Time for some old-fashioned partisanship


If the ideal of bipartisanship on major healthcare reform wasn’t dead already, President Obama’s summit meeting on Thursday killed it for good.

And that’s not such a bad thing.

There was never much of a chance that consensus would magically emerge from a seven-hour meeting in front of television cameras. The politicians in that room had been debating healthcare for months without an across-the-aisle meeting of minds.

But the summit meeting needed to lay the groundwork for what comes next: A wholly partisan attempt to ram healthcare legislation through the House and Senate. At that it succeeded -- by making it exquisitely clear that bipartisan action is far out of reach.


The next few weeks are likely to be Obama’s only chance to enact comprehensive change in the nation’s health insurance system, his top domestic policy goal. And his success will depend entirely on his ability to marshal Democratic votes in what is looking increasingly like a very good year for Republicans.

It won’t be easy. Many on Capitol Hill -- including some Democrats -- don’t think it can be done. But Obama and his legislative leaders have decided to make one last try.

That’s why Obama had to draw clear lines between what Democrats and Republicans want, and to force wavering Democrats to choose a side.

He clearly achieved that goal. It’s less likely that he made much headway with an increasingly skeptical American public.

Obama hoped to reframe the debate, to remind Americans that they want healthcare reform and that his plan includes provisions they support.

But the Republicans came back strong. They challenged the very need for comprehensive reform (“We don’t do comprehensive well,” Sen. Lamar Alexander of Tennessee said) and said, in any case, it would be too expensive -- arguments that have resonated with voters mired in a deep recession.

It’s not yet clear whether Americans will buy, as Obama hopes, that Democrats are now justified in passing a bill without Republican support. He tried to explain why a president who campaigned to change the way Washington works is falling into habits he once decried. In that, he got an assist from the Republicans: They not only trashed the reform bills the House and Senate have already passed, they also rejected the goal of comprehensive reform entirely.

The biggest question now is this: Will Obama be able to rally his own Democrats so he can actually win a vote? Last week, he sent his party members a message, letting them know that on this issue, he is all in. After months of ambiguity, he finally issued a healthcare proposal of his own (essentially, an endorsement of the Senate bill) and promised to work for its passage in the House.

The seven-hour television summit won’t touch off a stampede in public opinion in either direction by itself. Instead, the next few weeks will see a high-stakes drama of old-fashioned retail politics, as Obama and his allies try to sell 217 of the House’s 254 Democrats on a Senate bill that very few of them love.

In that endeavor, Obama and his appropriately partisan House speaker, Nancy Pelosi, will face four hurdles.

First, they need to work out their legislative choreography. The plan is for the House to enact the bill the Senate passed just before Christmas; but both the House and Senate want to make changes to it, beginning with canceling Nebraska’s exemption from Medicaid costs that other states would have to pay.

Because the Democrats have lost their 60-vote supermajority in the Senate, they hope to act through a budget reconciliation bill, which requires only 51 votes. But there’s a problem: The Senate wants the House to pass the main healthcare bill first; the House, wary of the Senate’s capacity for delay, wants the Senate to go first in passing the fixes.

Second, Pelosi needs to hold her liberal members in line, even though many of them object to individual parts of the Senate bill. She’ll appeal to them to consider that this is likely to be their last, best chance to pass healthcare reform of any kind.

Third, and more difficult, Pelosi needs to win the votes of moderate “Blue Dog” Democrats, some of whom face tough Republican challenges in conservative-leaning districts.

When the House passed its own, liberal-leaning healthcare bill last year by a vote of 220 to 215, the Blue Dogs were divided: 29 voted for the bill, 25 against. Blue Dogs should find the Senate bill, which spends less money, more palatable; but some of the 29 who voted for last year’s bill could easily fall away this year.

Finally, the speaker faces a problem on abortion: 64 Democrats voted last year to prohibit federal funds from helping to pay for any insurance plan that covers abortions, but the Senate bill comes with a weaker prohibition. Pelosi will have to win most of those 64 votes to pass the bill.

Obama campaigned for president promising more bipartisanship. Now, both to achieve his top domestic goal and to salvage his own political influence, he needs to act not only as an effective leader but as an effective partisan.