As every political reporter will tell you, Nancy Pelosi and her leadership team still lack the votes to pass the Senate health-care bill in the House, and they’re working to gather them up this week. But just what does this “work” involve? Somehow that question hasn’t been asked much in all the coverage of health care this week.
Obviously it doesn’t involve substantive persuasion about the merits of the Senate bill. House Democrats, having spent the better part of a year on health care, know as much as they’re going to know about what’s in the legislation — and enough of them think the Senate bill is awful to deny it a majority in the House. In fact, they hate it so much they’re seriously considering taking it up by a ridiculous legislative maneuver by which they don’t actually vote directly on the bill, but vote on a rule that considers it passed. You have to wonder how they imagine they’re going to explain this to voters this fall — and how that explanation (“I voted to pass it, but didn’t vote for it”) could possibly be less painful and damaging than just voting for the bill. But in any case, another detailed overview of the merits of the bill isn’t going to change their minds.
Pelosi’s work also doesn’t involve promises about improving the health-care bill — at least not anymore. The Speaker made it clear to members yesterday that she was done changing the second bill the House will vote on — the bill of revisions that the Senate will supposedly take up after the Senate version of Obamacare is passed by the House and signed by the president. So Pelosi is no longer promising that the health-care legislation itself will contain gifts to various members — she has no doubt done some of that in the second bill (which of course has not yet been made public), and House members will also vote to enact all of the deals that went into the Senate bill (the Cornhusker Kickback and the like) while pretending that the second bill will undo them. But that kind of dealing and trading within the health-care legislation itself is probably mostly over with.
So what remains? In their Politico piece noting that Pelosi has declared the reconciliation bill closed, Patrick O’Connor and Jonathan Allen suggest that Pelosi’s announcement means the wheeling and dealing for votes is over, and all that remains is an ideological appeal for votes. But members who were open to such appeals would have been on board with this bill long ago. In fact, what remains are deals outside of the health-care bill. What Pelosi is doing now is offering wavering members a variety of gifts and goodies that will be included in other bills (or in administration actions) between now and the November elections — and especially in this year’s appropriations bills. These deals will be much harder to discern than the crude buy-offs that Ben Nelson, Mary Landrieu, and others obtained for their states in the Senate health-care negotiations. They will no-doubt involve money and other favors for members’ districts or powerful constituents in unrelated bills — from transportation funds to Medicare payment decisions to an assortment of pet projects. And they will need to be delivered regardless of whether Pelosi gets enough members to switch their votes this way to actually pass the bill.
These special dispensations will present themselves in the course of the coming months, but we will probably never have a full picture of what they involve, and what it really took to get “no” votes from last time to switch (assuming any actually do so, of course.) We won’t know, that is, unless political reporters stop covering this week as though it involves a wonky substantive debate among House Democrats and started asking the Speaker and any members who change their votes about just what the “persuasion” process has involved.