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Scot Lehigh

Breaking up the healthcare bill

By Scot Lehigh
January 22, 2010

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ONE BIG takeaway from Tuesday: Democrats need to recalibrate on healthcare reform.

The majority party had thought it was just a conference committee agreement away from finally enacting near universal healthcare. But with Scott Brown’s stunning victory, the party will have to adjust.

President Obama signaled as much during a Wednesday interview with ABC’s George Stephanopoulos. A similar reality seems to be settling over the House. Speaker Nancy Pelosi said yesterday the votes weren’t there to have the House simply pass the Senate plan, a move that would preclude the need for further Senate action. All of which means the comprehensive healthcare legislation Congress worked on for most of last year is in deep trouble.

“I wouldn’t say it’s dead, but it certainly is on a resuscitator,’’ says US Representative Richard Neal, a senior member of the House Ways and Means Committee.

That isn’t what the party’s port side wants to hear. They prefer to take their cue from Admiral David Farragut: Damn the torpedoes, full speed ahead. There’s some discussion of easing the path for House passage of the Senate plan by hammering out a side agreement on how the legislation would later be amended. Others want to use the budget reconciliation process, which isn’t subject to a filibuster. Or to change the filibuster rule itself.

But any of those moves would inevitably be perceived as Congress thumbing its nose at Tuesday’s results. It’s true, as some liberals note, that Republicans weren’t constrained by their lack of a supermajority in passing George W. Bush’s tax cuts. There’s a signal difference, however. Although a tax cut may sometimes be bad fiscal policy, it’s almost always popular with the public. But Democrats have, at very least, lost the public relations war over healthcare reform. Repelled by the congressional sausage-making process, voters have become dubious about the legislation itself.

The liberal hope, of course, is that once the bill were enacted, the public would quickly come to support it. That’s highly unlikely, given the long time lag before key aspects of the legislation take effect. Instead, Democrats would be exposed to charges that they blithely ignored public opinion in passing the bill. And that’s a prescription for November disaster.

So what’s a demoralized party to do? Obama had the right idea when he told Stephanopoulos that Congress should “coalesce around those elements in the package that people agree on.’’

“It’s going to have to be reshaped,’’ said Neal, who favors scaling down the bill to focus on things like prohibiting the denial of coverage because of pre-existing conditions, capping out-of-pocket patient expenses, and allowing children to remain on their parents’ plans until age 26.

Breaking up the bill would also let supporters build public backing for the various pieces.

“Part of the problem with a comprehensive healthcare bill is that it is difficult to explain,’’ adds US Representative William Delahunt. “It would be much more effective to bring it out in a sequence and do the explanations so that people can see the benefits.’’

A piecemeal approach could also alter the political calculus.

“We ought to challenge the Republicans, ‘Are you in or out?’ ’’ said Neal. “If the answer is no on everything, that will give us an opportunity to define the issue for the American people.’’

One Republican who should be challenged in that fashion is Brown himself. After all, the state’s new senator didn’t run against each and every aspect of healthcare reform, but rather against this particular bill and the notion that Massachusetts, which already has near-universal care, should subsidize those states that don’t.

Brown seems to realize he can’t simply join the ranks of conservative Republican rejectionists. In his first post-election press conference, the new senator described himself as a new breed of Republican and stressed that though he would caucus with the GOP, he’d be beholden to no one.

If he wants to establish himself as an independent-minded senator, Brown has to show some bipartisan inclinations. Yes, he’s currently in the catbird seat - but that rewarding position carries risks all its own.

Scot Lehigh can be reached at lehigh@globe.com.

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