What the Health Care Bill Might Mean

The health care bill has finally passed, but its meaning is still unclear. The process and debate around the health care bill has been extraordinary beginning with attempts at bipartisanship, swiftly moving to accusations of socialism and talk of death panels and culminating with bigotry and hate. It is likely that the lasting images of the Tea Party protests will be of protesters calling Barney Frank a f*gg#t and calling John Lewis, one of the last living icons of the Civil Rights Movement, the n-word. These images will help define the Tea Party movement as one of backwards looking reaction, rather than some kind of patriotic post-partisan movement as some Tea Party apologists have described it.

The impact of the bill itself is going to be harder to determine. It will not, as its detractors have insisted, be the beginning of a government takeover of the economy or the first step to the Stalinist gulags. It is also not going to solve the problems of millions of uninsured Americans overnight. The bill will have a complex and not easy to predict impact. Some uninsured people will buy insurance while many others will still not be able to afford it. While the insurance industry will be reigned in somewhat because of new regulations, it will also be further empowered because of additional clients, profits and lobbying power. Efforts to improve the bill will move slowly, if at all.

The political impact of the bill is equally murky. At first cut it looks like a big victory for Barack Obama, Nancy Pelosi and the Democrats, but that is something of an overstatement. This bill is not so much a big victory for the Democrats as it is an impressive display by the Democrats of staving off defeat and humiliation. Moreover, both the Democrats and Republicans can claim some success. The Democrats can claim that despite millions of dollars in lobbying efforts, the Tea Party movement, red baiting and a deliberate campaign of lies, they have passed a historic bill. The Republicans can claim that despite being the defeated, minority party they substantially emasculated the bill eliminating the public option, Medicare expansion and other aspects which were most offensive to them and most fervently sought by the progressive base of the Democratic Party. Both parties have more than just an element of accuracy in these analyses, so the important question is where they each go from here.

Passing this bill should reenergize the Obama administration. The administration had, by early January, gotten itself into a position where having 59, albeit not reliable, members of their party's caucus in the senate, and a solid majority in the house was not enough to pass any legislation; and the election of an obscure former model to the senate from Massachusetts was enough to bring the administration to its knees. If the administration is buoyed enough by this victory to move forward seeking progressive solutions to the myriad problems facing our country, and not being afraid to do so without Republican support, then the bill will have had a substantial political impact. The bill provides the administration with a second chance, almost a rebirth, but they need to move fast.

If, however, the administration takes away a different lesson, that even with big majorities in congress, passing anything is too difficult, and that bipartisanship is still necessary, than the Obama presidency, whether it lasts through 2012 or 2016 will be effectively over.

The right wing and the Republican Party, to the extent there is a difference between those two groups, accomplished a lot as well. Through their opposition to the health care bill, they galvanized a radical right wing social movement that proved unafraid of making the most outrageous claims and using the nastiest language. Together, they tarnished the Obama brand significantly and almost crippled the Obama presidency. They also leveraged this to win a senate race in Massachusetts, of all places, for a seat that was occupied by the Kennedy family for more than half a century.

For the Republicans, however, the path forward is more complicated. The bill against which they fought so hard has passed, but the predictions of socialism, the end of the US as we know it and other apocalyptic rhetoric will not come to pass, making the anger around the bill harder to sustain. Simply refocusing this anger on whatever else the Obama administration proposes will not be an easy or effective strategy. The Republican Party needs to come up with another plan or risk losing the momentum it has gained from this fight.

The passage of the bill also changes the dynamic for the November election. The Republicans have had two of their best issues taken away from them. They can no longer assert that they Democrats are ineffective, as they have just passed this legislation, nor can they assert that Obama is leading the country down the road to Communism, because the absurdity of that statement will become even more obvious in the next months as implementation of the health care bill begins. If the Democrats can create some momentum of their own, and learn the lessons of health care, that bipartisan efforts are a waste of time and that right wing rhetoric can be safely ignored, then they may be able to substantially reduce the electoral damage in November.