Glide Paths

I trust Orrin Hatch to know a bit more about his fellow Republicans than Max Baucus:

Sen. Orrin Hatch (R-Utah), who has a long history of teaming up with Democrats on healthcare legislation, says Democratic healthcare reform plans now under consideration are “out of this world.”

Hatch also told The Hill in a Friday interview he would be “shocked” if Sens. Chuck Grassley (R-Iowa) and Mike Enzi (R-Wyo.) sign onto a healthcare deal with Democrats given the current trajectory of the legislation.

Seems kind of futile to keep negotiating with two people who will never agree to your terms. Unless your goal, too, is delay.

What this delay has started to cause, according to Jon Cohn, is a change in rhetoric from the White House that could signal a major change in the scope of the bill.

The trouble is the Senate, where the last committee to consider reform, the Finance Committee, remains exactly where it has been since early summer: Stuck. The committee remains divided over several issues, chief among them how to come up with the approximately $1 trillion (or more) it will take to pay for coverage expansions in the first ten years. And while some of the problem seems peculiar to the makeup of that committee--and the determination of its chairman, Max Baucus, to include Republicans who are highly suspicious of the whole enterprise--the same problem exists in the overall makeup of the Senate, where not even all Democrats are yet on board with the kind of effort the party leadership in mind.

On Sunday, Ceci Connolly of the Washington Post reported that administration officials have changed their rhetoric--and that some now talk, quietly, of putting the country on a “glide path” to universal coverage rather than achieving it in the next few years. This is an important development although not an unexpected one. The White House and its allies plan for all contingencies. There has always been a “Plan B” in case the support for full coverage, along with comprehensive reform, wasn’t there. And there have always been key players--both in the White House and Congress--who have thought maybe “Plan B” should be “Plan A.” After a rough few weeks, when the president’s poll ratings began to slip and the opponents of reform managed to gum up the works in Congress, such an outcome seems increasingly likely.

We have a pretty good idea of what that would mean, in terms of policy. Leaks out of the Finance Committee suggest that, absent support for a program with all of the funding and regulation reform needs, legislation would be far from ideal. It’d mean less financial assistance both for people who don’t have insurance and those who now struggle to pay for it. It’d mean less financial protection for people who get sick. It’d mean less choice for people who want a range of options, including a public insurance plan, from which to choose. (For more details, the Center on Budget and Policy Priorities has a full analysis.)

Working- and middle-class people, many of them now struggling to pay for insurance or at risk of financial catastrophe in case of illness, would be the ones to receive less in a watered down reform. This makes for both bad policy and bad politics, in no small part because the two are closely related. A reform that the middle class perceives as offering few benefits at substantial cost would be a prime candidate for rollback in coming years.

The delay caused people to believe that enthusiasm for reform in Washington had slipped, which caused a similar loss of enthusiasm throughout the country. And this led the White House to scale back their rhetoric (which I actually think is a good thing - make it bite-sized for public consumption), as well as potentially scaling back the whole policy. Sounds pretty well-coordinated to me.

It's almost as if Grassley and Enzi are following a design to hold up any bill and let the cracks in the Democratic coalition come to a head.

I hope I don't get hungry on more than that half a loaf for the next few years.