Snowe Falls, but More Obstacles Remain for Health Care Legislation

The health care reform debate is rapidly moving to some critical moments and critical choices in both the House and the Senate; the dynamics now raise fascinating questions about the process, the parties, the institutions and the norms inside Congress.

Let's start with Sen. Olympia Snowe (R-Maine), who has been the subject of almost endless fascination, admiration and distaste, the latter coming from conservative activists and liberal activists alike. One can imagine Snowe being the only politician ever to receive simultaneous negative ads from the Club for Growth and MoveOn.org.

The notion that one Senator can have so much power has rankled a lot of people and puzzled others, and I have gotten a lot of calls about it. My response has been the following: Even before the 60-vote hurdle became routine in the Senate, the late, great Sen. Daniel Patrick Moynihan (D-N.Y.) would remark about how achieving and implementing major social policy change--when Washington asks Americans to "trust us" that short-term pain will result in long-term gain--requires broad bipartisan leadership consensus or support.

If Obama can keep his Democrats together, he can achieve what Clinton could not.

That should mean not just 60 votes in the Senate, but 70 or more--and in the old days, that would be achievable. Medicare passed in 1965 by 68-21--and by 313-115 in the House. What are the odds today of getting 68 votes in the Senate (much less 300-plus in the House) for a health care reform bill? As George W. Bush was fond of saying, "slim to none--and slim just left the building."

Given the hyperpartisanship of our era and the now-reflexive use of the filibuster to block legislation, getting barely to 60 becomes the goal, and that makes the marginal votes as one approaches 58, 59 and 60 especially crucial, and gives great clout to the individual Senators in that position. The clout is magnified when the potential 60th is the only member of the minority party now willing to offer support, providing at least nominal bipartisanship. (If there were any hope of even modest bipartisanship, where a half-dozen or more minority Senators would be willing to sign on to a bill, we would have a different dynamic.)

I have known Olympia Snowe since the early 1980s. I spent time with her (and her Maine colleague and husband Jock McKernan) at Wednesday Group retreats. I worked closely with her on campaign finance reform. I can't think of another Senator I would rather have in that catbird seat. She is smart, has deep integrity, and is clearly using her leverage to try to make a better bill that will help more Americans and bring some measure of fiscal responsibility as well.

That said, it would still be better if there were the half-dozen or more Republicans ready to deal. The tragedy of the GOP strategy of voting "no" and hoping to derail any plan supported by President Barack Obama is that the bill could be much better if there were more Republican potential support--better malpractice reform, better ways to reduce defensive medicine, better ways to bend the cost curve, better ways to get real competition in the system. Those deals were there to be had; the White House and Congressional Democrats would have done a lot to get to 65 or more on this issue.

But we are left with Snowe (and perhaps her fellow Maine Republican, Sen. Susan Collins, and maybe a few more if and when we have a final vote on a conference report). Important as Snowe is, however, the big challenge for the president, Senate Majority Leader Harry Reid (D-Nev.) and Speaker Nancy Pelosi (D-Calif.) remains their fellow Democrats.

Bill Clinton in 1994 had nearly the same number of Democrats in the House as Obama does now. He had fewer in the Senate (he started with 57, but the number dropped to 56 after the special election victory in Texas of Kay Bailey Hutchison) but the filibuster was not the obstacle it is now. If he had held his Democrats together, Clinton could have achieved health care reform. If Obama can keep his Democrats together, he can achieve what Clinton could not.

Democrats so far in 2009 have shown markedly more discipline than they did in 1993, a product both of Obama's impressive coattails in the election and the awareness among today's Congressional Democrats that their lack of discipline in 1993-94 cost them their majorities for a dozen years. But it gets much tougher from here on out. Midterm jitters combine with ideological divisions and the natural tendency of Democrats toward disorganization and individualization. And throw into the mix a much more belligerent, organized and amplified outside advocacy movement on the left than existed in the Clinton era.

All this requires a serious test of leadership, political skills and substantive knowledge--finding ways to thread several needles to keep disparate groups of Democrats, separated by regional, parochial and ideological interests together, even as they are being pressured by Daily Kos, MoveOn.org, Michael Moore, Paul Krugman, the American Federation of State, County and Municipal Employees, the medical device community, rural doctors and hospitals, and fearful seniors, among many others. How do you keep Sens. Ben Nelson (D-Neb.) and Bernie Sanders (I-Vt.) in the same room, much less on the same page? Or Reps. Maxine Waters (D-Calif.) and Collin Peterson (D-Minn.), for that matter?

In the House, Pelosi has some slack to work with: the ability to lose nearly 40 of her own and still prevail. With just 60 Democrats, Reid has no slack, except perhaps a lone defector if he can secure Snowe on the Senate floor.

But Reid has one important weapon. He does not need 60 votes in support of a health care reform plan--he needs only 50 (with Vice President Joseph Biden in the chair to break a tie). He needs 60 only to invoke cloture and overcome a filibuster. If Reid can convince his team to view a filibuster as a procedural issue--that the key test of party loyalty is not voting for a health care reform plan but allowing the Senate to vote up or down on it--his task becomes much easier, and he can avoid the awkward and unpalatable alternative of reconciliation.

That is why Sen. Joe Lieberman's (ID-Conn.) comments last week were so interesting. Lieberman expressed great unease for the Senate Finance Committee plan and said he would vote against it if it were the plan. But Lieberman did not say that he would join a filibuster against it. Reid needs to craft a bill that makes sense fiscally and substantively. If he can also get Lieberman and his colleagues to agree not to support a filibuster or other comparable delaying maneuvers, he has a clear path to Senate passage. And we have a clear path to a nice Christmas present for the president.

Norman J. Ornstein is a resident scholar at AEI.

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