For weeks there had been hiccups, angry tweets, warnings of doom, and exhortations from the White House for Congress to move on healthcare reform. Then came last week, which will most likely be looked back on as a pivotal moment in this year's debate, regardless of its final outcome. First there was progress of a sort, if only because Democrats finally dropped the charade of seeking a bipartisan bill and pushed ahead on their own. And yet by week's end, in a show of how quickly things can change in Washington, their momentum had all but vanished.
It was only a week ago, in fact, that House leaders unveiled their bill, complete with a government-run insurance plan, amid a gaggle of collegial smiles. The next day, in the room where lawmakers once held hearings to examine the sinking of the Titanic, Democrats on the Senate Health Committee pledged not to let healthcare sink the country and approved their own bill along party lines.
Applauding the effort was President Obama, who told critics not to bet against him. "He's willing to expend every bit of political capital he has to achieve reform of the healthcare system of this country," said Sen. Chris Dodd.
After much hand-wringing over whether reform could get done before the August recess, Democrats last week said they were back on track and would, if necessary, forgo summer trips to the beach so that Americans don't have to keep paying for trips to the hospital by the uninsured. "We cannot put it off again," said Rep. Henry Waxman, who chairs the Energy and Commerce committee, the last of three House committees that must now approve the bill.
But the past five days have surely tested that resolve. Late last week, the Congressional Budget Office said the House bill would not control the country's rising healthcare spending. Moderate and conservative House Democrats revolted. A group of centrist senators sent a letter to the White House, urging the president to slow down.
By Friday afternoon, a tired-looking Obama gave a brief speech from the White House urging politicians not to lose track of the bigger picture.
Waxman, dubbed "legislative maestro" by House Speaker Nancy Pelosi, now has some serious harmonizing to do this week. There is much disagreement on his committee between progressive Democrats and fiscally conservative "blue dog" Democrats about what reform should contain and how to prevent small businesses from being penalized by new fees.
According to estimates, the House bill would cost more than $1 trillion, mostly to help pay for subsidies that would expand insurance to about 97 percent of Americans. But blue dogs say the bill doesn't do enough to make care cheaper. That view is shared by Congressional Budget Office Director Douglas Elmendorf, who testified last week that the bill does not provide the "sort of fundamental changes" needed to curb federal spending.
The 52 blue dogs have the power to force party leadership to listen. The bill only narrowly passed two committees last week, and Waxman's committee has 36 Democrats, eight of whom are blue dogs. If those eight, plus the Republican members, vote against the bill—a possibility—it will fail.
"The bill doesn't satisfy everyone," Rep. Pete Stark, who chairs an influential health subcommittee, said last week. "For progressives, it isn't single payer. For my friends on the right, it has the audacity to include a public health insurance option." Nonetheless, he said, "this bill will be one of the most important votes any of my colleagues will take in Congress."
Obama, recognizing the need to get more involved to avoid failure in the House, summoned Democrats on the Energy and Commerce Committee to the White House today.
Then there's the Senate. The House would raise money for its plan with a tax on incomes above $280,000. After some House Democrats balked at that figure, Pelosi this week suggested raising it to $500,000. Several Democratic senators have already said that just won't fly in their chamber. Meanwhile, Sen. Max Baucus, chair of the Senate Finance Committee, is still trying to work out a bipartisan deal behind closed doors.