Union University

Union University Department of Political Science

Department of Political Science



Health Care Reform Will Pass

Sean Evans, Chair and Associate Professor of Political Science
Aug 14, 2009

                Presidential approval has fallen to the low to mid 50s. 49% of the public oppose the Democrat’s health care proposal. Constituents express anger at congressional town hall meetings on health care. Congress fails to meet Obama’s August deadline of passing health care. Many see these signs and conclude that health care reform is Obama’s political “Waterloo.” Yet, political fundamentals dictate that some version of health care reform will pass this year.
                The trouble that Obama and the Democrats face is real – and predictable. New presidents always enjoy a honeymoon. However once they start making decisions, they begin to upset people and approval begins to fall. Obama’s approval is down but average for presidents at this point in their term.
                Same with opposition to health care. Everyone favors health care reform until they find out how it affects them. As Scott Rasmussen points out, 68% of American voters like their own health insurance plan and 74% rate highly their quality of care. Yet, 50% believe congress’s plan will reduce the quality of care and 78% believe the plan will result in higher taxes. This results in an intense opposition as 41% strongly oppose the plan compared to 25% who strongly support it. This suggests that the anger expressed at town halls is real and not manufactured.
                Plus, Congressional Democrats made some mistakes. They are moving too fast, trying to do too much, and forcing their members to take too many tough political votes. This leads Democrats to voice opposition to the bill which signals independents that the bill is too extreme which, in turn, lowers support for the bill. It also encourages a demoralized Republican opposition that they can regain power.
                However, political fundamentals favor passage of a bill. First, Rasmussen polls show that 63% of voters support providing health care to all Americans. Second, everyone admits that health care costs are out of control and need to be contained. Third, business, a traditional opponent of reform, favors reform because health care costs are making businesses uncompetitive. These factors are unlikely to change and will continue the demand for reform.
                Most importantly, Democrats have large, coherent majorities in congress and a leadership committed to using them to alter the larger political environment. In terms of numbers, Congressional Republicans are largely irrelevant. Democrats have a 78 vote advantage in the House and 60 seats in the Senate enabling them to break Republican filibusters.
                And the Democratic Party of today is more ideologically coherent. There are really no moderates left in congress. A moderate Democrat or Republican is not a centrist. One is a moderate relative to the base of one’s party. Thus, a moderate Democrat is really a moderate liberal. That is why Blue Dogs vote with their party 88% of the time and a majority supported TARP, the auto bailout, and the stimulus. So when looking at Blue Dog opposition to health care reform, remember that Blue Dogs are Democrats first. They support the goal of universal health care which makes negotiating a compromise likely.
                Moreover, politics forces vulnerable Democrats representing Republican leaning districts to support the bill. If they support the current plan, they anger constituents. If they oppose the bill, they look ineffectual and risk a primary challenge. If they kill health care reform, they create a Democratic image of extreme liberalism and incompetence. All scenarios increase the likelihood of defeat. Their best chance is to pass something and hope it works as well as predicted. Recognizing the political consequences of defeat and the potential long term political benefits of passage, Speaker Pelosi and Senate Majority Leader Reid will sacrifice some members to get a bill.
                So in spite of the pitfalls, “health care reform” will pass – though probably not in its current form.  Democrats are likely to drop some controversial features to appeal to independents while making a large down payment on universal health care that pleases the Democratic base.  Remember, health care reform will cost Democrats politically in 2010 but no bill will cost them more.

Article originally appeared in the August 14, 2009 edition of the Jackson Sun