The Treatment

Breaking: Help Passes Reform Bill, 13-10

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The Senate Health, Education, Labor, and Pensions (HELP) Committee just passed its reform bill on a party-line vote, thirteen to ten. (Chairman Ted Kennedy voted by proxy, as did a few others who were otherwise engaged.) It is, as I've written before, not a perfect bill but a good one. And it creates a marker by which the bill from Senate Finance, still to come, will be judged. In the end, of course, the two bills must be combined into one, either before reform reaches the Senate floor or during the floor debate itself. Either way, though, the HELP bill makes it more likely that final package is one liberals can embrace enthusiastically.

There will be a lot of commentary about the Committee's failure to attract any Republican support; Christopher Dodd, who has been serving as chairman in Kennedy's absence, expressed repeatedly his "regret" that bipartisan support proved elusive. But he also stated that he was content with the choice that he, and his fellow Democrats, made. "The important issue is a good bill," Dodd said in a press conference after the vote. "I will not sacrifice a good bill for [the sake of bipartisanship.]"

Dodd went on to note that a weak bill, even one with bipartisan support, might be difficult to sustain, both during the congressional debate and afterwards. In other words, a weak bill would do less for the American people--and they would be less satisfied with it.

He's absolutely right about all of that. And it's important to remember that bipartisanship was always a longshot on the HELP Committee. The most likely pickups were Senators Mike Enzi and Orrin Hatch. But while Hatch, at least, has some history of collaborating with Kennedy on health legislation, they both have fundamental differences with what the Democrats are trying to do.

If you want to guarantee coverage to all Americans, make benefits more reliable, and improve quality while restraining cost growth, you have to reorganize and regulate the insurance industry, redirect the patterns of medical care, and rejigger the way money flows through the health care system. You also have to raise some new revenue, at least in the short term.

Enzi and Hatch, like most Republicans, oppose these things. And that is certainly their prerogative. They are conservatives, after all. But that also means we shouldn't treat their decision to reject reform as some sort of failure.

--Jonathan Cohn 

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