New York Times Editorial: The Democrats’ Choice
Copyright by The New York Times
Published: March 3, 2010
Republicans’ lock-step opposition to comprehensive health care reform seems to be as much a matter of politics as principle. But either way, they have made clear that there is no dialogue or any possible compromise that will persuade them to change their minds.
That means it’s up to Congressional Democrats to move legislation forward — or throw away a once-in-a-generation opportunity to fix this country’s broken health care system.
On Wednesday, President Obama called on Congress to quickly take an up-or-down vote. He and Democratic leaders in Congress are going to have to work overtime to corral skittish members of their caucus. And Mr. Obama is going to have to keep making the case to the American people that reform is essential for all Americans’ security and for the nation’s future fiscal health.
The most straightforward way to enact reform would be for the House — which only needs a majority — to approve the bill passed by the Senate and send it straight to the president for his signature. Unfortunately, House Democrats appear unwilling to do that.
Liberal members of the caucus think the Senate bill should spend more money to cover more people and provide more generous subsidies. Fiscal hawks are nervous about the projected costs of either bill. And legislators who strongly oppose abortion think the restrictions on coverage for abortion in the Senate’s bill are too weak.
The multiple sniping has forced the Democrats to consider amending the Senate bill by “reconciliation,” a procedure that can sidestep a Republican filibuster.
Don’t be misled by Republican charges that the president is planning to “ram through” reform with a rarely used maneuver. The Senate already has approved its bill with a 60-vote majority. Both parties have used reconciliation in the past. The Republicans happily used it to approve the Bush tax cuts in 2001 and 2003.
Senate Democrats should be able to muster the 51 votes needed. So what will it take to win over the House?
Liberal Democrats are right that the Senate bill is too stingy. More money should be added to make subsidized insurance affordable and to help states pay for expanding their Medicaid rolls. That would drive up the cost somewhat and make fiscal conservatives even more nervous. Yet there is much in the Senate bill for them.
The two most important points they — and all Americans — need to remember is that the Senate and House bills are fully paid for by tax revenues and budget savings, and both would reduce future deficits.
The Senate bill also has two additional cost-control mechanisms: a tax on high-cost insurance plans designed to push people toward cheaper plans, and an independent board to push cost-cutting measures into the Medicare program. Both could probably be strengthened in reconciliation.
Neither the liberals nor the fiscal hawks will be able to get everything they want. Mr. Obama and Congressional leaders will have to persuade both camps that failure is the worst option of all.
Do House liberals really want to deny 30 million uninsured Americans the chance at coverage? Do House deficit hawks want the deficit to rise even more? Because without reform, there are no plans to rein in the relentless rise of medical costs and the Medicare obligation.
The issue of abortion coverage can’t be addressed in a reconciliation bill that must deal only with budgetary matters. The Senate bill already has onerous provisions that would likely discourage insurers on new exchanges from offering policies that cover abortions. The House bill is even more restrictive. Both are outrageous intrusions on a woman’s right to make health care decisions.
House Democrats who say they cannot accept the Senate’s abortion provisions must ask themselves a fundamental question: Are they willing to scuttle their party’s signature domestic issue and a reform that this country desperately needs, rather than accept the almost-as-tough language of the Senate bill?