The Real Battle for Health Reform Begins

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.