Tea-Leaf Reading On Health Care

I'm going to play against type for a second.

I'm going to be an optimist.

There are actually lots of signs out there that health care reform will get done, and even a few that it won't be totally awful.

On the "getting done" part, this is uncontroversial. Without a bill that Democrats can sell to the public as a victory, they will get wiped out in 2010. They cannot live with failure. Dems in the House all have to face the voters, while some Senate moderates can hide this cycle. But regardless, the pressure from the White House and those vulnerable members of Congress to get something done will be intense. Furthermore, Blue Dogs are resigned to a bill.

Even after the tough town-hall-style meetings, unrelenting Republican assaults and a steady stream of questions from anxious voters, interviews with more than a dozen Blue Dogs and their top aides indicate that many of the lawmakers still believe approval of some form of health care plan is achievable and far preferable to not acting at all.

“I can’t tell you how comprehensive it will be, but I do believe something will get passed,” said Representative Michael Arcuri, a second-term Blue Dog Democrat from New York.

The political temperature of the Blue Dogs — and their ideological counterparts in the Senate — after the five-week recess is crucial. As representatives of some of the nation’s most conservative territory represented by Democrats, they potentially have the most to lose if a Democratic bill spurs a backlash. Even with healthy majorities in Congress, every Democratic vote is critical given the reluctance by some Democrats to consider a major overhaul and near blanket Republican opposition.

One lawmaker in the group, Representative David Scott of Georgia, said his determination to enact a health care overhaul had been increased over the recess because of what he called the spread of misinformation and other unfair tactics engaged in by the opposition.

“I think now more than ever we must get strong in our resolve to pass health care insurance reform legislation,” Mr. Scott said.

Scott is the Rep. who had a swastika painted on a sign in front of his office.

The Blue Dogs know that they will be first in line to go down if health care fails. They can try to claim in their districts that they saved the world from the eee-vul intentions of Hussein X, but that won't work. After a failed effort, anyone with a D in front of their name will be toast. And the Blue Dogs will be first up to the sacrifice pit.

Meanwhile, there are actual, definable signs that the public option will have to be a part of whatever comes out of a must-pass bill. For one, labor supports it strongly. Few interest groups in the Democratic Party hold more influence. House Dems would be dead without labor. Second, members of Congress are putting their own pressure on the President. Like Ohio's Sherrod Brown.

"I think the president needs to step forward," Sen. Sherrod Brown, D-Ohio, said this week, "be more specific, more aggressively fight for a strong health reform bill with a strong public option. I think he's going to do that."

Then you have Blanche Lincoln setting up for what I actually think is a way to support a public option and claim that she stopped the liberals from doing their worst:

Sen. Blanche Lincoln (D-AR) has been tepidly supportive of a public option in the past, so her comments to reporters today come as a bit of a head-scratcher. "I would not support a solely government-funded public option. We can't afford that," Lincoln said.

Nobody has called for a government-funded public option. The House bills have it paid for through consumer premiums, with a modicum of start-up money. She appears to be girding herself for a premium-supported public option.

Now, this could all be completely off base, as you have to practically read hieroglyphics to understand what's coming out of politicians in Washington these days. But we know with a fair degree of certainty that:

1) there has to be a health care bill
2) conservative Dems know it and won't stand in the way
3) liberal Dems sound confident that the President will push for a strong public option
4) conservative Senate Dems seem to be playing a kabuki game about it

Sure, you have ConservaDems not up for re-election next year like Ben Nelson arguing for more bipartisanship (although even the examples he gives are already addressed by the House bills). But in general, the momentum is actually pushing in favor of a bill, and maybe even a good one. You can base your beliefs on that, or unnamed sources in the White House. We'll see.