As Congress returns to Washington, all eyes turn to the issue of health care reform. The month of raucous town meetings and showing up at events where the President is speaking with firearms did little to advance the debate. The media has begun to look at the lies of both left and right to discern where the truth can be found: Yes, there is abortion coverage in the current bills and no there are no death panels. What happens now?
Some Democrats, especially those from swing districts, may be convinced that too many people are worried about the effects of the changes for them to vote for the final bill. This is a mistake. Most Americans want reform, especially reforms that will put an end to the denial of coverage for pre-existing conditions. They also are worried, but remotely, about the escalating costs of health care. Some Americans, but not enough, and certainly not enough religiously motivated voters, worry about the uninsured.
The worst outcome would be if health care reform was defeated. Yes, some Democrats might lose their seats if reform legislation passes and people do not like the result. But, so long as the provision of affordable insurance is front-loaded and enacted as an entitlement that cannot be taken away, those who get health insurance for the first time will become lifelong Democrats. If reform is defeated, the Democrats will simply look ineffectual.
Whatever is, or is not, in the final bill and the manner by which it is passed will become less important politically once the bill is signed into law. People will not long remember who did and did not vote for cloture or if the reconciliation process is used to get the bill through the Senate. The focus will be on the implementation of the new law. Stories about people who have wanted health care but could not afford it and now have health insurance will dominate the news coverage. Concerns about the federal deficit are not shared by the average American who, understandably, does not perceive much of a difference between a 9 trillion dollar deficit and an 8 trillion dollar deficit.
Abortion coverage is different. The Democrats risk alienating many voters if they persist in using health care reform as a vehicle for extending the availability of abortion. Many Catholic swing voters, for whom abortion is an important, but not an exclusive concern, gave candidate Obama and the Democrats the benefit of the doubt last year based upon the pledge that the administration would seek to lower the abortion rate. Providing federal funds for health insurance plans that cover abortion will give the lie to all the nice talk about “common ground.”
The task for congressional Democrats is to pass a bill, almost any bill, that does not include abortion funding but which does whatever else is necessary to pass both chambers. If some Republicans vote for it, great. If they don’t, a vote of 58-42 is still decisive. And, once the decision is made, voters will not care so much how that decision was reached. And the crazies who disrupted the town halls and showed up with guns can go back to their ruminations about the President’s birth certificate.