If it wasn't clear enough the past several months, there's no doubt now that the Democratic Party -- for better or worse -- owns health care reform.
President Obama and Democratic leaders in Congress plan to have the U.S. House pass a $950 billion health care reform plan, modeled largely on the U.S. Senate bill passed last December. The strategy is that after the House passes the bill, senators will use reconciliation -- a budget procedure that only requires 51 votes -- to pass a series of "fix-it" measures supported by liberal members of the U.S. House.
While reconciliation is possible in the Senate, where Democrats have 59 votes, the effort may end in the U.S. House. Last year, Democrats passed health care reform there by a slim 220-215 margin. However, four of those "yes" votes are gone. The sole Republican to support health care reform last year, Rep. Joseph Cao, R-La., has already said he will vote against the new bill.
There are also several Democrats who only voted "yes" in the House because that particular bill specifically banned abortion services. The bill Obama is sending to the House allows individuals benefiting from the health insurance reform bill to pay for abortion services.
However, it would be foolish to underestimate the ability of House Speaker Nancy Pelosi, D-Calif., to forge a slim majority. She has been persuasive enough to craft majorities on health care and the energy bill. It's possible she may be able to push skittish moderate Democrats to support health care reform despite polls that show most Americans oppose the effort.
The fact is health care reform is the Democratic Party's most noteworthy effort of Obama's young presidency. If the Democratic Party, holding a large majority in Congress and a liberal president, fails to pass a health care reform bill, it will have proven itself unable to effect change. The lessons of 1994, when the Democrats failed to pass health care and lost its majority in Congress, are not too far in the past.
President Obama has been telling Democrats that most Americans will support health care reform after it is passed. He points to features of the bill that will cover 31 million uninsured Americans, prevent insurance companies from dropping coverage, regulate premiums, protect insurance when workers change jobs, and most importantly, protect health care programs such as Medicare from future bankruptcy.
The White House has also told Democrats in Congress that Americans will perceive Republicans' opposition as obstructionism. So far that hasn't been the case, according to the polls.
It's a tremendous political gamble trying to effect change of this magnitude in American life without bipartisanship.
Even if the Democrats succeed, it may cost the party its majority in Congress.
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