The Health-Care Summit Isn't a Negotiation, It's a Math Problem

Writing in The Wall Street Journal yesterday, Gerald Seib made an observation about tomorrow's health-care summit that I think is critical to understanding the proceedings. "The first is that the most basic predicate for success in any negotiation—that both sides, at the outset, think reaching an agreement is preferable to failing to reach an agreement—doesn't exist here," he wrote. In negotiation parlance, they call that a BATNA: the best alternative to a negotiated agreement. To figure out how your opponents will act, you need to understand the outcome they envision if the negotiation fails—that is, at what point can they happily walk away. The Democrats' BATNA is that they continue along the path they've been heading: have the House pass the Senate bill and make fixes like those the White House offered on Monday through the budget-reconciliation process in the Senate, where they will need only 51 votes.

The Republican BATNA is that health-care reform fails. The summit doesn't sway any of their members or any of those Democrats who have been hedging their bets, and the bill just limps toward death. More important, it's not clear that they'd prefer a negotiated outcome to their BATNA. If they successfully negotiate for the inclusion of some of their signature items—say, for example, medical-malpractice reform—they might feel compelled to vote in favor of reform. That hands the president and his congressional allies an enormous win and undermines their yearlong project of attacking Democratic reform initiatives. They can't vote for what they've spent months calling a "government takeover of health care" and then continue promoting their "Obama is a crazy liberal" narrative. No agreement would seem their preferred outcome. This is not a good-faith negotiation.

Once you accept the premise that tomorrow isn't truly a negotiation, then it becomes a mathematical puzzle. Do Harry Reid and Nancy Pelosi have the votes in their respective chambers? Hill sources tell me they don't think Reid has the numbers, yet but he's very close. They're hoping that tomorrow's optics—the president forcefully and eloquently making his case—will gather enough positive news coverage that the qualms of a few senators will be overcome. They're helped by two recent polls from NEWSWEEK and the Kaiser Family Foundation that both indicate that the more people know about the specific provisions of the reform bill, the more supportive they become.

The House is a different kettle of fish. For the first time this Congress, it's Pelosi, not Reid, who might have problems in her caucus. I'm told that Pelosi has a handful of votes in reserve, folks she didn't pressure the first time around, perhaps giving them a pass for political reasons, but whom she's prepared to sit on this time. The problem for us observers is that it's hard to figure out who those folks are exactly. She's definitely lost three votes from last time. Rep. John Murtha passed away, Robert Wexler resigned so he could head up a Middle East peace–focused think tank, and Neil Abercrombie leaves Friday to run for governor in Hawaii. The only Republican to vote for the bill the last time, Rep. Joseph Cao, has said he won't vote for it again. He was savaged by conservatives for his last vote, and his fundraising has suffered since.

So where does that leave Pelosi? The gurus over at First Read have the best summary going around:

So where does Pelosi get the handful of votes to get to 217? It will have to come from the pool of the 39 House Democrats who voted no last year—most of whom are Blue Dogs or face tough re-election campaigns in November. First, she can start with the three Dems who are retiring this year—Brian Baird, Bart Gordon, and John Tanner. Next, she can twist the arms of Dennis Kucinich and Eric Massa, who voted against the original because it wasn’t far-reaching enough. And then you have conservative-leaning Dems (Jason Altmire? Stephanie Herseth Sandlin?), who voted against the House bill because it had a public option or because it raised taxes on the wealthy. But the Senate bill the House will have to vote on doesn’t contain a public option, and doesn’t contain the millionaire’s tax. The argument to some Blue Dogs will be, if Ben Nelson, Blanche Lincoln, and Mary Landrieu could—ideologically—vote for the Senate bill, then they can too. In short, 217 votes are there, but getting them won’t be easy at all. 

It looks tough for Pelosi, but not impossible. But one thing is for sure: she doesn't take votes she's going to lose.