OK, the health care reform bill is now pretty much a done deal. Now we can look at what happens next.
Politically: Certainly, the Republican argument that the nation didn’t want this bill will be put to the test in a few months. It seems relatively clear that Democrats will generally be pleased at these results, and put those feelings to work electorally, and Republicans the opposite. What happens here may depend on a few things: whether displeasure is a stronger political motivator than pleasure, whether historical trends on party power play out, and how independent voters, in general, feel about this whole thing. Thoughts?
HCR in general: Many liberal politicians have said that this bill is a first, not final, step. But considering how much effort the first step took, will that make it more or less likely that they’ll try to do more in the future? The temptation will certainly be to rest on laurels, reap political benefits, and let the next guy do the rest. Will they? Will it at least affect what kind of things they try in the future?
Well, the next step is to get the reconciliation package passed. Even if that passes tonight yet, it’ll still need to go to the Senate (where, admittedly, it’ll stand a very good chance of passing, since it can’t be filibustered).
After that, the next step would be the public option, which I’m sure Grayson and a few others will continue trying to push, but realistically, I don’t think that has a chance until either a, the 2012 elections at the earliest (when we might hope to have 60+ legislators in the Senate again), or b, when the Senate rules are changed to go back to majority rule.
A couple of clarifications:
-independent does not mean moderate. There are people who are unregistered or registered as third party members who may have supported the bill, or opposed it because it was not sufficient.
-election outcomes are not solely dependent on the attitudes of swing voters. They are also affected by the turnout of regular supporters.
One question I have is about the conservative Democrats who opposed the bill: They represent conservative areas. Do they not realize that the right-wingers who opposed the healthcare bill may replace them with Republicans anyway? Just minutes after the reconciliation bill passed, a caller on C-SPAN said that she would never vote for a Democrat again. I suspect this attitude is pervasive within the right, which means that conservadems may have doomed themselves by voting against it.
I wish that the bill would be better, but it is clear to me that many will see the benefits (Some will appear later and it will not affect much the next elections later this year) and conclude that the Republicans really only deserve to be in the minority for generations for the fear mongering and lies they used to convince a good chunk of the American public.
Good luck with that. While there’s a slim chance the Republicans might get to 51 seats in the Senate, there’s no chance whatsoever they’ll get to the 67 needed to override Obama’s inevitable veto of the repeal. The earliest chance to repeal it would be in 2012, by which point enough people will have realized the benefits of it that repeal will be politically impossible.
I think what happens now is that we wait and see how well the new law actually works, and what happens to the people who voted for and against it. If things go well, there are probably going to be more reforms. If it turns out disastrous, either for the country or the congressmen who voted for it, further reform will be stalled.
It passed btw, for anyone not following along. I hope it’s everything that folks on this board think it will be. Personally, I’m more than a bit uneasy about this bill, and I hope I’m wrong about how this will all turn out.
Where do we go from here? Gods know. I guess the place to start is figuring out how to pay for it, and then figuring out what the final product (snort…as if) will look like and what it will and won’t actually do in the end. And see how the back scratching goes and what deals were made to get it through…and what all that will add to the mix.
My guess is that the only significant further movement we’ll see over the next decade will be to open up the exchanges to everyone. If the people allowed into the exchanges are happy with the coverage, then we’ll probably see political pressure to open them up.
It’s possible we might see Federalizing the exchanges into one big exchange and/or allowing a Medicare buy-in. But those seem fairly unlikely to me to pass anytime soon.
The Republicans run on a “Repeal the Bill” ticket in November, pick up seats in both houses, fail to repeal the bill (probably don’t give much more than the ol’ college try), engage in downright ghastly partisan behavior-- including the impeachment or attempted impeachment of President Obama-- and continue to run in future elections as “the party of morals and values.”
The GOP is going to find itself in a very tough position now that the bill is passed. The Tea Party set is going to scream for repeal but it’s clear that several parts of the bill are popular. Crafting a repeal proposal that will win votes is going to be difficult but ignoring health care will deeply anger their base. In short health care will be a big wedge issue and my hunch is it will help Democrats come November. Several of the benefits of the bill: closing the “doughnut”, money for clinics etc. will kick in by then giving them further campaign mileage.
Really? I feel just the opposite. Knowing that shortly, if I want to pursue some other venture in my life, I can leave my current workplace and know for certain that I can buy insurance elsewhere, without worry about them dropping me on a “pre-existing condition” clause. I feel liberated.
The big thing is that the uncertainty about what is going to be in the bill is gone. The stories seemed to cover the battle more than the content, and now this will change. I suspect most people will go back to favoring it now that the FUD has been removed, and because the hammer and sickle did not get raised over the White House after all. No death panels, no forcing you to switch doctors, no dead grannies. in fact, not much of anything before the elections - except I get to put my daughter back on my health insurance if she doesn’t have a job with insurance and isn’t in Germany enjoying UHC again.
Plus, the Republicans failed in their major objective. That’s got to count for something.
This isn’t done, not nearly. We still have a long way to go. This legislation doesn’t do much about cost control or limiting waste by getting insurance companies’ snouts out of the feed trough. It still leaves people uncovered. All those will have to be addressed at some point. I personally favor a stepwise expansion of Medicare eligibility until that becomes the single-payer system, but that’s for another day.
But later, maybe an election cycle or two further on, after this settles in and the credibility of all the lies that have been told about it dissipates. Social Security and Medicare passed in much the same way and amid much the same rhetoric, remember, and quickly became untouchable in much the same way that “Obamacare” will (the antis may regret that name).
The GOP is badly misreading, or badly overstating, polls that purport to show the public against it. They’re all pretty close, and even before the vote were already trending toward the Dems’ direction. If the GOP tries to campaign on a repeal platform, they’ll only harden their base while risking alienating the independents. Long-term, it’s going to hurt, just as it keeps hurting them that they opposed Social Security back in 1935.
And there’s the “Quien es mas macho?” factor, always present in politics, and historically a winner for the GOP. But right now, it’s “Obama y Pelosi son mas macho.” That won’t be easy to re-reverse.
For better or worse, the Republicans have been more successful in defining this legislation in the public mind, particularly among districts where Democrats are vulnerable. It seems to me that the political task for the Democrats has to be to figure out how to change that between now and November.
True. Part of that problem has been that the legislation has kept evolving, and that has kept Dems from defining what it is to the public. The Pubs’ task has been far simpler - they’ve only had to say “Higher taxes, creeping socialism” etc. to “define” it.
Pre-existing conditions for children
Tax credits for businesses with less than 50 employees
50 percent of the donut hole closed
Children covered by parent’s policy through age 26
No lifetime caps
Temporary high-risk pool for adult pre-existing conditions
New plans have no co-pays for checkups and preventive care
No rescissions
Insurance companies must report overhead rates
Appeals processes on new plans
Tax on tanning parlors
New screening procedures for “waste, fraud, and abuse” (yes, I know)
Medicare coverage for small rural health care facilities
Tax limits on BC/BS
More nutrition disclosures on restaurant menus (well, it’s something)
Early-retiree coverage
Better Web info
Tax credits for “new therapies”