So here we are…the final stage. Positioning has already started for the conference committee to reconcile the House bill and the coming Senate bill. At this point there appears to be three areas of concern–let’s deal with each in turn.
1. Financing. For how will the bill be paid? The House bill increases taxes on persons in the upper tax brackets, while the Senate bill taxes those with very good health care plans. The former makes conservatives upset while the latter makes some liberals upset–especially given that many unions have negotiated for precisely the kinds of plans that would be taxed. However, this is not the kind of issue that will hold back the bill–and I wonder if the Senate actually did this to use as a bargaining chip on which to compromise in conference committee to get what they really want.
2. The public option or expanded medicare buy-in. The House bill has it, but the Senate bill does not. Senators on both sides said they wouldn’t vote for it with/without one…but, one side flipped-floped on this issue and the other didn’t…so we clearly see for which side it means more. In addition, Obama himself will be a negotiating member of the conference committee and for several months now his support for the public option has been lukewarm at best–just yesterday calling it ‘symbolic.’
3. Abortion. This is the big one. Pro-life groups like National Right to Life and the more influential (because, unlike other pro-life organizations, they actually want to see the bill passed) US Catholic Bishops have pointed out that the Senate’s abortion language is unacceptable. In addition to forcing the federal government to manage, and taxpayer money to subsidize, an insurance exchange which covers abortions, the Senate bill will require purchasers of such plans to pay a distinct fee or surcharge which is extracted solely to help pay for other people’s abortions. David Brody suggests that the Senate will be forced accept the House language on abortion because pro-life democrat Bart Stupak has enough determined fellow democratic pro-lifers who are willing to kill the bill over this, and the other side does not.
My prediction? I think the senate will compromise on how the bill is financed in order to remove the public option. However, I think there will be blood on the floor over abortion language…but I hopefully predict that Stupak and company will steel their spines and force a bill that is comprehensively pro-life…something that will also signal the beginning of the end of the democratic party’s being beholden to the abortion-rights crowd.
Some wonder how a bill that is seemingly so unpopular could be passed. Well, the honest answer is that so many democrats–including the President–are so convinced that covering the uninsured is a moral imperative that they are willing to sacrifice their futures to get it. While this is something I very much admire, there is evidence that it might not be this dramatic. For the reason the numbers keep falling is not because more people want less of this kind of reform, it is because they want it to go farther. Good news for those of us who want to see those who cannot afford insurance and those who have preexisting conditions to get needed care.