
National Health Care Reform
September 9, 2009
With less than a week before Congress returns to Washington after a heated summer recess, the question is: what is next? In the remaining days of the Congressional session, will Congress be able to produce legislation that the President will sign before Congress adjourns for the year?
The next several weeks are critical for the outcome of the health care reform debate. David Axelrod, a senior adviser to the President, recently said, "I think it's fairly obvious that we're not in the second inning. We're not in the fourth inning. We're in the eighth or ninth inning here, and so there's not a lot of time to waste."
Before we look to how we moved so quickly from the second or fourth inning to the eight or ninth inning, it is important to review the events of past month as future strategy is being dictated by these events. First and foremost, the town hall meetings throughout the country generated wide media coverage and more importantly, made health care reform personal. Before August, much of the public discussion had been inside the Beltway with coverage limited to cable news or the Sunday talk shows. In August, all local news channels and papers carried the coverage in every small town and big city in America.
The town halls have clearly taken a toll on the President's popularity, which has dipped to 50 percent according to the Gallup Organization. Should this number fall below 50 percent, President Obama will be surpassed only by President Ford (in his third month) and President Clinton (in his fourth month) as the fastest popularity drop by a president post-World War II.
With the impact that declining Presidential popularity has in trying to get legislation advanced, it is clear that the White House is contemplating a new strategy as Congress returns next week.
So, what is next?
If it is the bottom of the eighth, there is not a lot of time for legislation to advance. All eyes will be on the Senate Finance Committee as the bellwether for a bipartisan deal. If a bipartisan bill is able to emerge from the Committee by mid-September, this will likely bode well for a bipartisan deal in the Senate.
The central question, of course, is how will the Senate Finance Committee handle the public plan? The answer to this question may very well dictate whether Senate leadership will reconsider its current strategy and instead seek to pass the bill procedurally on a simple majority basis. This last resort strategy is fraught with legislative unpredictability and will be met with strong opposition. A robust public plan seems unlikely given the moderate elements in the Senate. No mention of a public plan seems equally unlikely given the Democratic party base. The answer may very well lie in a co-op model or a "trigger" option.
In the House, activity in September will be geared toward reconciling the different bills that emerged from the three committees of jurisdiction over July. This will be primarily a leadership-driven process through the Rules Committee of the House. We fully expect a more partisan bill to emerge from the House than the Senate, with some possible concessions made to Blue Dogs Democrats in the House.
Will a deal get done?
With the passing of Senator Kennedy, we have lost the best bipartisan legislative closer in history. Most political pundits believe it is time for President Obama to step up to the task of sealing a legislative deal. The task won't be easy as the President must gain enough moderate support while not alienating the more progressive branches of the Democratic party. But, in order to get both the House and Senate to ultimately act as one, the President may be the only one with the political will and public authority to bridge the differences that have separated the parties and branches to date.
The President will speak to Congress in a joint session on September 9, 2009. While there are limited details of what he will say as of this writing, there is no doubt that this will be a crucial moment in the health care reform debate. President Obama has demonstrated that he is one of the most effective orators of our time. In this speech, the specific language and the Congressional reaction to the language may very well foreshadow the course of the debate for the remaining weeks of Congress.
While the 111th Congress is technically scheduled to recess in October, past sessions have routinely extended well into December. Whether Congress is able to develop a bill that the President will sign will be dictated by the actions of a few key policymakers over the next several weeks.