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Reading the ObamaCare Tea Leaves

Shikha Dalmia
November 22, 2009, 10:57am

Last night's Senate vote to move forward with the debate on the universal health "don't-care" bill left me deeply pessimistic that this monstrosity could be stopped now. The margin of resistance - mere four senators -- appears too thin for a filibuster. All Comrade Harry Reid has to do, it seemed to me, is continue to smother them in taxpayer-funded goods till they succumb. After all, Sen. Mary L. Landrieu of Louisiana's resistance has already earned her $100 million in extra Medicaid reimbursement for her state. And though she continued to pledge resistance if this or that wasn't changed in the final bill, she was singing a decidedly more conciliatory tune on the Senate floor last night. She recounted the many things she liked about the bill and others that "needed improvement." Nothing was a deal-breaker for her anymore.

Everybody has a price, and if there are only three or four Senators who need to be bought, what does Harry Reid care how much he has to raid taxpayers' pocket to buy them off - especially since defeat will leave the president politically castrated for the rest of his term?

But the Politico this morning has an analysis that has caused me to think that maybe -- just maybe -- it's not over yet.

There are plenty of credible pockets of resistance inside and outside of Capitol Hill that might well derail the bill, Politico's analysis shows.

One: Public option politics.

Politico notes: "Right now, there is no public option plan that could garner 60 votes. A public plan "trigger" if private insurers fall short could come close - saying, losing Sanders but picking up Olympia Snowe (R-Maine) - but there's no guarantee it would fly in the House."

Two: Pro-life and pro-choice activists.

Politico notes: "Anti-abortion activists insisting that health reform cannot expand federal funding for abortions...Reid can't afford a single defection - and already, Sen. Ben Nelson (D-Neb.), who opposes abortion rights, says weak language could be enough to oppose final passage.....

House Speaker Nancy Pelosi could lose at least 10 Democrats if the Senate tried to water down the tough anti-abortion language in her bill."

Three: Various constituencies that will bear the brunt of higher taxes.

Politico notes: "The House and Senate have starkly different visions of how to pay for reform. And the House hates the Senate tax, and the Senate hates the House tax.

Not surprisingly, politics are at play. The House went with a populist soak-the-rich tax on "millionaires" to pay for almost half the near-trillion dollar price-tag in its bill. And bowing to pressure from powerful union backers, Democrats steered clear of any tax on the so-called "Cadillac" plans - high-cost policies that many unions have negotiated for their workers over the years........Reid relies heavily on taxing the Cadillac plans - but won't touch a millionaires tax, which was never debated in the Senate."

Taxing Cadillac plans will lose unions and taxing millionaires will alienate all the rich, limousine liberals who voted for Obama.

Four: A senior revolt.

The Senate bill would cut close to half a trillion in Medicare. "So here we are telling the American people that we're going to fix health care in America and the way we're going to pay for the massive government takeover of health care is through cuts in Medicare?" says Sen. John McCain (R-Ariz.). Republicans are going to pound this and this will put Democrats between a rock and hard place. To keep AARP support - without which this bill will be in deep trouble - Democrats will have to roll back these cuts. And when they do, the bill will no longer be deficit-neutral putting President Obama in a bind because he would be breaking a promise not to sign any bill that raises the deficit by a "single dime" and jeopardizing even more the re-election chances of at least four or five Blue Dogs.

Five: Big Pharma.

Politico notes: "But there's another danger to Democrats lurking in the bill - dissent toward the White House deal with the drug-makers. Many Democrats feel PhRMA got off easy by only having to kick in $80 billion in cuts toward health reform. Some liberal Democrats want to change the deal's terms and force the industry to sell drugs to the federal government at a discount.

PhRMA insists that would bump up the seniors' Medicare prescription drug premiums by 20 percent. If the Senate includes the rebates, industry officials privately say that they'll consider running ads slamming senators for voting to increase seniors' drug costs.

'PhRMA would have to let people know the truth,' said a senior pharmaceutical lobbyist. 'I don't know why they would want to increase premiums.'"

My best guess? I think Democrats will ultimately get something through. All the internal contradictions will certainly make the bill creak mightily as it moves forward, but they won't cause it to collapse. The only hope is very massive outside resistance that even the MedicoCracy-- otherwise called Democratic leadership -- in Washington can't ignore.


Shikha Dalmia is Senior Analyst


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