It was too much to hope that the watching-grass-grow stage would be over when Sen. Max Baucus unveiled his long awaited, painstakingly negotiated health reform bill. No, both Democrats and Republicans apparently view this as a mere starting point.
The Montana Democrat, who chairs the Senate Finance Committee and led months of bipartisan negotiations, had to release his bill Wednesday without one Republican on board. It was very public evidence of failure. He wore a smile, however, and insisted some Republicans will sign on before the bill leaves the committee.
Maybe he hadn't yet seen statements from Senate GOP leader Mitch McConnell and House GOP leader John Boehner. Disregarding the countless hours of talks and fine-tuning among three Democratic and three Republican senators, both McConnell and Boehner called the Baucus bill "partisan." McConnell further ripped it as a "thousand-page, trillion-dollar government program" that cuts Medicare and raises taxes on families and business. Talk about cold.
Baucus' fellow Democrats, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid, weighed in at tepid. Reid called the bill "another important piece to the puzzle" and said he looks forward to a "healthy and vigorous" committee debate. Pelosi said the House bill "clearly does more" to help people buy coverage and prescription drugs, and has a public insurance option that would compete with private plans.
On the left, there was bitterness and name-calling. Daily Kos bloggers called the Baucus bill a debacle and cut it to pieces. Site founder Markos Moulitsas himself called Baucus "the biggest idiot in the entire Senate." Matthew Iglesias said Baucus made huge substantive and procedural concessions "to get nothing." Marcy Wheeler coined the phrase "MaxTax" – defined as "your mandated payment to (obscene adjective) insurance companies."
So how bad is it, really?
The Baucus bill, like the two other major bills before Congress, would protect people from being excluded or dropped from coverage, and from going bankrupt. It has an exchange, or web-based marketplace, that eligible individuals and businesses could use for one-stop comparison shopping for policies. It promotes all kinds of pilot and demonstration programs designed to get doctors and hospitals to provide better, more coordinated and hopefully less expensive care. And like the two other major bills before Congress, it would require most Americans to buy health insurance.
That's the source of one big problem. Unlike the other bills, Baucus sets aside what Pelosi and other liberals view as an insufficient amount for subsidies to help lower-income people handle that requirement. That's a math problem that shouldn't be impossible to resolve at some point in the process. Same with a Baucus provision that allows insurance companies to charge older people up to five times as much as younger people (the House bill limits the differential to two times as much).
Another math problem, more complicated, is how to offset the cost of expenditures such as the premium subsidies. The Baucus bill would tax the highest end plans offered by insurance companies. Some senators fear that instead of ending such plans, the companies will raise all premiums. But there are other avenues to raise money – particularly if you're not worried about getting Republican votes.
The stickiest problem is, as always, the public insurance plan that some Democrats, such as Jay Rockfeller of West Virginia and Roland Burris of Illinois, say they must have while others – such as Ben Nelson of Nebraska – say they can't accept. The Baucus bill sets up a system of consumer owned co-ops in place of a public plan. But an analysis Wednesday from the nonpartisan Congressional Budget Office was dismissive of the co-ops' potential competitive and fiscal impact. "They seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments," the agency analysis said.
It is easy to sympathize with liberal anguish. Why should Democrats make so many compromises if no Republicans are going to support the bill anyway? But conservative Democrats are among those insisting on fiscal restraint and resisting a public option. And even if every single Democrat was in the chamber and voted yes, that's only 59 votes – not enough to get the Baucus bill or some variation of it past a filibuster.
The hope of getting 60 votes assumes that ailing West Virginia Sen. Robert Byrd is able to be present, and that either Maine Republican Olympia Snowe relents in her opposition or that Massachusetts legislators approve the appointment of an interim senator to fill the late Ted Kennedy's seat. It also assumes that conservative and liberal Democrats swallow their objections and perhaps hold out hope of moving things their way in a conference committee with the House.
Whatever makes it to the Senate floor, it would be exhilarating to see Democrats present a united front and get it done. It is so rare that they show the kind of discipline that Republicans are famous for. It is maddening to look back at the Democratic votes former president George W. Bush managed to win for his deficit-busting priorities -- unfair tax cuts for the rich, an unpaid-for Medicare prescription drug plan and the tragic war in Iraq. Contrast that with the lockstep Republican opposition that killed former president Bill Clinton's health care reform drive and nearly killed his 1993 budget, the one that set the country on the path to a booming economy and a budget surplus.
In fact those are great models for Democrats to keep in mind as the wrangling and legislating drag on. Simply put, stick together in the crunch. It'll pay off for the party and the country.
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