The Obama administration's support for an individual insurance mandate without a public option is triggering what appears to be a full-fledged liberal revolt against the Senate's healthcare compromise, and for the first time raises the realistic prospect that reform could die amidst internecine Democratic bickering.
An ominous sign resonant of the contentious 2007 standoff over immigration reform: The conservative right and the hardcore left are both beginning to attack the current proposal, terming it a "monstrosity" and lambasting its cost.
"Insurance companies win," DailyKos founder Markos Moulitsas declared Tuesday. "Time to kill this monstrosity coming out of the Senate."
If healthcare reform ultimately crashes and burns – which most experts still consider unlikely -- it will ironically stem not from Republican opposition but rather Democrats' inability to stave off an insurgency within their own caucus.
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"What I find to be amusing and curious about this whole situation," GOP insider Ken Blackwell tells Newsmax, "is that Obama's call for the end of partisanship probably should have started at home. The schizophrenic nature of the new Democratic Party has never been so evident as in this situation.
"It will be fascinating to see," he adds. "This is a make it or break it issue for the Obama administration. He's put all the chips on the table on this one."
As Blackwell suggests, for the first time in the year-long healthcare reform debate, Republican leaders see a realistic scenario whereby a goal-line stand stops healthcare reform on the one-yard line.
Liberal blogs are aflame over the notion that despite the Democratic supermajority, their leaders would consider an individual insurance mandate without a public option to bring the nation a step closer to a single-payer system. Caving into moderate Democrats' demands, they say, essentially hands a windfall to the very private insurance firms whose corporate greed is at the heart of the current system's problems.
Former Democratic presidential candidate Howard Dean is taking the lead for the progressive opponents, telling ABC's George Stephanopoulos on Good Morning America that the Senate bill "is a bigger bailout for the insurance industry than AIG."
In another eerie echo of the rhetoric on the right, Dean complains the latest proposals, which have yet to be scored by the Congressional Budget Office, are too expensive.
"We're in crisis here," he told MSNBC on Wednesday. "This bill I think is more likely to make the crisis worse instead of better, because it's so expensive."
Progressive criticism of the bill has morphed into direct criticism of Obama's management of the reform effort -- a boldness no doubt inspired by Obama's plummeting, sub-50 percent job-approval poll numbers. Dean flatly declared "I disagree with the president" over Obama's prediction that if healthcare reform doesn't pass this year, the opportunity to do so won't come again for another generation.
Dean is not alone in taking on Obama.
"Snowe? Stupak? Lieberman? Who left these people in charge?" firebrand progressive Rep. Anthony Weiner, D-N.Y., declared in a statement released Tuesday. "It's time for the president to get his hands dirty.
"Some of us," Weiner continued, "have compromised our compromised compromise. We need the president to stand up for the values our party shares. We must stop letting the tail wag the dog of this debate."
The rising animus of progressives against a Senate version of the bill that has no public option, wouldn't expand Medicare coverage, and yet would require all citizens to buy insurance from profit-driven corporations is generating increasing resistance from the ideological left.
The response from the left is giving conservatives hope that that reforms could be stonewalled altogether, for better or for worse.
"Yes, I think that is possible," former White House Press Secretary Dana Perino tells Newsmax. "Although they will probably still try to pull something out for the president before Christmas, I think there’s a fair chance that they crater and don’t pass it. With President Obama’s approval hovering at below 50 percent, elected officials won’t feel beholden to the White House.
"And the truth is, if this bill had great policy, the politics would be easy," she adds. "The bill is a monstrosity and I believe that people are coming to the conclusion it’d be better to wait and get it right then to rush and create a monster."
One obvious solution for Democrats would be to remove the individual mandate. But that undermines the entire purpose of healthcare reform – to cover the uninsured.
Says Heritage Foundation senior healthcare expert Ed Haislmaier: "Now if you've got to take the individual mandate out you've got to take the rest of the bill out because it doesn't work without an individual mandate. So what do you do? … What's happening is the arguments of the hard left and the hard right are creeping in gradually, and getting resonance in the middle."
That resonance is reflected in a slew of recent polls that show steadily sinking public support for current healthcare reform measures. An ABC News/Washington Post poll on Tuesday indicated only 44 percent of voters now support healthcare reform, compared to 51 percent who say it's a bad idea. Americans believe reform will weaken Medicare by a 45 to 22 percent margin. And 66 percent say it will worsen the federal budget deficit, compared to 30 percent who believe it will help the deficit or have a neutral effect.
Another measure of rising skepticism that Democrats can swing a compromise within their own caucus: The Intrade future market, the site where people buy futures contracts predicting the outcome of events. Intrade now calculates only 2.6 percent chance that a reform deal can be struck by year's end. This summer, those odds stood at 50 percent. And the odds that a bill will pass by June aren't much better – only about 6 percent.
Controversial Illinois Sen. Roland W. Burris of Illinois is the latest to balk at the compromise. Speaking on the floor of the Senate Tuesday, he said: “My colleagues may have forged a compromise bill that can achieve the 60 votes that will be needed for it to pass. But until this bill addresses cost, competition and accountability in a meaningful way, it will not win mine."
Some are suggesting Burris' tough stance is political payback for the Obama administration's opposition to his re-election hopes.
"I think his insistence on public option is nothing more than an 'I gotcha' to the Obama administration for not, in his estimation, giving full support for his reelection to the seat," Blackwell says. "As a senator from Illinois, I think he's going to have an enormous amount of heat.
"He's of an age and a disposition that he might be able to withstand it, but I doubt it," Blackwell adds. "I think in the end he folds." Perhaps so, but the fact that Burris is threatening to oppose the Senate bill is yet another indication of the uphill battle Democrats still face.
Some Senate moderates still aren't in the fold yet either.
Yesterday Sen. Ben Nelson, the moderate Democrat from Nebraska, departed the White House to make it clear that he remains recalcitrant over wording in the Senate version that permits abortion coverage for individuals who receive premium subsidies from the federal government.
"I'm not on the bill," Nelson said. "I have spoken with the president and he knows they are not wrapped up today. I think everybody understands they are not wrapped up today and that impression will not be given."
Nelson has said he will not vote for a bill that permits a subsidy of abortion.
Of course, how much of the current political rancor is a negotiating ploy is anyone's guess.
Most observers still expect the Democrats, who believe their drubbing in 1994 resulted from the failure to pass former President Clinton's healthcare-reform proposal in 1993, to find a way to reach at least a symbolic agreement.
"I think Rahm Emmanuel and [John] Podesta and everybody associated with the Chicago way will ultimately find a way to get it done," Blackwell says.
"That's what's driving that right now," says Haislmaier. "'We've got to pass something or we're going to get killed.' That's what's driving [Senate Majority Leader] Harry Reid and the Obama people."
University of Virginia Center for Politics director Larry J. Sabato says reform is becoming "one of the most complicated legislative juggling acts ever."
He says odds still favor the bill's passage because, "Democrats believe that without a health care bill, the party base will be so disillusioned that Democratic voter turnout will plummet in November 2010, resulting in a GOP landslide."
A diluted, symbolic victory in the Senate will create further problems for Democrats, however. House progressives have declared the Senate bill "irreconcilable" with their House version, which contains both a public option and a ban on federal subsidies for abortions.
If reform efforts do implode, Blackwell says. It may not be over the much-discussed public option, but rather over the old fault line of Roe v. Wade. After all, it was only after the House passed the abortion-ban amendment that House Speaker Nancy Pelosi was barely able to collect the votes she needed to pass the House version.
"I think that's the killer issue when it's all said and done," Blackwell tells Newsmax. "Those of us who have been fighting that issue will hold the winning card, because that's the most difficult issue for them to get agreement on in the schizophrenic nature of the new Democratic Party. This could be what collapses the house of cards."
If Democrats do manage to avoid an implosion, Sabato cautions that still may not be adequate to rally their base in time for the midterms.
"With some liberals and progressives condemning the already-slimmed health care bill and calling for its defeat," Sabato says, "one wonders whether passage of a bare-bones bill will be enough to spur Democratic turnout next year. It is possible that Democrats are in a damned-if-you-do, damned-if-you-don’t corner. We’ll see."
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