More On the GOP Health Care Blunder

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THE PLANK DECEMBER 21, 2009

More On the GOP Health Care Blunder

My argument that Republicans blew it by not offering Democrats a much smaller health care deal has drawn some dissent. Ross Douthat argues that Republicans got most of what they wanted in the bill anyway -- moderate Democrats did their work for them by taking out the public option and forcing deficit neutrality. The bill couldn't get much smaller without blowing up the whole thing: "To get something much more affordable," he writes, "you wouldn’t just need to persuade the Democrats to shave a few hundred billion off the price tag; you’d have to persuade them to take a radically different approach."

That's certainly true provided the Democrats insisted on offering universal coverage the the whole (non-illegal) population. But what if they didn't? Remember, at the beginning of the year, several Senate Democrats were urging President Obama not to take up health care reform at all. And they were dying for Republican cover. So imagine a Chuck Grassley offered them, say, a few hundred billion dollars in Medicaid expansion plus malpractice reform and bigger health savings accounts. I'd guess at least one Democrat would jump at that offer. And all they'd have needed is one Democrat to make that deal and say no more, and they'd have sunk universal health care.

The Atlantic's Derek Thompson, in the course of scolding me for what he oddly calls "chest-beating rhetoric," offers a couple retorts of his own. Thompson writes:

I see no evidence that cooperation from Olympia Snowe or a handful of Republicans would have tugged this legislation to the right. After all, some of the places where Snowe seemed willing to compromise -- for example, a public option trigger -- are actually to the left of the current legislation, which lacks any sort of public option, whatsoever. So it doesn't follow that Republican cooperation with health care would have "lured a chunk of Democrats to sign something far more limited."

I agree -- the assent of Olympia Snowe and a handful of other Republicans would not have tugged this bill to the right. What I wrote in my post was that if Chuck Grassley had offered a bill in the neighborhood of $400 billion or so, I think at least one Democrat would have taken the deal. Obviously, that's a counterfactual and nobody can know this for sure. Thompson has a right to disagree, but he should respond to what I actually wrote rather than respond to a different argument that I don't agree with.

Thompson continues, "Chait seems to think that this bill is not seen as partisan and too liberal, but I worry that he's wrong." Thompson proceeds to "refute" me with a lot of evidence showing that the health care bill has lost public support.

Wait, I think the bill is not seen as too partisan or liberal? I don't think that at all! I think the opposite, and that's what I wrote:

The strategy had some logic to it: If all 40 Republicans voted no, then Democrats would need 60 votes to succeed, a monumentally difficult task. And if they did succeed, the bill would be seen as partisan and therefore too liberal, too big government. ...The Republicans may gain some more seats in 2010 by their total obstruction, but the substantive policy defeat they've been dealt will last for decades.

Maybe I wasn't clear enough: the Republicans helped themselves politically short-term, but at a very high long-term policy cost. I think they could have prevented a universal bill by peeling away one or more Democrats who wanted  a bipartisan deal more than they wanted universal reform. The GOP withdrew this half-a-loaf measure and gave the Democrats just two choices: enact a Democrats-only (or Democrats plus Maine only) bill, or have a 1994-style fiasco. It was a big bet, and the Republicans, while gaining short term, will be paying for it a long time.

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