After nearly 48 hours of trial balloons and kabuki theater, it seems pretty clear that the White House is focusing its attentions on a couple different potential paths forward for health care reform.
The first, and seemingly preferred, idea is to court Sen. Olympia Snowe (R-ME), give her tremendous say in the shape of legislation, and then, if that’s good enough to get 60 votes in the Senate, pressure House progressives to hold their noses and go along with it. It wouldn’t be pretty though. Snowe’s preferred approach appears to be a ‘trigger’ for a public option — implementing a public option only if insurance companies are unable to rein in costs and expand coverage by a certain fixed date. And House progressives have really put themselves on the line for a public option free from any trigger mechanism.
If that strategy fails at any point along the road, the White House could still turn to the Democrat-only strategy of passing reform (or at least, many elements of reform) through the filibuster-proof budget reconciliation process. Just yesterday, former Senate Majority Leader and current White House ally Tom Daschle wrote in the Wall Street Journal “should Republican intransigence continue, [Democrats] must focus on the budgetary implications of health reform and use the Senate rules of budget reconciliation to allow a health-care bill [to] move with majority support. The choice between complete legislative failure and majority rule should not pose a dilemma for any Democratic senator.”
That’s an important tell.Given his closeness to the president and the importance of the reconciliation option, it seems unlikely Daschle would significantly out of step with Obama’s thinking on this issue.
The budgetary implications of health care reform would likely include Medicaid expansion, subsidies for low- and middle-class people to buy insurance, taxes and spending shifts needed to cover the cost of those measures, and, perhaps, a public option. Though a number of political and legislative questions about passing a public option in that way remain unanswered, the pressure on party leaders to include a strong public option in reconciliation will be tremendous if negotiations with Snowe don’t pan out. While it remains unclear whether a robust public option could muster the required 50 votes in the Senate, if the White House doesn’t at least threaten to push big reforms through reconciliation, it will have given up much of its bargaining power relative to her and, perhaps, Sen. Susan Collins (R-ME).
(The other key elements of health care reform–mandates, and insurance regulations–would likely still be subject to a 60-vote threshold in the Senate.)
In the meantime House progressives are being left in the dark as to where the President stands right now, particularly on the public option. How long will that last? We may know more in a matter of hours and through the weekend, after Obama briefs members in a conference call later today. Stay tuned.