You've Got Questions, We've Got Answers

Yesterday FiveThirtyEight's Nate Silver posed 20 questions to those on the left who said "kill the bill" on health care reform.  Today, he's posted the answers he got from both FireDogLake's Jon Walker, and Big Orange Kos and his response to them.

It's a lengthy read, but it's the best discussion yet I've seen on the future of health care reform in this country.  It's two activist progressives versus Nate's

(Highlights after the jump...)

Questions 11-14 are the most interesting, frankly and the ones I will look at here (MM is Markos Moulitsas and JW is Jon Walker):

11. Would base voters be less likely to turn out in 2010 if no health care plan is passed at all, rather than a reasonable plan without a public option?

MM: Nope, if Democrats gave it a serious shot, and then built campaigns around the obstructionists. Caving in to Lieberman, Republicans, and corporate interests, on the other hand, sends the message that the Democratic super majorities are irrelevant, and all the hard work from the last four years in electing them was a wasted effort.

JW: My goal has always been reconciliation, the use of the nuclear option, or the White House using its influence to back down conservative Democrats — something that hasn’t happened yet. I think this question is misleading because that is not the actual choice on the table. It is bad bill with regular order, a better bill with 50 votes in the Senate, or no bill.

I'm actually coming around to the view that Democrats are about equally screwed either way, in large part because of the vehemently negative reaction that we've seen from the left over the past 72 hours. The left is fracturing over this issue in ways that are nothing like what I've experienced since I began covering politics for a living -- which granted, was only two years ago.

12. What is the approximate likelihood that a plan passed through reconciliation would be better, on balance, from a policy perspective, than a bill passed through regular order but without a public option?

MM: Likelier. Seems self-evident. And really, Medicare and the VA health system shows that the government is quite capable of handling health care.

JW: Extremely high. If I did not believe a much better bill could be passed using reconciliation I would not have been advocating for it for months. It is a pure myth that a good bill cannot be passed using reconciliation.

I don't understand the confidence here, and it smacks to me of wishful thinking. I'm not a process wonk, but the overwhelming opinion among people who are is that, although the public option might survive the reconciliation process, things like the ban on denying coverage for people with pre-existing conditions, the additional regulations on insurers, and the creation of the health insurance exchanges would almost certainly not. Plus, the bill would have to be deficit neutral over five years and would be subject to renewal every five years.

If your lone objective were to end up with something that you could call a public option, then yes -- reconciliation offers some possibility of that. But I don't see how you're likely, on balance, to wind up with a better bill -- losing the guaranteed issue provision alone would probably outweigh the inclusion of a public option.

There's also the idea, which Jon has advanced, of using the reconciliation process for some parts of the bill but not for others. It's a creative idea, but I don't see how it works, since it's not like you can keep this a secret from people. If you plan to pass certain provisions under reconciliation so as to circumvent Ben Nelson, it seems to me nearly certain that Ben Nelson would counter-circumvent you by filibustering the parts of the bill that you attempted to pass under regular order. So you'd still end up with half a loaf -- although maybe a different half than you might have otherwise.

Now, I certainly do think the Democrats would have some chance of passing portions of the bill under reconciliation in 2011; in that case you wouldn't have this transparent bait-and-switch with the moderates and could claim that you'd received a new mandate from the public.

13. What is the likely extent of political fallout that might result from an attempt to use the reconciliation process?

MM: Fallout with the DC press corps? They didn't mind when Republicans used it to pass their tax cuts under Bush, but that's a different time. I'm sure they'll hyperventilate about it now. The voters? I've seen no data that suggests they care about process. Just results. Democrats would cheer, Republicans would bitch, but those guys will bitch anyway.

JW: I think it will be very small. People care more about results than process. If reconciliation results in this early Medicare buy-in starting in 2010, I think it would be a huge net political gain for Democrats by showing that reform is working.

Was there a political fallout from Bush’s tax cuts because they where done through reconciliation? I do think there was.

More wishful thinking, IMO. The Bush tax cuts were popular; health care is not. Moreover, the filibuster actually polls well, so use of the procedure itself would be unpopular. If you intersect an unpopular policy with an unpopular process, I don't know what you're going to get, but the downside risk would seem to be fairly profound -- as in, I'd take even money at that point that the Democrats would lose the House.

Also, tax cuts are a relatively straightforward application of the reconciliation process -- health care is not, and the resulting procedural debate would last weeks if not months, giving the public plenty of time to stew over it.

14. How certain is it that a plan passed through reconciliation would in fact receive 51 votes (when some Democrats would might have objections to the use of the process)?

MM: It'd be nice to find out.

JW: First you only need 50 votes plus the vice president to break the tie. Second, are you really asking progressive to not stand up for better policy because there are possibly 11 Democrats who will bring down the reconciliation bill to protect their absurd Senate clubhouse feel?

The Democrats in the Senate seem were willing to give Joe Lieberman anything he wanted to get a bill labeled “health care reform” passed. If they will swallow their pride for Lieberman, they will do it for reconciliation if that is the only way the can get the “win.”

Hey, if this were the only risk I'd say "go for it". But it is another contributing factor on the downside. For starters, you're going to lose any senator who is already looking for an excuse to vote against health care reform -- meaning Lincoln, Lieberman, Nelson, Landrieu. You're going to lose a couple of process hawks -- Byrd, probably Conrad, probably Bayh, maybe Feingold. There are far short of 50 enthusiastic votes for the public option -- there are closer to about 43, and that includes a couple of the process hawks. The odds of getting to 50 votes under reconciliation would seem to be about 60/40 at best.

My thoughts:

Nate's dead right on 11.  Failure to pass a public option bill here may be the pickaxe blow that caves the tunnel in.  I thought the Teabaggers were bad, but there's still a pretty nasty breaking point that could divide the left just as powerfully, and this is it.  If that happens, all bets are off as to 2010 and 2012.  I wasn't worried before.  I'm scared now.

12?  I don't see a better bill coming out of reconciliation at all.  Period.

13, Nate sees that it would be 50-50 that the Dems lose the House if they go for reconciliation.  He's wrong.  I'd put it at 80-20.  Here's why:  The Dems have already shown how easily they've been beaten at the messaging game so far this year: you have to look no further than Obama's poll numbers for that.  Reconciliation will be portrayed as the ultimate act of Democratic party fascism, and the Dems will lose that battle in the Village press so completely that it will become a tsunami.  The left will say "screw it."  They'll get buried.  The Dems are just unable to win short of the GOP botching things as badly as they did in 2006 and 2008.

14...well, 13 is why 14 is not going to happen.

Any other thoughts?