Monday, March 15, 2010

The HealthCare Follies Continue

If I could make sense of the health care mess.... well, maybe I can, but let's start with the storyline.

First, over the weekend, the Democrats announced that they were pretty much giving up on getting everyone in Bart Stupak's coalition to come back into the fold...
Stupak notes that his negotiations with House Democratic leaders in recent days have been revealing. “I really believe that the Democratic leadership is simply unwilling to change its stance,” he says. “Their position says that women, especially those without means available, should have their abortions covered.” The arguments they have made to him in recent deliberations, he adds, “are a pretty sad commentary on the state of the Democratic party.”
They may get some of stupak's coalition, but not all.  Stupak's more electrifying charge (that Democrats actually argued that the amendment created more costs due to more babies being born) is apparently an argument he's heard from individual Democrats, but not the House leadership. It's still pretty appalling, and sure as hell sounds like a death panel, as Allahpundit noted. The U.S. Conference of Catholic Bishops, who previously backed the House bill, have now jumped ship. Perhaps they don't believe the Senate simply made a typo in another provision that could lead to publicly-funded abortions...
Liberals wanted to expand the reach of community health centers, which have provided low-cost health care to people in underserved areas since the 1960s. And they wanted the health care bill to commit $7 billion for these health centers. The moderates agreed, and new language was hurriedly added to the Senate bill.

"This is all stuff that was inserted late at night and they were trying to reach a final agreement" on the bill, says Timothy Jost, a professor and health law expert at the Washington and Lee University School of Law. Unfortunately, no one remembered to write in an explicit provision explaining that this $7 billion in spending for the health care centers would be subject to all the usual restrictions on how federal money is spent. One of those restrictions, the so-called Hyde Amendment, prohibits most federal funding for abortions.

..."It seems that this is something that slipped by," Jost says, "because elsewhere in the bill they made [funding] subject to [the Hyde amendment]."

And that's how a silly slip-up allowed the anti-abortion forces to issue the dubious claim that this bill will unleash a flood of federally-funded abortions. But though the Democrats' omission makes it easier for anti-abortion rights groups to claim the community health care ceneters funding could pay for abortions, it doesn't make it true.

Community health centers don't perform abortions. They never have—not even in the 1960s and 1970s before the Hyde Amendment was introduced. And they don't plan to in the future. In a statement issued last week, the clinics' umbrella organization, the National Association of Community Health Centers (NACHC), said that "health centers do not plan to, nor are they seeking to, become providers of abortion." And Secretary of Health and Human Services Kathleen Sebelius has pledged that none of the money from the health care bill will be used to fund abortions at community health centers.
The problem is that leaving a loophole like that is an invitation for someone to abuse in the future.  None of the points mentioned above prevent someone from using the loophole to fund abortions in the future. Even if you agree that it's a typo, then it brings to mind the question of why we should trust Congress enough to believe there aren't additional "typos" that will come to light later, when they're rushing to try and pass a bill before the President heads overseas (and before their members go home for an Easter recess that might not be so restful). Maybe they can use Nancy Pelosi's latest stupid argument in favor of the bill -- unemployed artists will no longer have to find jobs to finance their health care, since the government will subsidize it, allowing them to not work and pursue their life's dream!  Hey, I can finally puruse my dream of being an "artist" who watches TV all day!  But that's all backdrop for the real remaining issue -- the vote count.

The White House is confident it will have passage of the week -- so confident that two major advisors essentially guaranteed it on the Sunday talk shows.  Of course, the House Majority Whip (you know, the guy who actually has to count the votes for the Democrats) says they don't have the votes yet.  Which means the White House is still looking for votes, which might be why they're suddenly backtracking on the President's pledge not to have any more special deals in the legislation...
Still seeking votes for his proposed health care overhaul, President Barack Obama appears ready to reverse his position and allow unpopular deal-sweetening measures in the hopes of finding Democratic support for legislation whose future will be decided in coming days.

...Clinching support, though, might require Obama to back away from his insistence that senators purge the legislation of a number of lawmakers' special deals.

Taking a new position, Axelrod said the White House only objects to state-specific arrangements, such as an increase in Medicaid funding for Nebraska, ridiculed as the "Cornhusker Kickback." That's being cut, but provisions that could affect more than one state are OK, Axelrod said.

That means deals sought by senators from Montana and Connecticut would be fine — even though Gibbs last week singled them out as items Obama wanted removed. There was resistance, however, from two committee chairman, Democratic Sens. Max Baucus of Montana and Chris Dodd of Connecticut, and the White House has apparently backed down.

Axelrod said the principles the White House wants to apply include "Are these applicable to all states? Even if they do not qualify now, would they qualify under certain sets of circumstances?"
Somewhere, Jim Geraghty is updating his line that all of Barack Obama's promises have an expiration date. However, the real issue is why Gibbs and Axelrod would issue such blanket guarantees.  I think there's a combination of two things going on here.  First, they have some degree of confidence (hopeful confidence? desperate confidence?) that Nancy Pelosi will get the votes somehow, despite the loss of at least a few Stupak bloc voters.  The second issue is that they're trying to create a sense of inevitability and momentum for the bill -- it can't be stopped, so people (or at least, wavering House Democrats) should get on board.  I think it's a mix of both, really, but the question House Democrats have to be asking is whether they can really trust this Administration to get the pulse of America right.

Axelrod seems to saying that he wants the GOP to make the fall elections about the health care bill.  I think what House members realize is that the GOP does not have to do it -- the Tea Parties, the independants, and the core GOP base are already making it about the bill, without much in the way of urging from the GOP leadership.  The rebellion against the health care reform bills and process wasn't coordinated from above, much as the Obama Administration fervently wishes it were.  The fact that it comes from the grass roots means that the arguments Axelrod is making will be arguments that Democratic candidates will be having with constituents as much as with opponents.  And when you're arguing with people, it's tough to get their vote.

And this is before we get to the optics of the situation -- and here's new Senator Scott Brown,who is the walking, talking symbol of what this debate has cost Democrats, delivering Saturday's GOP response to the President's weekly radio address...
Maybe you remember what President Obama promised in his State of the Union address. He said he was going to finally focus on jobs and the economy for the remainder of this year. I applauded him for that. Well, here it is, it’s almost spring. And what is he out there talking about again? That same 2,700-page, multi-trillion dollar healthcare legislation.

So, an entire year has gone to waste. Millions of Americans have lost their jobs, and many more jobs are in danger. Even now, the president still hasn’t gotten the message.

Somehow, the greater the public opposition to the healthcare bill, the more determined they seem to force it on us anyway. Their attitude shows Washington at its very worst – the presumption that they know best, and they’re going to get their way whether the American people like it or not.

And, when politicians start thinking like that, they don’t let anything get in their way – not public opinion, not the rules of fair play, not even their own promises.

They pledged transparency. Instead, we have a healthcare bill tainted by secrecy, concealed cost, and full of backroom deals – and that’s just not right. They should do better. The American people expect more.
Let the vote-counting continue. Firedoglake's estimate is here. Jay Cost is here. The Hill is here. I have no count, but a prediction that the bill with either pass by a small majority, or go down in flames as moderate Dems bail and are followed by liberals seeking to make a statement on the bill not going far enough.

At the end of the day, I doubt the bill dies, even if it doesn't pass this week. The Obama Administration needs a win, no matter how many votes this costs them in the fall. I think the longer this carries on, the worse things get for them, and I don't just mean this fall. The chicanery being used to push this bill through... well, let's just say a declaration of Shenanigans is coming.

Get your brooms.

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