Healthcare

Healthcare reform bills are going to start coming out from behind their respective curtains in the days and weeks to come, and the issue will consume the entire summer here in Washington. If two bills pass the House and Senate before Congress begins its August recess — which is currently the plan — we will be able to say we have witnessed a miracle.

How the Democrats plan to pull this off is beyond me and most other Congress-watchers who have witnessed the gridlock and legislative grinding halt that most major initiatives encounter in the marbled halls of the Capitol. President Obama’s aggressive push for passing something this year is admirable and likely the only hope healthcare has of becoming a reality at all during his presidency, but what we’re seeing nearly halfway through June isn’t encouraging.

Obama faces growing public concern over deficits and debt and is pledging to pay for healthcare through “pay-go” budgeting rules, meaning every expenditure is paid for by a cut somewhere else. This means raising taxes or slicing other spending items like entitlement programs — all of which have been fought to death in the past; there are no easy savings left.

Republicans have lined up against a public plan, Democrats are split on whether the public plan would only kick in on a trigger, Obama hasn’t been clear at all which kind of public plan he wants and will fight for, a proposal to hit up generous health plans isn’t only opposed by the rich but by unions whose members often enjoy such plans, taxing employer benefits is now on the table and agreement is nowhere to be found.

Obama doesn’t have Tom Daschle or Sen. Edward Kennedy (D-Mass.), both of whom he figured all along would push this behemoth over the finish line. He has reconciliation — the budgetary procedure by which he can push through a reform package with only 51 votes in the Senate, protected from filibuster. But business is nervous, conservative Democrats are nervous, and Republicans already say the process is being rushed and they are being shut out. Democrats who have been around longer than Barack Obama know that passing something as large as an overhaul of the healthcare system should be a bipartisan process with adequate buy-in from the minority. Otherwise it is likely to get repealed soon after.

I will recognize the miracle, should it happen. And I hate to be a cynic. But this doesn’t feel like six weeks from floor passage of two bills to me.

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