One Vote on Health Care Reform

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There are many events in life that, while more or less predictable in themselves (House passage of the health care bill), turn out to have an impact and significance that is only truly apparent after they occur. The passage of the House health care reform bill last night strikes me as one of them.

The precise contours of the post-conference legislation remains uncertain in a number of key respects, especially in regards to the public option. But having watched the events leading up to the House vote and the politicking in the senate, I have little doubt that a broadly similar bill will pass the senate, be reconciled with the House bill in a conference report and bill that will be signed by the president in relatively short order.

The reason these sorts of events happen so infrequently is that they are like colossal ships or vast armies, very difficult to build or assemble and get on their way but also extremely difficult to stop or turn once they are under way.

As Bill Kristol noted in his famous 1993 GOP strategy memo on the Clinton health care reform initiative, the key danger Republicans face from health care reform is precisely that the public will like it. And I suspect that the more forward thinking and perspicacious of his partisan colleagues today see it the same way.

If a health care reform bill passes, it’s greatest point of vulnerability will be in the 2010 election. That’s not only because of the on-going fall-out of the 2008 financial crisis, which sets the Democrats up for a tough midterm election. It’s also because a lot of the key reforms in the legislation don’t kick in for a few years. But even if you assume the worst possible outcome for the Democrats in 2010, loss of both houses of Congress, Republican majorities still wouldn’t be able to overturn the law because President Obama would veto their repeal.

Last night’s vote makes me think this will happen and it will be a genuinely historic development.

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