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It’s Not Over
Health-care legislation could still fail in the House.


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Ramesh Ponnuru

Democrats are doing a victory lap. White House spokesman Robert Gibbs says that with Senate passage of the Reid bill, “Health-care reform is now a matter of when.” The press is doing its best to convey the impression that Republicans are throwing in the towel — follow the link in the last sentence to see a good example of such reporting. Pundits have moved on to arguing what the opponents of the health legislation did wrong.

But the Democratic celebrations are premature, as Republican despair would be. This battle isn’t over, and opponents of the legislation could still win.

Throughout the debate, most people have assumed that if the legislation died it would be in the Senate. The assumption was understandable: The Senate is traditionally the place where legislation dies, where minority parties and sometimes individuals can block action. The House, on the other hand, is where party discipline is supposed to make it possible to enact nearly anything the majority party wants.

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What people are forgetting is how narrow the margin in the House was the last time around. Speaker Pelosi won the vote for her version of health-care reform by 220 to 215. If three votes had switched, the opposition would have won 218 to 217.

Why would any of the 215 no votes switch to yes? Three possible reasons come to mind. First, some congressmen may think that the bill has improved: Perhaps a few Blue Dog Democrats will be pleased, for example, by the abandonment of the public option. Second, they may face more pressure from President Obama and Speaker Pelosi. But presumably the Democrats who voted no were already under a lot of pressure to keep the bill from dying the last time the House voted on it. Having said no earlier, they can probably say no again. (I’m assuming that Pelosi did not have many potential yes votes in reserve.) Third, they may face pressure from voters in their districts to vote for the bill. But this seems unlikely: I haven’t heard of a single congressman who voted no and now regrets it, and the polls do not suggest that a no vote carries electoral risks.

Now consider some of the reasons a few of the 220 yes votes might switch to no. My guess is that Reps. Bart Stupak (D., Mich.) and Joseph Cao (R., La.) will switch to no because the Senate bill is more abortion-friendly. Some other Democrats might come along with Stupak. Not many progressives will vote against the bill because it lacks a public option. Most of those who said they would were bluffing. But it wouldn’t take many of them to have an impact. If Stupak, Cao, and one progressive flip, and nobody flips Pelosi’s way, she loses the vote. Other congressmen may reconsider their support because the tide of public opinion is running against it.

So on the one hand Democrats gain Blue Dog votes because of the dropping of the public option, and on the other they lose votes because of abortion, public opinion, and, um, the dropping of the public option. Of course it is impossible to predict that the opposition will net the three required votes. But the possibility can’t be ruled out, either.

If health-care legislation ends up dying in the House, the 60 Senate votes for it will end up having hurt the Democrats by pushing the issue into 2010 and thus closer to the elections. (If it had died in the Senate, liberals also would have been able to blame it on that body’s undemocratic features. It will be harder to spin a repudiation in the House.) The Senate has made the stakes higher. It hasn’t made the outcome certain.

– Ramesh Ponnuru is a senior editor of National Review.



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