Health Care Reform Fate Still Mystery

Scanning the stories on Memeorandum this morning, it appears that a radical reform of America’s health care system is either a fait accompli or deader than a doornail.  Why, even Bob Dole is conflicted.

Karl Rove has a piece in WSJ titled “The GOP Is Winning the Health-Care Debate.” He cites polling data:

According to Fox News surveys, the number of independents who oppose health-care reform hit 57% at the end of September, up from 33% in July. Independents are generally a quarter of the vote in off-year congressional elections.

Among college graduates, opposition to health-care reform is now 50%, while only 33% support it, according to Gallup’s Sept. 24 poll. College graduates are slightly more than a quarter of the off-year electorate.

Among seniors, opposition to ObamaCare hit 63% in last month’s Economist/YouGov Poll. But the number from that poll that should spook Democrats is this: 47% of seniors said they “strongly” oppose health-care reform, just 27% “strongly” support it. Seniors are the biggest consumers of health care, and their family members will probably take their concerns seriously. Seniors will likely cast about 20% of the votes next year.

These are indeed interesting data points and would seem more evidence that the GOP should pick up a sizable number of seats in next year’s elections. But it doesn’t necessarily mean anything in the context of the current legislative debate, aside from strengthening the resolve of current Members who oppose the reforms on the table and perhaps striking fear into the hearts of those on the fence.

Erick Erickson had a piece at Red State yesterday afternoon titled “Senate GOP Folding Over Health Care Reform” which reports, “I am told quite reliably that in a meeting today on Capitol Hill, Republican Senators began to rapidly move toward concessions on health care because they are afraid they cannot hold their members. Some Republicans are now thinking of supporting a government program.” An update, however, informs us these reports were “overblown.”

A report in The Hill has the bill preferred by House Democrats gaining steam.

Rep. Lynn Woolsey (D-Calif.), the leader of the Congressional Progressive Caucus, told a closed-door caucus meeting that the group’s “whip count” showed it had 208 of the 218 votes needed to pass what liberals call a “robust” public option. That version would link rates to Medicare plus 5 percent.


“I said we have the votes to pass a robust plan,” Woolsey said. “This is without leadership stepping up and saying, ‘We’re for this.’ “

This is interesting but academic; there’s nothing like 50, let alone 60, votes in the Senate for anything like this.

Meanwhile, depending on which report you read, former Senate Majority Leader and Republican presidential nominee Bob Dole supports some kind of comprehensive reform, thinks it’s a shame that partisan politics gets in the way, and either thinks it inevitable that a bill will get passed soon or that we’ll have to wait a long time if it fails this year.

In the midst of all this, the Congressional Budget Office issued a report finding, as NYT puts it, “The Senate Finance Committee legislation to revamp the health care system would provide coverage to 29 million uninsured Americans but would still pare future federal deficits by slowing the growth of spending on medical care.” Presumably, this means that Democrats who normally poo-poo CBO and Republicans who usually laud it will simultaneously have a change of heart.

Regardless, Ezra Klein finds that there’s not all that much difference between the system that CBO is scoring and the status quo.

Unless you’re uninsured, or on the individual market, this bill is not expected to affect you. CBO estimates that 29 million Americans who would’ve otherwise been uninsured will be covered. That’s a very big deal. Five million Americans who would otherwise have been left to the individual market will find a better option. And 3 million Americans who would’ve otherwise been in employer-based health insurance will be on the exchanges or, in some cases, on Medicaid. The insurance exchanges are projected to serve 23 million people come 2019, and 18 million of the members will be low-income and on subsidies.

That leaves 245 million non-elderly Americans who will pretty much be in the exact place they would’ve been otherwise. As for the elderly, the CBO doesn’t include them because they’re on Medicare. They, too, will be where they otherwise would’ve been.

This, presumably, is why the polls are showing a decline in support for reform. The people who will be paying for it, after all, will mostly be in the same boat they’re in now.

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James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.


  1. Marty says:

    I’m not sure I’d characterize ex-Sen. Dole as conflicted – he called out McConnell in the Kansas City Star as being obstructionist on a measure that he says is “one of the most important measures members of Congress will vote on in their lifetimes”

    Another quote from Dole: Dole, to his credit, is having none of it. “I want this to pass,” he said. “I don’t agree with everything Obama is presenting, but we’ve got to do something.”

  2. kvc says:

    Where did Bob Dole’s thought’s come from and when did he become someone to quote? Were we hoping he would offset JimmBo Carter? I think all past presidents and presidential nominees should live in the same condo complex in American Samoa on three meals a day of processed food and apple juice. The price of winning and loosing.

  3. Marty says:

    In addition to his presidential campaigns, Dole does have over 30 years in the House & Senate, and has long been a respected opinion in conservative circles. It’s interesting to note that a number of conservative Republicans (most of whom no longer have political skin in the game and are free to contemplate policy for it’s own merits) have come out in favor of Health Care reform – in addition to Dole, Howard Baker, Bill Frist, and Gov. Schwarzenegger have all come out in favor of reform. Only when there’s a political requirement is there strong opposition to any type of reform.

    I wouldn’t put too much credence in Karl Rove’s tea leaf reading…his track record lately has been miserable.

  4. Furhead says:

    Dole is so liberal. And dark, too.

  5. Steve Plunk says:

    It’s still all talk about insurance without any mention of controlling costs. In the long run it will bankrupt us.

    Real reform must tackle the cost issue. That would include tort reform.

  6. odograph says:

    I was pleased to see my old idea, vouchers, spoken for by a big-time economist (Martin Feldstein)

    Interestingly Feldstein doesn’t endorse vouchers for basic care, but vouchers for major medical:

    Specifically, the government would give each individual or family a voucher that would permit taxpayers to buy a policy from a private insurer that would pay all allowable health costs in excess of 15 percent of the family’s income. A typical American family with income of $50,000 would be eligible for a voucher worth about $3,500, the actuarial cost of a policy that would pay all of that family’s health bills in excess of $7,500 a year.

    His argument is that this would provide a net savings immediately, as well as providing that universal safety net. The details matter, of course.

  7. Our Paul says:

    Let me start with:

    This, presumably, is why the polls are showing a decline in support for reform. The people who will be paying for it, after all, will mostly be in the same boat they’re in now.

    First of all, I searched Fox, Gallup and Economist/YouGov and cannot find the magic numbers that Carl Rove quoted. Now I admit I am not a whiz at this exploration of the net so remain hopeful that some gallant man or women will rescue me by providing a link…

    Second, as Nate Silva has pointed out, when the Public Option is included the results on this subject are all over the lot. Not unexpected, the center right has invested considerable energy in obfuscating health care reform. Socializes medicine anyone?

    Third, as folks with bigger cranial vaults than this rum sodden correspondent have pointed out, reform without a public option will be a bonanza for Insurance Companies.

    Our much despised far out liberal and known rabble-rouser Daily Kos just published his Research 2000 poll (9/28 to 9/30). It points to no change in his tracking numbers. But there is one nugget in his data that will bring no comfort to Dr. Joiner, to wit:

    Republicans and Democrats are mirror images of each other. But look at indies — they are twice as likely to punish a legislator for voting against the public option than reward. (Indies are Independents, OP)

    Said it before, but I will say it again. When ideology rules the brain, you may not see a problem as being significant. And, if you define a problem, you may not see solutions because of ideological constraints. What I have not said before is rather obvious, and I will put it on Dr. Joiner’s plate, or anybody else in this thread that cares to answer: If the Republicans as a solid block prevent significant health care reform, are there untoward or detrimental effects you can visualize that will persist out to the next two or three election cycles?

  8. anjin-san says:

    Where did Bob Dole’s thought’s come from and when did he become someone to quote?

    Another day, another “conservative” ripping a combat vet…