Holy Cow, Is Congress Getting Serious About Real Health Care Reform?

By Peter Dreier, The Nation. Posted October 26, 2009.

Social movements are messy, so it is often difficult to know, in the midst of the battle, which side is winning. But in the past month, momentum on healthcare reform has unmistakably shifted as liberals and progressives have taken to the streets, the Internet, the airwaves and the halls of Congress to push for a bold public option, strong regulations on insurance abuses and a progressive tax plan to finance reform.

The Obama administration and its allies in Congress now understand that permitting the unholy alliance of insurance industry muscle, conservative Democratic obfuscation and right-wing mob tactics to defeat the president's healthcare proposal would write the conservative playbook for blocking other key components of his agenda -- including action on climate change, immigration reform and labor laws. So in just the past few weeks, we've seen a change in strategy, a strong grassroots movement and markedly firmer resolve by the White House and liberal Democrats in Congress.

The Summer of Right-Wing Rage

At the end of the summer, pundits were already writing obituaries for major healthcare reform. Particularly during the August Congressional recess, an epidemic of right-wing anger against Obama and his policy agenda -- of which healthcare reform was simply an immediate and convenient target -- captivated the media, which reported disruptions at Congressional town hall meetings as though they were an accurate reflection of public opinion rather than a pep rally for extremists, encouraged by Fox News and talk-show jocks. The right-wingers stoked fear and confusion by warning that Obama's "socialized medicine" plan would create "death panels," subsidize illegal immigrants, pay for abortions and force people to drop their current insurance.

Republican officials, including Senator Charles Grassley, Senator Jim Demint, Republican National Committee chair Michael Steele and conservative pundits Glenn Beck, Rush Limbaugh, Sean Hannity, Bill O'Reilly and Betsy McCaughey repeated these myths. And support for the public option tumbled over the summer in response. In June, 62 percent of Americans told Washington Post/ABC pollsters that they favored a public option. By mid-August, support had slipped to 52 percent. Obama's popularly fell, too, as jobs continued to disappear and the administration's proposals to bail out the banks and the auto industry met with right-wing attacks and public skepticism.

For months Obama had insisted that any significant reform of the healthcare system include a "public option" -- an expanded version of Medicare that would compete with private insurance companies, pressuring them to reduce costs and providing Americans with greater choice. Republicans made it clear that they wouldn't support any plan that competes with the insurance industry or challenges its runaway costs and irresponsible practices. With huge majorities in both houses of Congress, Obama didn't need to win Republican votes, but he still held out hope for a bipartisan bill. More troubling, Obama discovered that even he couldn't charm the conservative Democrats in Congress into supporting his plan.

By the end of August the president, unsure of his political footing, was sending signals that he might settle for reform without a public option, assuaging conservative Democrats and the insurance industry but angering many of his progressive supporters.

The death in August of healthcare reform stalwart Senator Ted Kennedy bolstered the influence of Senator Max Baucus, chair of the Senate Finance Committee, which was drafting its own health reform legislation. Baucus, a darling of the health insurance and pharmaceutical industries, has been particularly opposed to Obama's proposal for a public option.

In its August 17 cover story, Business Week reported that "The Health Insurers Have Already Won." As if to confirm Business Week's analysis, in mid-September Steve Elmendorf, a lobbyist for UnitedHealth, sent out invitations to a fundraiser at his home for House Speaker Nancy Pelosi. That same day, reports from CNN and the Associated Press suggested that Pelosi appeared to back off her nonnegotiable support for the public option.

Targeting Insurance Industry Giants

Health Care for America Now (HCAN), a coalition of unions, community organizations, consumer groups, environmentalists and netroots groups such as MoveOn, has been spearheading the reform campaign since the group was launched in July 2008. In Pennsylvania, a combination of HCAN activism and Representative Joe Sestak's primary challenge to the newly Democratic Senator Arlen Specter pushed the incumbent to become a reluctant reformer. (Specter first voiced support for a public option at an HCAN rally in June.) During the summer, as healthcare reform bills moved through Congress, HCAN, MoveOn, the Service Employees International Union (SEIU) and the American Federation of State, County and Municipal Employees (AFSCME) launched television advertising campaigns, costing several million dollars, that asked Senate and House members in key states to support bold legislation that included a public option.

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Peter Dreier, professor of politics at Occidental College, is coauthor of "The Next Los Angeles: The Struggle for a Livable City" and "Place Matters: Metropolitics for the 21st Century."

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