Lawmakers, public grapple with health care endgame

Many Democrats consider their health overhaul increasingly politically dicey now, but "are betting that the only thing worse than passing a bill many of them don't like is not passing one at all," the San Francisco Chronicle reports. Failure to pass legislation, according to House Speaker Nancy Pelosi, "would be very bad for the American people and very, very bad for us." According to the article, "[a] year of Democratic in-fighting, compromises and relentless GOP attacks have deeply tarnished health reform's luster," and fostered the assumption that the overhaul would increase premiums and cost more than expected. But Democrats believe they must act soon to pass reforms while they still hold a 60-vote majority in the Senate (Lochhead, 1/11).

Democrats' narrow filibuster-busting Senate majority will be jeopardized by this autumn's election, with two senior Democrats last week announcing that they would retire at the end of the current session, McClatchy/The Seattle Times reports. Among the "number of modern, rapidly changing political dynamics" exerting pressure on Congress are "the rise of hyper-partisanship magnified by today's Internet, talk-radio and cable-TV ideologues; the drawing of legislative district lines to maximize partisan purity and to avoid making lawmakers have to appeal to voters of all stripes; and the passing from the scene of legislative veterans who came of age politically in the pre-technology age and who were schooled in the art of compromise" (Lightman, 1/9). 

Meanwhile, the Senate's liberals have also found themselves "on the defensive," even though attention has focused on the political troubles of moderates, The Hill reports. "Most of the criticism of liberals has come from left-wing advocacy groups angry at the bill's lack of a public option. Such a component was dropped from the measure earlier in December" (Rushing, 1/11).

In the House, Republicans are actively seeking to recruit Democrats to the minority party, The Washington Times reports. "Republicans have listed 37 Democrats who they think are vulnerable to political pressure on the issues of Medicare funding, abortion and the federal budget. The list includes several Democrats in moderate districts who could face difficult re-election fights." Democrats earlier passed their version of the overhaul by a three-vote margin (Haberkorn, 1/11).

And, the White House has struggled this year to sell the health overhaul to the public, sending disparate messages that ranged from arguments that health reform was a moral imperative to those suggesting the measure was really meant to save money, The Washington Post reports. "The president and his aides sent mixed signals on the 'public option' as well, voicing support for a government-run plan while signaling their willingness to see it die to get a bill passed" (Balz, 1/10).

The New York Times reports on the gulf between voters expectations for President Barack Obama's optimistic plans for tackling health care early in his administration and the reality of today's debate. One Colorado voter, an auto mechanic, "said in an interview at his shop, the Congressional debate deteriorated into a partisan brawl, and Congress has virtually ignored his biggest concern: holding down health costs." The Times says, "The concern illustrates the challenge Mr. Obama and Democratic lawmakers face in trying to meld House and Senate bills in a way that can be sold to the public. All kinds of issues are still in play, from how to cover abortion to whether to tax high-cost health plans" (Pear, 1/10).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.