What to Expect When You're Expecting ... A Democrat Compromise Health-Care-Reform Bill


Obama is set to deliver (yes, pun intended) a comprehensive health-care-reform bill Monday morning, to precede Thursday’s bipartisan health-care-reform summit. What will be in it, and how will it play out? Chances are it will fall somewhere in between the House and Senate versions (refresher course on the House and Senate versions here), but that still leaves a lot of wiggle room. Here are the five big things that I’m expecting and watching out for:

Numbers that meet in the middle: The easier issues for Obama to address are those of scale, the subsidies and monetary figures that are generally more generous in the House’s more expensive bill. They don’t hit on any moral (see: abortion) or ideological (see: public option) fault lines. They are things like the House bill expanding Medicaid to everyone under 150 percent of the poverty line and the Senate capping things at 133 percent. Fellow Gaggler Dan Stone and I predicted a while back that the numbers would be somewhere in the middle, and I'll still stand by that.

A fight over abortion: As is often the case with abortion legislation, there’s no "safe" route on this one: on both sides of the House’s controversial Stupak language, you have members of Congress adamant about their position and, thus far, unwilling to cede ground. While the Senate’s softened language is more in line with Obama’s stance on abortion, dropping the Stupak language could potentially alienate a critical number of House members. Either way, my sense is abortion is going to continue to be a fight until the very end of the health-care-reform debate.

A lesser battle over the excise tax: Throughout the debate, Obama has stood by the so-called Cadillac tax, which would be levied on the insurers who provide America's most expensive plans, as a way to help pay for health-care reform. But with labor groups, public opinion, and a number of representatives adamantly against this one, I think it's plausible that Obama (who already gave in to some labor demands on this issue) could let the tax fall by the wayside as a way to shore up some sorely needed support.

Liberal frustration at another public-option defeat: As Dan Amira over at New York magazine adeptly put it, “The public option has been killed and revived so many times now that you'd think it was a character on Lost.” This Gaggler does not know a ton about Lost but does know basic math, which is not on the liberals’ side for this one: despite reports of a "surge," 18 senators signing a petition for the public option does not add up to 51 voting for it. Even though it's generally a popular policy, I’d be surprised to see it in the Obama package.

Republican outrage: One Republican supported the House version of the bill. Zero supported the Senate version. Mash the two up together and what do you get? Chances are, not a lot of Republican support. The Republican rebuttal will likely be along the lines of "we have ideas, we presented them, and asked to start from scratch." But a [insert number of pages of the new bill here]-page bill is a far cry from a blank sheet of paper.

I’ll be back Monday to see how my predictions fared and look for any other points of interest in the Obama plan.