March 24, 2010

By Joe Rothstein

The health reform bill is now the health reform act. The issue takes on an entirely new profile—but don’t expect it to go away. Not for a while. The Republican opposition will continue to test both its politics and its constitutionality. The politics likely will be settled this year. The court challenges? Who knows.

The final hours of debate in the House brought into sharp focus these two parallel narratives —political and substantive—that over the past year of debate often seemed so diffuse and muddled.

The partisan politics flew out of the box early. Before the measure had even been considered in any congressional committee North Carolina Senator Jim DeMint exhorted Republicans to oppose it on the grounds that it would be President Obama’s “Waterloo,” weakening him for the remainder of his term in office. It was hardly a subtle way to kick off the debate, and had little to do with substance. How could it? There wasn’t yet a line of substance on paper.

That set the tone for much of what followed. Congressional Republicans quickly became invested in regimenting their troops to enforce total opposition. Visions of 1994 danced in their heads. Solid Republican resistance to President Clinton’s health care reform efforts had helped bring on the 1994 GOP takeover of both houses of Congress. Why wouldn’t the same strategy work again?

In retrospect, President Obama’s hands-across-the-aisle quest for bi-partisanship seems so quaint. It was never reciprocated in the House. In the Senate, tedious negotiations with Republican Senators Grassley, Enzi and Snowe killed whatever momentum existed for finishing the bill while the Democrats still had 60 Senate votes.

For Republicans, polls showing increasing opposition to the bill were like political catnip. They got very heady with each new taste, each new pundit column seeming to confirm that total resistance was a wildly successful political strategy this year, as it was in 1994.

With delicious irony, the very week that the Democrats managed to pull health reform across the finish line the widely read (in political circles) National Journal featured Senate Minority Leader Mitch McConnell and House Minority Leader John Boehner on its cover with this headline: “Movin’ On Up? John Boeher and Mitch McConnell discuss the prospect of Republican control.” The story began: “Measuring for curtains?……”

On the night of the final vote partisanship was under full throttle. Democrats cheered Democratic speakers. Republicans cheered Republicans. There was one House, but two teams. Nearly every Republican marched to the microphone to repeat, almost word for word, “I ask unanimous consent to revise and extend my remarks in opposition to this flawed health care bill. ” It wasn’t enough for Republicans to vote against it. Each had to stand up and call it “flawed,” for those watching on C-Span. What discipline!

Just think of it. All of those Republican members, representing urban and rural areas, rich and poor districts, every region in the country—-and not a one of them could see any merit in a bill that mirrored the one Mitt Romney presided over in Massachusetts, and not unlike the one Richard Nixon proposed 35+ years ago. Why? Because to kill the bill would be President Obama’s Waterloo. That was the politics of it.

But there was another narrative, and it was just as important. For many Republicans, the substantive differences were very real and deeply felt.

Wisconsin Congressman Paul Ryan, one the House Republicans’ rising stars, gave an impassioned closing speech that framed the health bill as a defining expression of what kind of country America is and will be.

America has been built on personal self-reliance, not “paternalism,” thundered Ryan. To turn health care into a right managed by the state is foreign to who we are and compromises everything we’ve become through our history of unique individualism.

Boehner and minority whip Eric Cantor, another Republican star, echoed that theme. Both were genuinely moved by what they felt to be a horrendous departure from the nation’s self-reliant past. Boehner sees this as nothing less than an “apocalypse” for America.

In expressing these views they were channeling the feelings of tea party protesters and many other concerned Americans. The substantive opposition saw the health reform proposal as 1984, not 1994. For Boehner and many House Republicans, there was no space between substance and politics. They anguished over the prospect of 1984 Big Brother, while at the time relishing what they believed would be the 1994-like political opportunity in November.

But how much of a departure is the new health care act for America? As Democratic Majority Leader Steny Hoyer said in his closing argument, if Republicans really believe the new health act is a government takeover of health care, to be consistent they should offer proposals to repeal Medicare. Medicare, after all, is a government program. Everyone pays taxes into it. The government handles all the money, sets all the rules and rates and pays all the bills.

There were dozens of speeches Sunday night about missed opportunities for bi-partisanship. Perhaps the biggest missed opportunity of all was that the Republicans didn’t try to improve the health care system when they had both the White House and both houses of Congress. Democrats rarely move in lockstep. Surely some would have supported a Republican proposal.

Republicans missed the opportunity to reform health care their way. The substance of reform got away from them. And it’s possible, maybe even likely, that before the year is over the politics will have eluded them as well.