After an entire year of debate and legislative processes regarding the health care reform proposed by the Obama Administration, many have argued that the bill is dead. On the Democratic side, House Speaker Nancy Pelosi declared in a press conference last January 21 that she does not think that it is possible to pass the bill “in its present form without any change [...] in the House”. Thus, it seems that the party has not ruled out adding some changes that could make the bill more attractive to the currently opposing House members, although the bill seems to have no future in its current form. However, it could be argued that, even though the future of the health care reform as it was first proposed has been definitely thwarted, possible changes in the bill might open new possibilities and create new alliances and agreements between the Republican and Democrat parties.
Chris Frates in his article “Harry Reid, Nancy Pelosi work to save health care reform” states that Senate Majority Harry Reid and House Speaker Nancy Pelosi “have begun considering a list of changes to the Senate bill in hopes of making it acceptable to liberal House members”. Some of the possible changes suggested by Frates are “additional Medicare cuts and taxes, the elimination of a special Medicaid funding deal for Nebraska and a move to help cover the gap senior's prescription-drug coverage”. Moreover, recent articles on the situation of the health care reform published by “CQ Politics” suggest that Democrats might take a break of several weeks to regroup and reorganize their strategy. Senator Christopher J. Dodd, has recently declared that “it will be up to President Obama to get Democrats’ health care legislation back on track, perhaps by taking a breather for a month, six weeks, and quietly go back and say the door’s open again”.
Alexis Simendinger in his article “Messages from Massachusetts: Democrats seemed to hear what they wanted to hear from Tuesday's special election, which means they can't all be right,” argues that Democrats could adopt any of the following two strategies in the near future. First, they could try to convince the House to pass the bill proposed when the party had 60 votes or, “they could use the budget reconciliation process - which requires only 51 Senate votes - to pass another bill that fixes some of the sticking points between the two chambers”.
However, the debate about the bill cannot be reduced to the possibilities and expectations of changes and, how Republicans and Democrats could come to an agreement about them. The analysis of some of the previous events in the last weeks, such as the election of Republican Scott Brown in Massachusetts, reflects that there are many tight and complex links between politics, policy, representative institutions and the voters, who form part of the American political system understood as a deliberative democracy. Alan Greenblatt in his article “Where the Mandates Are: Federal dollars for health, education, finance, and transportation have strings attached” argues that there are many strings, or factors, attached to the health care reform that have influenced the Democratic Party's approach to the bill. In other words, some of the intrinsic aspects of the proposed bill derived from previous steps taken by the Obama administration, such as stimulus laws and their respective budgets that could affect greatly certain economic sectors of many states, and their specific interests. For example, Greenblatt suggested that “Democrats' attempts to achieve universal health coverage depended on states expanding Medicaid coverage, which would mean greater costs for states”.
Another example that reflects the complex nature of political processes is the previously mentioned election of Republican Scott Brown in the special Senate elections that took place on January 19th in Massachusetts. Brown defeated Attorney General Martha Coakley in an unexpected political race that affected, among others, the bill's possibilities by changing the Democrat's 60 seat majority. Emily Cadei in her article “Brown's upset spurs Democratic soul-searching,” argues that Coakley's defeat “boils down to a poorly run campaign combined with a political environment that was more toxic than they anticipated”. With this statement, Cadei refers to Coakley's apparent lassitude about the race and the influence of some media strategies, such as the “folksy television spots […] featuring President John F. Kennedy morphing into Brown and Brown driving his pick-up truck around Massachusetts”. Moreover, the budget behind Coakley's campaign seems to have been more limited than Brown's. Stuart Rothenberg in his article “Massachusetts Senate Race: Thinking the unthinkable,” written before Brown's victory, stated that the National Republican Senatorial Committee (NRSC) made quietly some moves that helped Brown's victory. Mostly, moves such as transferring “$500,000 to the Massachusetts Republican Party to support Brown’s candidacy”. The remarkable support by the NRSC was probably not solely motivated by Brown's possible influence in the process of health care reform, but because of its possible effect in future midterm elections against the Democrats – who, in the opinion of many, should not rest on their laurels.
After all, it is not the first time that a Democratic administration faces elections after a health care reform fiasco. John. F. Harris in his article “Clinton years hold clues for Obama” argues that Clinton's “Democratic disaster in the midterm elections of 1994, [from which ] he recovered in time for an easy reelection in 1996” could be a good reference point and a reminder of the implications of meddling with the American health care. Nevertheless, Obama keeps reaffirming his intentions and goals regarding the initial bill. In the article “President Obama: My agenda has run into 'buzz saw',” reporter Nia-Malika Henderson states that in the last declarations by Obama at an Ohio community college, he argued that he will keep fighting for the reform, saying that “[he] didn't run for President to turn away from these challenges.[He] will not stop fighting for you [Americans]”. However, this type of repetitive statement seems to have become a rather useful tool for the opposition, who has more chances than ever to spread skepticism about the feasibility of such reform.
Approaching conclusion, it is necessary to return to the initial question regarding health care reform: “Will Democrats accomplish Health Care Reform in the 11th Congress?” The most sensible answer seems to be “perhaps,” given the complexity of all the factors influencing the issue and that their final alignment cannot be accurately translated into “yes” or “no” answers. A useful analogy to understand the mechanisms involved in legislative processes, such as this health care reform, is that of the Rubik's Cube Puzzle, of which its “three dimensions represent the complex interplay of ideas, interests and institutions in the [...] House” (Edsall, White). The analogy aims at explaining that political events should not be understood through single-caused explanations, but as a combination of the mentioned roles and actions of individuals, institutions, interest groups and the principals of the involved parties. For example, regardless of the final decision of the House about the reform, many different factors would have influenced that decision: from the quality of Obama as President of the United States, to the behavior of the members of the Democratic Party such as Coakley, to even the fluctuation of interests of different groups, like insurance companies and their capacity to exert pressure. Moreover, other less obvious factors such as the American underlying political culture and the special, unique role that Obama has played in the political arena as the first African American president will have their share of influence, raising questions that have been in everyone's mind for quite some time – is Obama trying to achieve too much, too soon? Are American society and the current economy ready for the consequences of passing the proposed bill? Would changing the bill to reach a bipartisan agreement on health care reform betray the Democratic character of the reform?
Time and only time will answer these questions and the controversy over health care reform, as the different factors of the political equation align to solve the paradox.
M.J. Soria
PS - Watch what the White House has to say about it!
http://www.whitehouse.gov/Issues/health-Care
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