Healthcare reform passes, political headaches begin | Slag Heap

Healthcare reform passes, political headaches begin

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Is it possible for something to be historic and yet not terribly surprising at the same time? That's how I feel about yesterday's healthcare reform vote in the U.S. House. 

Democrats got their shit together -- OK, I guess it was a bit surprising -- and passed the thing. Predictably, this was met with handwringing by the likes of Republican Tim Murphy, who lamented that, "A long time ago people stopped communicating and doors closed ... [W]e have to make sure this is not a moment that divides America."

(Note to Rep. Murphy: If you're worried about divisivenes, you might want to talk to the Tea Partiers. A Philly-based chapter of the movement sent out a blast e-mail observing that a pollster "has called the partisan vote 'a political Jonestown.'  We think that's an understatement." An understatement? How is alluding to the mass suicide of more than 900 people an understatement?)

Anyway, Democrat Mike Doyle voted for the measure, predictably. And Jason Altmire, predictably, voted against it.

I say "predictably," though a lot of folks were upset by Altmire's decision. But the conventional wisdom is that party leaders gave Altmire a quiet go-ahead to vote "no" on the measure. After all, as Nate Silver notes, the most useful factor for predicting how a Dem would vote on this issue was how Obama did in his or her district back in 2008.

In every district where Obama got less than 40 percent of the vote, the Democrat voted against healthcare reform. In districts where Obama got between 40 and 49 percent of the vote, the odds of a Dem voting against the bill were two-in-five. 

In Altmire's district, Obama took 45 percent of the vote, so he was right on the bubble.

Even if you regard Altmire's vote as cowardly, though, you have to admire the guy's finesse. His statement in opposition to the bill is a masterpiece. It begins with Altmire fretting over costs:

I ran for Congress in large part because I believe we need to find a way to bring down the cost of health care ... [While] the cost of inaction on health care is great, ... it would be an even bigger mistake to pass a bill that could compound the problem of skyrocketing health care costs.

Such bottom-line concerns are utterly consistent with what Altmire has been saying since last summer. Say what you want, the guy didn't flip-flop. (Of course, that's partly because you can't flip-flop unless you first take a position one way or the other.) 

Altmire follows with some blather about how the reform creates "winners and losers" -- as if the current system doesn't do the same thing -- but then hits his stride again. 

It has become clear that the vast majority of my constituents want me to oppose this bill. Particularly hard hit would be western Pennsylvania’s Medicare beneficiaries, which many experts believe would experience dramatic premium increases with enactment of this bill.

That bit about Medicare is a bit of a poser: Medicare recipients could see some improvements in the prescription-drug plan, for one thing, and the American Association of Retired People has been a consistent champion of the measure. But hey, it never hurts to play to the fears of cranky seniors. And truth to tell many of the cost-saving proposals meant to protect Medicare -- like reining in fraud and abuse -- are easier said than done. 

But my favorite part of Altmire's statement is this one:

I am acutely aware that my decision to vote against the health care bill will disappoint some of my constituents and alienate supporters of the bill. The politically easy vote would have been to vote with my party.

So just above, Altmire observed that "the vast majority of my constituents want me to oppose this bill." But taking an overwhelmingly popular position is an act of courage? Not sure that follows. 

Altmire's probably right that there's only lukewarm support for this measure in his district. And he's also consistently said that he couldn't support a measure that his constituents were strongly opposed to. Give him points for consistency, sure. But courage? Ehhhhh ...

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