Sunday, March 14, 2010

Why must THIS bill pass?

Speaker of the House Nancy Pelosi seems determined to bring the Patient Protection and Affordable Care Act (HR3590) to a floor vote in the House.
"It won't be long," before lawmakers vote, predicted Speaker Nancy Pelosi. She said neither liberals' disappointment over the lack of a government health care option nor a traditional mistrust of the Senate would prevent passage in the House.
Winning House passage of HR3590 is the essential first step in the Democrats' grand strategy to enact some measure of health care "reform" (ironic, given that this bill does not accomplish anything vaguely resembling reform, as I have discussed previously).  Since January, the Democrats' have pursued a two part strategy:  Pass HR3590 then immediately pass legislation to "fix" HR3590.
The health care bill appeared on the cusp of passage in early January, but was derailed when Senate Republicans won a Senate seat in Massachusetts, and with it, the strength needed to sustain a filibuster and block a final vote.
In the weeks since, the White House and Democrats have embarked on a two-part rescue strategy. It calls for the House to pass legislation that cleared the Senate in December, despite numerous objections, and for both houses to follow immediately with a second bill that makes changes to the first.
However, it is by no means certain that the bill has the votes to pass the House.  Democrat leaders such as James Clyburn of South Carolina have stated bluntly that, as of today (14 March 2010), the Democrats could not pass HR3590.
A dose of reality came from Rep. James Clyburn, the third-ranking House Democrat and main vote counter. "No, we don't have them as of this morning, but we've been working this thing all weekend," said Clyburn, D-S.C.
Furthermore, it is all but certain that the American electorate does not want HR3590 to move forward:
  • On the Congressional tracking site OpenCongress.org, a mere 23% of their users favor the bill, the tally as of today being 317 in favor and 1035 opposed to the bill.
  • RealClearPolitics' polling summary shows that every major polling organization finds Americans opposed to HR3590 by significant margins--even the Democrat-oriented Public Policy Polling reports only 39% of Americans in favor of the bill compared to 50% opposed.
  • A Gallup Poll published on 9 March 2010 shows that 48% of respondents want the bill to fail, and only 45% want the bill to pass.
  • Another Gallup Poll published on 12 March 2010 shows Americans identifying jobs and the state of the economy as more important concerns than healthcare (31% identify jobs as most important, 24% identify the economy as most important, with only 20% identifying healthcare as most important). Gallup's discussion of that poll also reveals that healthcare has not been a top priority among Americans since at least September of 2009.
  • In January, Gallup found that a majority of Americans favored suspending work on health care reform efforts following the Massachusetts special election to fill the late Senator Edward Kennedy's seat in Congress, which was won by Republican Scott Brown.
All of which begs the question why must this bill be passed?  If the American people do not want it, if the Democrats themselves are challenged to find votes for it, why must HR3590 be this Congress' contribution to health care reform? 

 In light of Gallup's January poll, the argument that Democrats must pass "something" or be crucified come November's mid-term elections fails to persuade; if the American people want the effort tabled for now, not passing legislation on health care is hardly going to offend voters' sensibilities.  

The CBO's own scoring of the bill and its negligible-to-adverse impact on health insurance premiums over the next few years undercuts the proposition that Americans will embrace HR3590 once it becomes law and its "benefits" become known--the CBO score amounts to a refutation that there are any appreciable benefits relative to health care as it stands today.

That it is not incumbent upon Democrats to pass any manner of bill putatively classified as "health care reform", and that the "reform" being brought to final vote in the House presumably near the Ides of March for 2010 is, by Congress' own scorekeepers, not reform at all, perhaps explains why Democrats have so clearly lost the "message war" on health care--and they have.  Even Democratic pollsters such as Patrick Caddell and Douglas Schoen acknowledge this:
First, the battle for public opinion has been lost. Comprehensive health care has been lost. If it fails, as appears possible, Democrats will face the brunt of the electorate's reaction. If it passes, however, Democrats will face a far greater calamitous reaction at the polls. Wishing, praying or pretending will not change these outcomes.
The Democrats' have lost the message war because the bill they have crafted does not meet the undeniable desire of Americans for reform of our system of health care.  In attempting to rebut Caddell and Schoen, Obama pollster Joel Benenson makes a telling admission.
Let's take the CNN poll from early January -- the most negative independent poll on health care and one that predated President Obama's proposal. Only 40 percent supported the bills passed by Congress, while 57 percent opposed them. But in a crucial follow-up question, a net of 10 percent of all Americans opposed the bill because it was "not liberal enough." If one makes the reasonable assumption that these people are far more likely to side with supporters of the president's plan than with Republicans who are obstructing it, the results would show that 50 percent favor the plan or want a broader one, while only 45 percent oppose the plan.
Benenson's mistake is that his reasonable assumption is not at all reasonable, because it rests on an implicit presumption that HR3590 is, in fact, "health care reform."  If the presumption is changed to that HR3590 is not "health care reform", then the "reasonable" interpretation of opposition to HR3590 for lack of sufficient liberalism puts that net 10 percent firmly with conservatives who oppose HR3590 for the simple reason that, while liberals may disagree on what manner of reform is desirable, liberals and conservatives apparently can agree that HR3590 is not "reform.".  

The presumption that HR3590 is not "health care reform" at all has support from the Congressional Budget Office, and that such is the perception of the American public is supported by the 9 March 2010 Gallup poll:  The top two reasons for opposition, that it would raise insurance costs and that it did not address the real problems, doubled in popularity from a total of 19% to a total of 39% since September of 2009.

That alone should be reason enough to scrap HR3590 and assemble new legislation:  Democrats campaigned and continue to campaign on a platform of reforming health care.  With the legislation they have before Congress today, the consensus of everyone is that they are stubbornly refusing to deliver on that promise.

Since Americans want health care reform, Congress should reform health care.  The first step forward in doing so must be to kill HR3590.