Bill Manzi.com

The U.S. House passed by a very narrow margin the health care bill that has been the subject of heated debate for what seems like forever. The battle now moves to the Senate, where passage of anything remotely resembling the House bill seems unlikely. The Globe ran a story today on some of the key differences, and they are stark. The Globe also ran a story on the potential for a Joseph Lieberman filibuster of any health bill that may contain a “public option”. So Harry Reid has his work cut out for him on the political end of this equation. Speaker Pelosi lost 39 Democrats on the final vote count, and I believe the Majority Leader is going to have his share of troubles keeping all of his caucus in line. Timing is now critical, as the President has called for a bill before year end. That potential has been called into serious doubt. The President should be concerned, as slippage into an election year can not be helpful to this bill. The December recess should also create political problems for the potential passage of a health bill.

If the Democrats are successful in getting a bill then the results will be clearly owned by the President and the Party. I do agree that universal coverage is a critical component of health care reform, but if that is all that is achieved and we see a spike in premium costs for those currently insured or a massive increase in the debt then there will be a political cost that will not be pretty for the Dems. Cost control in the existing system is essentially left for another day by the current efforts, and while the politics of that decision are obvious the resulting financial strain may not be bearable, even in the short run. Steve Pearlstein over at the Washington Post talks about some of the realities in a recent column, as does Fred Hiatt today. Will the President get a bill out this year? The political focus has centered around the political cost to the President of failure to get a bill. What will be the political consequence of success?