Obama and Health Care: From the House to the Senate

Almost exactly one year after the historic election that brought Barack Obama to the White House, the House of Representatives passed a health care bill that is itself historic. No president has ever moved the ball this far forward on health care. For a moment, the dramatic vote recalled the enthusiasm and esprit that characterized the Obama presidential campaign. We well remember the long lines of people young and old, rich and poor, of all races and ethnicities, preparing to cast the vote of their lives.

After a generation of cringing in the shadow of dominant Republicans, Democrats now find themselves with their own moment as America evolves into a multiethnic political community with a possible resurgence of support for government intervention. The Democrats have become a majority governing party built on a new popular base that is younger and more diverse than ever before, even as the Republicans are girding for irrelevance as a party of older angry white men, based mostly in the South and relentlessly hostile to all government intervention. Even Republican candidates are falling behind in the wake of the troika of Sarah Palin, Rush Limbaugh and Glenn Beck, who drove the chosen Republican candidate out of a New York congressional race and saw the Democrats pick up a seat they had not won since the Civil War.

The Democrats’ problem, though, is not the Republicans. It is the Democrats. As a governing party, the Democrats are struggling to achieve ambitious legislative goals while maintaining enthusiasm in their mass base. The recent elections in New Jersey and Virginia revealed the consequences of not paying attention to the base, as Democrats saw a big voter decline among Democratic voters.

To keep people working hard and excited, a national party has to offer a choice between one side and the other. It has to be willing to make enemies, or at least opponents. It has to offer drama and characters.

Until the great moment in the House Chamber on Nov. 7, the Democratic side has been fairly subdued on the health care debate, while the Republicans have used the teabaggers to ratchet up their base. And characters? Democrats have them in abundance: Henry Waxman, Chuck Schumer, Jay Rockefeller and many others who have been holding the line on health care. Before and after his death, Edward Kennedy was the central dramatic figure in health care. But the public sees more of the protesters than of the Democratic leaders in Congress.

The White House decided in the summer to devote the lion’s share of its attention to an uninspiring senator from Montana, Max Baucus, who promised to craft a centrist, bipartisan bill. But instead of helping his party, Baucus happily stretched out his time in the spotlight for months, forcing long delays in the legislation. From the view of the average Democratic voter, health care consisted of President Obama, on the one hand, Baucus leading a pointless set of wandering talks on the other and, occasionally, Republican Olympia Snowe of Maine offering the mystique of bipartisanship. There was not much mention of the bill created by Kennedy’s committee, or the work of Henry Waxman (D-Los Angeles), or the many other Democrats who could have generated public interest. If that was the face of the health care team, who cared?

By elevating the importance of the centrist holdouts over the liberal loyalists who built the main set of bills, Obama made the classic teacher’s error of rewarding the bad kids with attention while taking the good kids for granted. So, naturally, the bad kids wanted more, and the good kids got annoyed. As soon as Olympia Snowe’s week of fame was over, Lieberman (I-Conn.) showed up to announce his deeply principled opposition to a health care bill — the principles of which he had previously supported.

So it was striking that when Obama went to the House to rally the troops in a closed-door session on Saturday, Nov. 7, he gave advice that perhaps he had begun to take himself. The Republicans will come after you whether you vote for the bill or not. There is no safety in opposing it. So you might as well do what is right. He spoke of the dramatic, historic moment. And when they passed the bill, he adopted it as his own. It is a classic presidential technique to use the more responsive House against the more hidebound Senate, and Obama, who has emphasized the Senate over the House for months, seems now to have gotten that.

As the bill moves to the Senate, the danger of another slowdown is high. In the Senate, obstacles to change are immense and written into the Constitution itself. James Madison and his fellow Federalists feared a fever of popular excitement for radical plans, and the Senate was meant to be a bulwark against the excess energy of the people. Senators like to think of themselves as solons of the Roman Empire. They will treat the House bill with disdain. They will announce that they will take all the time they need. Senate Majority Leader Harry Reid will wring his hands. Reid shocked the world by putting a public option in the draft Senate bill, but he will have to fight to keep it there. 

But, really, these are politicians, and they care most about two things: What you can do for them, and what you can do to them. No one wants to be on the wrong side of history. Reid may now see that his own re-election in Nevada, which is in serious peril, can only be salvaged by mobilizing the Democratic base. And even the self-centered Senate moderates may understand that it is time to get this done and to do it well.

And for those who don’t cooperate, the leadership can threaten “reconciliation” (passing the bill without facing a filibuster), and the caucus can reexamine committee chair positions. Even in the Senate club, actions should have consequences.

Obama will have to recast his earlier strategy of massaging the egos of those least likely to help. He needs to highlight and showcase those who have advanced the cause from the start, like Rockefeller, and he should go back to the spirit of Ted Kennedy and, while he is at it, Harry Truman. Kennedy and Truman pretty much outrank naysayers Blanche Lincoln (D-Ark.) and Lieberman, but if the Senate moderates stretch things out for very long, if this debate goes much longer, it will really hurt Obama and the Democrats in 2010.

Because it’s time to get off health care and onto the economy.

The moderate Blue Dogs are wrong about the politics of health care. Opposing the president on health care will only lose them Democratic votes, without winning enough independents to balance out the losses. But they are right about one thing, and that is that Obama can now best help the party by focusing on the economy. There’s no time to lose; the economy has to be issue No. 1, and that’s why Baucus’ waiting game, which he drew out with Reid’s permission, was so damaging. Time’s up. The Democrats need to harvest the stimulus and health care victories. With the unemployment rate above 10 percent, the jobs issue is likely to dominate the coming year. Even if Obama can make progress on other issues, the economy will dwarf them all.

The president can spend the next year jawboning employers to hire new workers and banks to lend money. He can use regulatory and other frameworks, cut stimulus project ribbons, visit unemployment lines and all in all make advocating for the downturn’s casualties the president’s main job. He should remind people of the mess he inherited and that those who are attacking his economic policies put us in this spot in the first place. 

Oddly, though they do not always realize it, the interests of the House and Senate Blue Dogs are, in fact, the same as Obama’s: a quick completion of health care and a turn onto the economy.

History is watching. That is the talk that Obama will have to give the Senate Democratic caucus. It is also a talk he has to give once again to himself.

Are the Democrats a majority governing party? Are they ready or not? Or just a bunch of freelancers? It’s time to decide.

Raphael J. Sonenshein is chair of the Division of Politics, Administration and Justice at Cal State Fullerton.