As many of the smarter pro-life leaders anticipated over the past week, Michigan Rep. Bart Stupak’s winding road toward supporting the Senate version of President Obama’s national health care reform came to an end as an “aye” today thanks to an Executive Order from the White House.
Indications are that Speaker Nancy Pelosi, who had previously promised Planned Parenthood in closed-door meetings that there would be no floor vote on Stupak’s provision against taxpayer funding for abortion, is mere hours from achieving a momentous political victory. Without the Stupak group—Democratic Reps. Jerry Costello and Dan Lipinski are viewed as the only holdouts, and at least one of them disagrees with the EO strategy—Pelosi would’ve had to come from behind to find one or more flips from no to yes, but with the opponents of abortion funding safely in hand, it’s all over but the counting.
It takes a certain kind of crazy to stand up to a united president and a leadership in your own party, and by the end, it was apparent to many that Stupak, for all his personal dedication on the abortion issue, never wanted to be the barrier to reform and wilted in the political spotlight. Despite the fact that pro-life groups and the U.S. Conference of Catholic Bishops are unified in saying that this EO will not prevent taxpayer funding of abortions—at best, this will now join Mexico City as an abortion policy which is changed by executive fiat whenever the White House changes hands—it is a sufficient fig leaf for Stupak and his tiny band, and that may be all they wanted all along.
As for the victors: even with her overwhelming partisan majority, Pelosi’s achievement shouldn’t be underestimated—particularly because no one, outside of a few cheerleaders in the blogosphere, is happy about this legislation. The left and right are disgusted with this bill, either because of the backroom deals cut with the pharmaceutical industry, or the nationally mandated payoff to the private insurers, or the creation of massive new burdens for individuals and employers—well, there’s plenty to pick from. It’s hard to get votes for something disliked by so many people for so many reasons, especially for something that could spell the end of your political career—but she did it.
The president will not hesitate to sign the Senate bill into law, and the reconciliation process that will play out in the Senate will not hold him back. He has expended all of the bipartisan goodwill he had before coming into office on this measure, and he will gladly take this ideological remaking of American social policy as the outcome, even with its ugliest flaws.
In the end, Pelosi and Obama’s achievement is likely to come at a hefty political price. It seems clear that the American people aren’t as easy to buy off or cajole as their elected officials, and over the coming months, as they learn more about what’s within this new system, Republicans are counting on them disliking it. In a time of economic tension, the effects of new tax requirements could be immediate and tangible. And in the long term, the most significant aspect of this reform that no one has talked about that much is what it will do to the American job market—thanks to taxpayer-funded subsidies for coverage that create “cliffs” at certain income levels, many Americans will experience new penalties for success which will impact their decisions in the future.
For the foreseeable future, America’s health care system belongs to Barack Obama and Nancy Pelosi, two politicians without any background in health policy and whose views are based more in meeting the demands of special interests and ideologues than in pragmatic policy solutions that achieve real change. But despite what you may have heard on television over the past few days, nothing about this reform is impossible to undo. It is now up to the states and the people to respond—in the courts, and at the ballot box.
Benjamin Domenech, a former speechwriter and political appointee at the Department of Health and Human Services, is managing editor of Health Care News.