The News of Its Death Is Greatly Exaggerated

Kathleen Sebelius said the public insurance option is not essential, adding to a steadily growing conventional wisdom that the public option is now dead. Not so fast.
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Kent Conrad has repeatedly said there are not enough votes in the Senate for a public option, and now says he won't vote for one. HHS Secretary Sebelius says the public insurance option is not essential. These statements add to a steadily growing conventional wisdom that the public option is now dead.

Not so fast. This fight hasn't even come close to being played out yet.

Conrad is accurate that there are not currently 60 votes in the Senate for a public option. But what conventional wisdom ignores is that there are 64 House members who are unequivocally on record as saying they will not vote for a health reform bill that has no public option, way more than enough to take that possibility off the table. So there are two possibilities right now:

  • If both sides of this equation hold tight, no bill passes at all
  • Something happens to change the dynamics

The conventional wisdom says that while it is entirely possible that the first scenario happens, that if the second scenario happens it will be because House progressives fold. There seem to be no other possibilities to all the expert prognosticators.

Now, I will admit that progressives have been known to fold before, as Chris Bowers wrote today. But let me suggest that there are other possibilities here, scenarios that are actually within the realm of the possible. If progressives in the House hold their ground, if they hang tough on the public option, what happens next will go something like this:

1.The House will find the votes to pass a comprehensive bill with a public option soon after they get back from August recess. That will be reasonably easy, because Pelosi will be able to peel off a reasonable number of Blue Dogs, many of whom have said they would support a public option, to vote for the bill.

2.The Senate will find the votes to pass a convoluted, tortured, unworkable bill, not only with no public option but so messed up and compromised to be unworkable anyway. This is less certain than number one, but Democrats will probably find a way to pass something.

3.The conference committee will sit for several weeks as Senators like Conrad say we will never pass a public option, House progressives says we will never pass something without a public option, and the White House, Pelosi, Reid, and conference committee members work out details to try to get something passed.

At that point, there are a few possibilities. One is that Democratic leaders just give up and declare health care reform dead. That seems unlikely to me, given the high stakes. Another possibility is that House progressives just fold up. That is more likely given recent history, but given their clear promises and the strong pressure on them not to, they might just hold this time. So let's assume for the moment that they do hold strong. Here are a couple of possibilities for getting a bill passed:

A.The first is that conservative Senators are given a fig leaf compromise on the public option, so that they can say to people they forced a compromise, and then are brought over with all kinds of other incentives that make them more comfortable with the bigger bill.

B.The second is that the conference committee simply breaks the bill in half, one half being the less controversial part that everyone agrees upon, the other being the public option and the financing, both of which can go through the reconciliation process. Then Obama and Reid muscle the 50 votes they need for support.

None of this is easy, and none of it is pretty, but having been through a ton of these kinds of issue fights, both from inside the Clinton White House and from the outside, I can tell you that all of this is doable. These kinds of rhetorical logjams happen all the time, where it looks like the House and the Senate are both unalterably dug in, and then magically deals get done. On important bills, effective Presidents and Congressional leaders find some tough-to-thread-the-needle sweet spot, or they use some uncomfortable or inelegant legislative tool, and things that matter can get done. The media and establishment conventional wisdom, which always tends toward the dire and toward the conservative scenarios, is sometimes proven wrong. So ye of little faith, do not give up hope. The worst thing sometimes happens, but not always. Politicians sometimes sell people out, but not always. Keep fighting for the public option.

If you're looking for inspiration, take a page out of Gov. Dean's book. I co-moderated this part wonky, part political, part fiery panel (along with the wonderful Texas AFT union organizer Tanya Tarr) with Gov. Dean, and I'm sharing it with you because like me, he still believes hope for a public option is still alive and worth fighting for.

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