Health care: Dems just don't have the votes 

Now that the White House and Democrats are making a last push to pass their so-far-unpassable national health care bills, the only thing that matters is whether they can get 217 votes for victory in the House and 50 votes (plus the vice-president's tie-breaker) for reconciliation in the Senate. Good policy doesn't matter. Bad policy doesn't matter. All that matters is votes.

The White House and Democrats have lost sight of the essential insanity of the process -- desperately searching for corners to cut so they can pass an enormous re-ordering of the American economy that Americans don't want -- because all they can think about now is passing something. It could be anything, as long as it is "comprehensive."

So where are the votes? Start in the House. House Democrats have to do two things. First, they have to pass the health care bill that Senate Democrats passed on December 24 -- Cornhusker Kickback, Louisiana Purchase and all. They could stop there and send the bill to the president's desk, but that, of course, is not going to happen. So they then have to pass a set of agreed-upon "fixes" to the Senate bill that the Senate would then pass by using the reconciliation process. (The fixes will start in the House; reconciliation bills have to originate in the House because all revenue measures have to originate in the House.)

The original House health care bill passed last November by a 220 to 215 margin. But supporters have lost four votes since then. Democrat Rep. Robert Wexler has left the House, and Rep. Neil Abercrombie is expected to leave this week. Rep. John Murtha died, and Republican Rep. Joseph Cao, the only GOP lawmaker to vote for the bill, now says he will vote against the measure. That leaves Democrats with 216 votes, one short of the 217 it will take to pass. (That number is one less than the usual 218 because of the vacancies in the House.)

In addition, it's thought that some number of Democrats who voted for the original bill will likely vote against the Senate version because it lacks the House bill's language on the subject of abortion (the president's proposed compromise doesn't help on that subject, either). Republicans estimate there may be 11 such Democrats. If there are, that takes the number down to 205, which means Speaker Nancy Pelosi will need to find a dozen "yes" votes to make up the difference. It is widely thought that she had some possible yes votes in reserve last November, to be used if they were absolutely essential to passage. Are there 12? No one knows.

And that doesn't begin to consider the Democrats who voted in favor of the House bill last November but have now finally been persuaded, by continued public opposition in the polls, the Senate election in Massachusetts, and the generally worsening political climate for Democrats, that another vote in favor of the wildly unpopular health bill would be suicidal. Can Pelosi really be willing to bet that she can get everyone who originally voted yes on the bill to vote yes again? And for the Democrats who originally voted against the bill -- does anyone believe that any are going to change their minds to vote yes?

Remember, no matter what you hear, the House will have to vote yes on the original Senate bill, outrages and all. Democratic leaders will try to arrange things so that that vote will somehow be obscured, and the emphasis will be on the "fixes" reconciliation bill, but for health care to become law, the House will have to approve the Senate bill. Do you think the Democrats' Republican opponents might mention that in the coming campaign? Of course they will. Which means Democrats will be explaining and explaining and explaining that they fixed the outrageous problems in the bill at the same time they passed it. Would you want to make that case every day on the stump?

The bottom line: Pelosi is probably many votes short of being able to pass the Senate bill, along with the still-unwritten fixes. In public Democrats are trying to create a sense of inevitability about the bill -- they've tried to do that at various times during the year-long process -- but there is absolutely nothing inevitable about the passage of their national health care plan.

I'll cover the Senate in a later post.

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Staff Report

Staff Report

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A daily newspaper covering San Francisco, San Mateo County and serving Alameda, Marin and Santa Clara counties.
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