Even Nancy Pelosi’s harshest Republican critics don’t doubt her ability to wrangle votes. She again has a chance to pass Obamacare through the House in a bout of arm-twisting so intense it might violate the Geneva Conventions.
If Pelosi somehow succeeds, Democrats will tell themselves they’ve finally attained a goal that has eluded them since Truman. But it won’t be over.
In terms of the Iraq War, it will be the toppling–the–Saddam Hussein–statue phase of the operation, with more combat still in the offing. If the bill becomes law, it will suffer a legitimacy gap that will make it vulnerable to repeal.
One, it will have passed on strictly partisan votes. This wouldn’t matter if the bill were a routine matter, say the annual appropriations bill for Health and Human Services, instead of a reordering of one-sixth of the economy. Support from the minority party would show that it has the kind of broad, sustainable base of support it now lacks as the spawn of a heedless ideological bender.
Two, its skids were greased with rotten deals. Democrats hope to eliminate the special provisions that have tarred the bill in a separate package of “fixes.” Regardless, the bill wouldn’t exist in its current form if key senators hadn’t been bought off with hundreds of billions of dollars in legislative bribes. That taint can’t be undone.
Three, a parliamentary trick is necessary to its final passage. Because Democrats no longer have 60 votes for the bill in the Senate, they have to pass their fixes under “reconciliation,” short-circuiting the normal amendment process. Republicans have resorted to reconciliation many times before, although typically on the fiscal measures for which the maneuver was originally intended, or on legislation enjoying bipartisan support.
Four, the bill has been sold under deliberately false pretenses. Pres. Barack Obama can’t admit the bill’s real purpose is to cover the uninsured no matter what the fiscal consequences. So he sounds like GOP budget hawk Paul Ryan when he talks about it. Obama insists that it will cut the deficit, bend the cost curve down, and reduce premiums, when it’s likely to do the opposite on all three counts.
Five, the bill is abidingly unpopular. It has been under water, sometimes deeply so, in almost every poll. The public has sent a consistent message that it opposes the bill, with the Senate election in Massachusetts providing the exclamation point.
Obama’s original choice for health-care czar, Tom Daschle, warned Democrats long ago that bulldozing reform through on a narrow basis would make it liable to repeal. He cited the example of Australia, where reforms were passed, repealed, and passed again throughout the 1970s and 1980s. In the U.S., Obamacare-style insurance reforms were passed, then fully or partially overturned in Kentucky, New Hampshire, and Washington after those states suffered spiraling premiums and insurance-market meltdowns.
So Obamacare needn’t stand forever. Aspects of the bill that take hold immediately (ending lifetime limits on care, etc.) won’t have a broad-based effect. The large-scale subsidies for insurance don’t kick in until 2014, after myriad tax increases and cuts to the popular Medicare Advantage program. Nothing in the bill will seriously limit the premium increases against which Obama now inveighs. They may even worsen as young, healthy people leave the insurance market, knowing they soon will be able to wait to get insurance until after they are sick.
Reversing any of this won’t be easy. Republicans will need 60 votes in the Senate, and Obama will wield his veto in defense. The law’s delayed onset will give Republicans breathing room, though. Surely, it won’t look any more affordable as the entitlement crunch approaches and the Washington agenda turns to deficit reduction. And Republicans may well have elected a president before it fully takes effect.
T. S. Eliot said “there is no such thing as a Lost Cause, because there is no such thing as a Gained Cause.” Even if it passes, Obamacare won’t be a “gained cause,” but a source of unremitting, high-stakes contention.
– Rich Lowry is editor of National Review.