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Despite Infighting, Democrats May Proceed Alone on Health Reform

August 19, 2009 at 12:00 AM EST
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Looking to attract GOP votes, Democrats are waging a fierce debate over whether a public option must be part of health care reform. Scholar Norman Ornstein and The Hotline's Amy Walter predict a health reform bill will clear Congress despite Democrats' infighting.
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JIM LEHRER: And still to come on the NewsHour tonight: the Swiss bank deal; crowded California prisons; and “60 Minutes” creator Don Hewitt.

That follows our health care reform update. Tonight, we look at the squabbling among the Democrats. NewsHour correspondent Tom Bearden begins.

TOM BEARDEN: Liberal Democrats are in an uproar after the Obama administration signaled over the weekend that a public option was not an essential part of health reform. New York Congressman Anthony Weiner.

REP. ANTHONY WEINER, D-N.Y: If the president thinks we’re going to get the votes without public option, he’s got another thing coming. That won’t pass the House.

TOM BEARDEN: For months, the president has insisted that a public option was a necessary part of fixing the country’s health care system. This is what he told the American Medical Association in June.

U.S. PRESIDENT BARACK OBAMA: If you like what you’re getting, keep it. Nobody is forcing you to shift. But if you’re not, this gives you some new options, and I believe one of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market so that…

TOM BEARDEN: But the president and his aides have also stopped short of making the public option a deal-breaker. This is what Mr. Obama said at a weekend stop in Grand Junction, Colorado.

U.S. PRESIDENT BARACK OBAMA: This is a legitimate debate to have. All I’m saying is, though, that the public option, whether we have it or we don’t have it, is not the entirety of health care reform. This is just one sliver of it.

TOM BEARDEN: Those comments, and similar ones made by Health and Human Services Secretary Kathleen Sebelius on Sunday, have sparked a firestorm amongst liberal Democrats. Representative Jesse Jackson, Jr., of Illinois was asked yesterday at a town hall meeting if he could support a bill without a public option.

TOWN HALL QUESTIONER: If there is not a viable public option in the final legislation, health care reform legislation, would you vote for that legislation?

REP. JESSE JACKSON, JR., D- Ill.: A health care reform without a viable, strong public option is a non-starter for us.

TOM BEARDEN: Jackson is also a member of the Congressional Progressive Caucus, which sent a letter to Sebelius on Monday saying that taking the public option off the table would be a “grave error.”

That view is not shared by all Democrats in Congress. Moderates, such as North Dakota Senator Kent Conrad, contend that a public option would make it impossible to attract Republican votes and would doom any health care bill.

SEN. KENT CONRAD, D-N.D.: The fact of the matter is, there are not the votes in the United States Senate for the public option. There never have been. So to continue to chase that rabbit, I think, is just a wasted effort.

Obama has not abandoned the plan

Norman Ornstein
American Enterprise Institute
The goal of the administration has for a long time been getting a bill through the House and a bill through the Senate. They don't have to be the same bill. And the political calculations in both houses are different

TOM BEARDEN: With the party split on the public option, and with the growing prospect of little or no Republican support for any of the current bills, the administration insisted yesterday it had not abandoned the idea yet.

ROBERT GIBBS, White House press secretary: The president has said repeatedly that he's open to different ideas and discussions, that his preferred option was the public plan.

TOM BEARDEN: The administration's balancing act is likely to continue, with recent polls showing the electorate is also divided on the public plan.

JIM LEHRER: And to Norman Ornstein, resident scholar at the American Enterprise Institute, and Amy Walter, editor-in-chief of the Hotline, National Journal's political daily.

Norm, is this thing among the Democrats real?

NORMAN ORNSTEIN: Oh, there's a real dispute here, there is no doubt. A good part of it is, Jim, is that the goal of the administration has for a long time been getting a bill through the House and a bill through the Senate. They don't have to be the same bill.

And the political calculations in both houses are different, as Kent Conrad said. The Senate simply doesn't have the votes, mostly because you have a bar of 60 there.

But what they're also learning is they're not going to have Republican support, so it gets down to, how can you build majorities with Democrats? And you've got some real divisions among the Democrats. The administration's trying to thread two needles here at the same time, and they're getting a few finger marks along the way.

JIM LEHRER: Amy, how would you describe the divisions? First of all, you agree these are real? These are real?

AMY WALTER: Absolutely, yes.

JIM LEHRER: These are not just showboat divisions?

AMY WALTER: No, they're not, although I will say that, you know, trying to cover something like legislation on cable television is a very difficult thing to do, and so a lot of this...

JIM LEHRER: But we're not on cable television.

NORMAN ORNSTEIN: Thank goodness.

Democrats are the biggest barrier

Amy Walter
The Hotline, National Journal
For this administration, it has always meant being able to work with Democrats. It is intraparty, not interparty. And so trying to make sure that Democrats get on board is always going to be their biggest challenge on major pieces of legislation

AMY WALTER: Right, but a lot of people are watching the debates, and they're watching the town hall forums, and they're hearing from certain members of Congress who are saying this is a no-starter, this is a done deal. You're not really getting the full breadth of where other members of Congress are coming from.

But it is pretty clear that -- and we've been talking about this, I feel like, since this election ended in November, which is when we were talking about bipartisan cooperation. For this administration, it has always meant being able to work with Democrats. It is intraparty, not interparty.

And so trying to make sure that Democrats get on board is always going to be their biggest challenge on major pieces of legislation, because the bottom line is, there aren't those moderate Republicans left in Congress. They've been defeated over the last couple of elections.

JIM LEHRER: So it's either do it with Democrats or you don't get it done?

AMY WALTER: That's right. Or you get one or two Republicans.

JIM LEHRER: OK, so is this thing -- is it all about the public plan? I mean, is that either going to take it or not take it?

NORMAN ORNSTEIN: There was a very interesting piece in the Washington Post today about how the administration has been kind of taken aback that this whole focus has turned...

JIM LEHRER: Yes, I saw that, yes.

NORMAN ORNSTEIN: ... around with the public plan. This is a sweeping health care change that we're talking about that involves more than insurance. It involves changing the way we get our health care delivered. It involves bringing a whole lot of people into the system in the first place, many of whom will have nothing to do with this particular issue.

It's become a flashpoint in part. And a part of it is the liberal Democrats don't -- aren't sure they trust the administration in the end, and they're not sure they trust their own leaders who are trying to juggle a lot of different things.

Nancy Pelosi in the House, a card-carrying member of that Progressive Caucus, is trying to appease a group of Blue Dog conservative Democrats. In the Senate, you go from Kent Conrad and Ben Nelson, quite conservative on these kinds of issues, to a Bernie Sanders, a socialist who is a part of the Democratic caucus, and a Barbara Boxer.

And liberals are trying to keep the pressure on the administration, don't want them to concede too soon, and want to be sure they get as much as they possibly can. So some of this is a kind of bulls jockeying around trying to push each other around a ring.

JIM LEHRER: Yes, go ahead.

AMY WALTER: Which would be happening. I think that the idea that this is happening simply because it's being televised isn't the issue as much as this would be happening behind the scenes anyway, that I don't know that the...

JIM LEHRER: The divisions are already there.

AMY WALTER: The division's always going to be there.

JIM LEHRER: This being ready to be played on.

Role of government is central

Amy Walter
The Hotline, National Journal
There are going to be those divisions between the Blue Dogs, who do feel cautious about having too much of a government role in the private sector, and liberal Democrats who want to have more government involvement in things like health care.

AMY WALTER: That's right. And I think it's always been sort of sitting there under the surface.

And I think we've also known all along that the main issue here is the role that government is going to play in this. And so whether we call it a public plan or whatever we're going to talk about, there are going to be those divisions between the Blue Dogs, who fundamentally are fiscal conservatives who do feel very cautious about having too much of a government role in the private sector, and more liberal Democrats who, by their nature, do want to have more government involvement in things like health care or the economy.

So those things were always going to clash against each other. That it came out in something called the "public plan" is just what happened, but it was always there.

JIM LEHRER: Do you have a magic glimpse into the truth as to what the president's position is right now on the public plan?

AMY WALTER: I think that there is this idea that we've got to go back to the fundamental issue here, which it seems to me started off with cost control, right, that this was going to be more than just we're going to fix around the edges, that if we don't get to the issue of containing costs of health care, then doing all this other surface work isn't going to matter, and the only way you do that is by having competition.

And so it seems at some point, if there's not a competitive piece of this, whether we call it a public plan or a co-op or whatever we do this...

JIM LEHRER: Co-op, something like that, in addition to the...

AMY WALTER: To the other changes.

JIM LEHRER: ... private plans, there's got to be something else, at least that's who -- that's what the president believes.

AMY WALTER: That's right.

JIM LEHRER: OK.

You read it the same way, that...

NORMAN ORNSTEIN: Yes. I think, look, here's the fundamental: President Obama wants a health bill enacted into law where he can sign it and declare victory, and he is going to be very flexible on the individual components.

Amy is absolutely -- and, remember, we're trying to get bills through the House and Senate, whatever they contain. Then we go to a conference committee to make a compromise. Then you bring something back that they can shape and mold to an up-or-down vote where Jesse Jackson, Jr., might have to be told, "You vote for health care or the whole thing dies, whether it contains what you want or not."

There are options here to try and move us towards that competition. One is the cooperatives. Another, which may come back on the table, is something that Republican Olympia Snowe had talked about, which is a trigger. You say, "All right, private companies. You show that we have that competition. Bring the prices down. Bring people in. But if it doesn't happen in five years, the guillotine comes down and we get a public plan on steroids."

That's another way in which you can shape this to achieve a goal without necessarily giving the group that wants a public plan what they want.

JIM LEHRER: How serious is the jeopardy in which passing this legislation now rests? I mean, is it going to happen? I mean, is this real stuff here, getting back to my first question?

AMY WALTER: Right, whether there's going to be a bill at all, you're saying, to vote on?

JIM LEHRER: Yes. Yes.

AMY WALTER: It seems to me that that is absolutely something that's going to happen, because you have Democrats...

JIM LEHRER: You think it is going to happen?

AMY WALTER: ... right, that they're going to vote on something. Whatever this ends up being is another question. But they know -- look, Democrats are looking and they're seeing a couple of things. One, they say, wait, we have control of the House, the Senate, and the White House, and we can't get a bill through? That's not going to work very well for us in 2010.

JIM LEHRER: It's not a good headline.

The legacy of past reform attempts

Norman Ornstein
American Enterprise Institute
And in some ways, ironically, the trouble that the bill seems to be in, the conventional wisdom that maybe we are in 1994 all over again, may give the president more leeway with the activists in his own caucus who are demanding a public plan.

AMY WALTER: It's not a good headline. The irony -- I sat in on a focus group in Maryland of independent voters a couple of weeks ago, and it was interesting. Their number-one concern about health care was that folks were moving too fast, that Congress was moving through this too quickly and not taking enough time.

The irony is, of course, is that the longer that this bill sits out here as sort of a pinata -- and it's getting, you know, bashed back and forth by Republicans -- the harder it's going to be to keep it together, for Democrats to keep it together.

So they need to -- Democrats do need to move this very quickly through, get something signed, at the same time you have the public saying, "This is moving too fast."

JIM LEHRER: What's your reading of it? I will not hold you to this. Maybe I will.

(CROSSTALK)

NORMAN ORNSTEIN: Oh, sure, you will. You will.

JIM LEHRER: But is this thing...

NORMAN ORNSTEIN: I think it's very, very likely that we're going to get a bill through. Remember, you know, 16 years ago, when health care reform was up, almost all of the major interests thought that it was just not going to happen, and they fought to kill it.

Now, if you talk to those lobbyists or others who are engaged, from the insurance industry, the pharmaceutical industry, the doctors, the AARP, they all think we're going to get a bill, and that will give it a little momentum.

Now, of course, one of the major reasons we're going to get it is that, when it failed 16 years ago, Democrats suffered a bloodbath. They were put in the political equivalent of Guantanamo, 12 years in the minority as a consequence. The same thing could happen this time.

And in some ways, ironically, the trouble that the bill seems to be in, the conventional wisdom that maybe we are in 1994 all over again, may give the president more leeway with the activists in his own caucus who are demanding a public plan. They're starting to see that he is not omnipotent, that he can't just dictate the terms here. And it may make them swallow a little bit harder to get in the end something that is a quarter of a loaf.

AMY WALTER: Right, because they recognize the rule that, in a midterm election, the president's approval rating is one of the most important factors as to whether that party succeeds or fails in that election.

And what we're seeing right now is, as Obama's numbers are starting to drop, you have a lot of Democrats worried about that same sort of thing, about we're going to be in another 1994 situation. So if you vote against the president -- that's what these members I'm sure are getting this from the White House right now -- you will imperil the president, which will imperil your chances a year from now in your own election.

JIM LEHRER: You can watch me now right down that both you, Amy, and you, Norm, predicted there will be a health reform bill pass the Congress of the United States.

AMY WALTER: OK.

NORMAN ORNSTEIN: Indeed.

JIM LEHRER: OK, thank you both very much.