The Real Battle for Health Reform Begins

Posted by Mike Lux, Open Left at 10:15 AM on October 14, 2009.

The preliminaries are finally over in the battle to finally, finally, finally -- 97 years after Teddy Roosevelt first proposed it -- pass comprehensive health care reform. I think the right sports analogy to use is the extended, exhausting, NBA playoffs: after 82 regular season games, 16 playoff teams play in a best-of-7 series to get to the second round, and then the remaining eight teams play best-of-seven to get into the conference finals for another exhausting best of-7 series. I think that's about where we're at, the conference finals, where the coming days will seem like a long tiring 7-game series that is only the preparation for the even more intense final championship round.

I am excited, though, because this is a whole lot further than we got to when I was in the White House health care war room in 1994. We got the bill out of some of the committees, but never out of Senate Finance, and never had a realistic chance to have a floor fight.

So now come the machinations and maneuvering to figure out how to merge the two bills in the Senate and three in the House. The strategy now looks to be to get through on the Senate side with the 60 Democrats and maybe Snowe, but to continue to hold reconciliation (where you only need 51 votes) out as an option if needed once the conference committee comes back.

As I had predicted awhile back, Baucus' initial bill in Senate Finance was an ugly mutt of compromises and decisions, but it got a little better in the committee process, as he gave the progressives on the committee a few solid improvements here and there. Reid will now merge the two bills, and I am convinced that he will work to create a better bill in the process, and then we have the floor fight and finally conference committee. At every stage, I think progressives have the ability, if they stick together and negotiate well, to make progress.

 On the highest profile and incredibly important public option issue, I believe we are now well-positioned to have a public option in the final bill. We have come a long way since those summer months where all the conventional wisdom repeatedly said the public option was dead, but I think we are now at a position where the biggest question is more likely to be how good the public option is, not whether we will have one. There will continue to be conservative Democrats who want to placate insurers and Olympia Snowe by dropping the public option, but I think progressives can stop that from happening. The key, as it has always been from the first day of this fight, is for progressives, especially in the House, to stay together and stay strong in the negotiations. In fact, I will go so far as to say this: progressives should not panic if the Senate bill isn't great on the public option issue, and Democrats in general shouldn't panic if the conference committee is a long drawn-out affair with lots of fussing and fighting. We have come too far not to get a bill, and as long as House progressives stay strong and stay together, that bill will have to include a pubic option.

The conference finals are about to begin, but I'm not going to tell you to pull up a seat, because we need every progressive to stay in the game (yes, I will torture this metaphor to the end). It is only because of the progressive movement that health care has been on the agenda, and only because of that movement that the debate has not drifted inexorably to the right. We have a shot at passing a strong bill that will actually cover all Americans and create competition and a check on the power of the insurance industry. We have a shot at making history. Let's stay on the court until the victory is won.

Mike Lux is the founder of Progressive Strategies LLC and a director of the Center for Progressive Leadership, the Proteus Fund and the Arca Foundation.