A Blue View

Weiner To O'Reilly: "You gotta stop making stuff up about the bill"

Under New Law, States That Provided More Health Care (Ma, Wi) Will Do Much Better Than Those That Didn't (Tx, Az, Al)

It pays to be ahead of the curve and have done the right thing. States that already provide an extensive health care safety net will have to do less to bring all the new uninsured into the system than the generally GOP states that did not. NY Times:

Because of the new health care law, Arizona lawmakers must now find a way to maintain insurance coverage for 350,000 children and adults that they slashed just last week to help close a $2.6 billion budget deficit.

Louisiana officials say a reduction in federal money to hospitals that treat the uninsured under the bill could be a death knell for their state-run charity hospital system.

In California, policymakers estimate they will have to come up with an additional $500 million a year to make necessary increases in payments to Medicaid providers.

Across the country, state officials are wading through the minutiae of the health care overhaul to understand just how their governments will be affected. Even with much still to be digested, it is clear the law may be as much of a burden to some state budgets as it is a boon to uninsured consumers.

States with the largest uninsured populations, like Texas and California, might be considered by its backers the biggest winners to emerge from the law, because so many additional residents will have access to health insurance. But because those states are being required to significantly expand their Medicaid programs, they are precisely the ones that will face the biggest financial strains, in many cases magnified by existing budget shortfalls.

“The federal government has to account for states’ inability to sustain our current programs, much less expand,” said Kim Belshé, secretary of California’s Health and Human Services Agency.

In contrast, states like Massachusetts and Wisconsin, which already have extensive health care safety nets, do not expect to spend much more money, while still taking in billions in federal grants.

In Massachusetts, for example, which already has a form of universal coverage, the federal government will wind up taking over from the state a significantly larger share of the costs of Medicaid coverage for adults without children, officials said.

“On balance, it’s definitely a gain,” said JudyAnn Bigby, secretary of the Massachusetts Office of Health and Human Services.

Supporters of the new law have argued that states will benefit from efforts to slow health care inflation and billions of dollars in new federal spending on subsidies for the uninsured and on an array of programs like community health centers.

But even with more federal help, the challenge for states like Alabama, Arkansas and Texas that now offer only limited Medicaid coverage will be substantial. In these states, Medicaid has been mostly restricted to low-income families with children, pregnant women, certain people with disabilities and some elderly. The income cutoffs have also been extremely low.

"Patriot" & GOP Reaction To Health Reform (Cartoons)

"Obama to GOP on health-care repeal: 'Go for it'"

Wash Post:

An exuberant President Obama dared his Republican critics Thursday to campaign this fall on a platform to repeal his health-care law, urging them to "go for it."

"If they want to have that fight, we can have it," Obama told an audience of 3,200 people packed into the University of Iowa Field House.

"I don't believe that the American people are going to put the insurance industry back in the driver's seat," he said. "We've already been there. We're not going back. This country is moving forward."

And so is the White House, which had hardly finished celebrating the health-care victory before shifting into high gear on a new nuclear arms reduction treaty, aggressive regulation of the financial industry, changes to the military's "don't ask, don't tell" policy, and planning for the possibility of another Supreme Court vacancy.

The White House is eager to return to a focus on jobs and the economy by casting Republicans as the party standing with big banks and financial institutions. On Friday, officials plan to announce a new effort to help the unemployed with their mortgage payments as part of a broader effort to address the continuing foreclosure crisis.

With the health-care victory in hand, the president will also be freer to pursue his foreign policy goals. On Friday, the White House will formally announce that the United States and Russia have reached agreement on a new treaty to reduce the stockpile of deployed strategic nuclear weapons. The agreement is a key step toward Obama's campaign promise of a world without nuclear weapons.

Obama's appearance here was his first outside Washington since he signed health-care legislation into law, perhaps his most important domestic achievement since taking office 14 months ago. His half-hour speech served as the unofficial opening of his election-year campaign on behalf of that signature issue and, by extension, his anxious party.

Obama characterized the measure as both a historic achievement and a "middle-of-the-road" reform, implicitly offering Democrats a formula for explaining the law to skeptical voters in November. He also attempted to lower expectations over how quickly Americans will see the effect of a law that will be phased in over four years.

Interrupted often by applause, Obama evoked some of the same populist themes he used in the weeks leading up to the health-care vote. He sounded frustrated in those appearances, as he railed against Republican recalcitrance, special-interest lobbying and the political culture of Washington that he says treats public policy as a sporting event.

But on Thursday he electrified a college-town crowd with a winner's bravado, signaling to congressional Democrats that their success in passing health care is something to run on, not away from.

"From this day forward, all of the cynics, all the naysayers -- they're going to have to confront the reality of what this reform is and what it isn't," Obama said.

Obama won Iowa in 2008, but the political climate here has turned sharply against Democrats amid rising unemployment and anti-Washington sentiment.

The Right Begins To Eat Its Own

Fearing donor anger, David Frum's criticism of the GOP ("The GOP's Waterloo") was apparently a bit too much to take:

Three days after calling health-care reform a debacle for Republicans, David Frum was forced out of his job at the American Enterprise Institute on Wednesday.

The ouster also came one day after a harsh Wall Street Journal editorial ripped the former speechwriter for President George W. Bush, saying he "now makes his living as the media's go-to basher of fellow Republicans" and accusing him of "peddling bad revisionist history."

Frum made clear, in a letter to AEI President Arthur C. Brooks, that his departure after seven years as a resident fellow at the conservative think tank was not voluntary. "I have had many fruitful years at the American Enterprise Institute," he wrote, "and I do regret this abrupt and unexpected conclusion of our relationship."

In a brief interview, Frum said "there was no suggestion by AEI" that his sharp criticism of the GOP's health-care strategy was the reason for his dismissal. He declined to say what Brooks told him.

"They invited me to remain associated with AEI on a non-salaried basis," Frum said, and he declined ...

Brooks said in a statement that while AEI will not discuss personnel matters, "David Frum is a truly original thinker and we are proud to have been associated with him for the last seven years. His decision to leave in no way diminishes our respect for him."

Bruce Bartlett, another conservative scholar who has been at odds with the right, wrote that Frum told him AEI staffers "had been ordered not to speak to the media" about health care "because they agreed with too much of what Obama was trying to do. . . . The donor community is only interested in financing organizations that parrot the party line."

"Sweeping health care overhaul" Is Complete: Both Chambers Approve Reconciliation Bill

NY Times:

Congress on Thursday gave final approval to a package of changes to the Democrats’ sweeping health care overhaul, capping a bitter partisan battle over the most far-reaching social legislation in nearly half a century.

The bill, which Democratic leaders hailed as a landmark achievement, now goes to President Obama for his signature.

“The American people have waited for this moment for a century,” the Senate majority leader, Harry Reid of Nevada, said at a news conference. “This, of course, was a health bill. But it is also a jobs bill, an economic recovery bill, was a deficit-reduction bill, was an antidiscrimination bill. It was truly a bill of rights. And now it is the law of the land.”

In a fitting finale to the yearlong health care saga, the budget reconciliation measure that included the final changes was approved first by the Senate and then by the House on a tumultuous day at the Capitol, as lawmakers raced to complete their work ahead of a two-week recess.

The final House vote was 220 to 207, and the Senate vote was 56 to 43, with the Republicans unanimously opposed in both chambers.

The reconciliation bill makes numerous revisions to many of the central provisions in the measure adopted by the Senate on Dec. 24, including changes in the levels of subsidies that will help moderate-income Americans afford private insurance, as well as changes to the increase in the Medicare payroll tax that will take effect in 2013 and help pay for the legislation.

The bill also delays the start of a new tax on high-cost employer-sponsored insurance policies to 2018 and raises the thresholds at which policies are hit by the tax, reflecting a deal struck by the White House and organized labor leaders. It also includes changes to close the gap in Medicare prescription drug coverage known as the doughnut hole, and to clarify a provision requiring insurers to allow adult children to remain on their parents’ insurance policies until their 26th birthday.

Many of the changes were intended to address the concerns of House Democrats, as well as to bridge differences between the original House and Senate bills and to incorporate additional provisions sought by Mr. Obama ...

The Senate voted after running through an obstacle course of Republican amendments and procedural objections, which kept lawmakers working through Wednesday night until 3:30 a.m. Thursday.

Republicans, raising procedural challenges, identified small flaws that struck out two minor provisions. Those changes forced the bill to be sent back to the House one more time.

Historic Overhaul Of Higher Ed Aid Also Becomes Law Of The Land

NY Times:

Ending one of the fiercest lobbying fights in Washington, Congress voted Thursday to force commercial banks out of the federal student loan market, cutting off billions of dollars in profits in a sweeping restructuring of financial-aid programs and redirecting most of the money to new education initiatives.

The revamping of student-loan programs was included in — if overshadowed by — the final health care package. The vote was 56 to 43 in the Senate and 220 to 207 in the House, with Republicans unanimously opposed in both chambers.

Since the bank-based loan program began in 1965, commercial banks like Sallie Mae and Nelnet have received guaranteed federal subsidies to lend money to students, with the government assuming nearly all the risk. Democrats have long denounced the program, saying it fattened the bottom line for banks at the expense of students and taxpayers.

“Why are we paying people to lend the government’s money and then the government guarantees the loan and the government takes back the loan?” said Representative George Miller, Democrat of California and chairman of the Education and Labor Committee.

Democrats celebrated the legislation, a centerpiece of President Obama’s education agenda, as a far-reaching overhaul of federal financial aid, providing a huge infusion of money to the Pell grant program and offering new help to lower-income graduates in getting out from under crushing student debt. Still, the final bill is less ambitious than the original proposal.

Congressional allies of the student-loan industry attacked the overhaul as an overreaching government takeover. The legislation substitutes an expanded direct-lending program by the government for the bank-based program, directing $36 billion over 10 years to Pell grants, for students from low-income families ...

Even as the Democrats’ decision to attach the student-loan overhaul to the health care package virtually ensured its passage, banks fought fiercely up to the last minute, prompting some lawmakers, like Senator Ben Nelson, Democrat of Nebraska, where Nelnet has its headquarters, to cast their vote against the overall bill.

Although private banks will no longer be allowed to make student loans with federal money, many will continue to earn income by servicing those loans.

The Congressional Budget Office said the direct-lending approach would save taxpayers about $61 billion over 10 years. Roughly $40 billion of the savings will be redirected to higher education. Education programs will get an additional $10 billion from the health care package.

The bill includes some landmark changes, like automatic increases, tied to inflation, in the maximum Pell grant award. But for individual students, the increase in the maximum Pell grant — to $5,900 in 2019-20 from $5,550 for the 2010-11 school year — is minuscule, compared with the steep, inexorable rise in tuition for public and private colleges alike.

And because college costs are rising so quickly, the maximum Pell grant now covers only about a third of the average cost of attending a public university, compared with three-quarters in the 1970s, when the program began. So each year, more students graduate with debt of more than $20,000.

The legislation will make it easier to pay back student loans, by reducing the share of income that a graduate must devote to loan payments and by accelerating loan forgiveness — but not right away. Those who take out new loans after July 1, 2014, will have to devote 10 percent of their income to payments, down from the current 15 percent, and those who keep up their payments will have their loans forgiven after 20 years, reduced from the current 25.

“Income-based repayment is a fantastic addition to the Senate bill that will allow over a million students to avoid being crushed by unmanageable levels of debt,” said Rich Williams, a higher-education advocate at the U.S. Public Interest Research Group.

With the new legislation, students will have to take out their loans through their college’s financial aid office, instead of using a private bank.

Cap & Trade Is Dead. Long Live Cap & Dividend!

NY Times:

Less than a year ago, cap and trade was the policy of choice for tackling climate change.

Environmental groups and their foes in industry joined hands to embrace the approach, a market-driven system that sets a ceiling on global warming pollution while allowing companies to trade permits to meet it. President Obama praised it by name in his first budget, and the authors of the House climate and energy bill passed last June largely built their measure around it.

Today, the concept is in wide disrepute, with opponents effectively branding it “cap and tax,” and Tea Party followers using it as a symbol of much of what they say is wrong with Washington.

Mr. Obama dropped all mention of cap and trade from his current budget. And the sponsors of a Senate climate bill likely to be introduced in April, now that Congress is moving past health care, dare not speak its name.

“I don’t know what ‘cap and trade’ means,” Senator John F. Kerry, Democrat of Massachusetts, said last fall in introducing his original climate change plan.

Mr. Kerry’s partner in promoting global warming legislation, Senator Lindsey Graham, Republican of South Carolina, pronounced economywide cap and trade dead last month and has since been working with Mr. Kerry to try to patch together a bill that satisfies the diverse economic, regional and ideological interests of the Senate.

That plan, still being written, will include a cap on greenhouse gas emissions only for utilities, at least at first, with other industries phased in perhaps years later. It is also said to include a modest tax on gasoline, diesel fuel and aviation fuel, accompanied by new incentives for oil and gas drilling, nuclear power plant construction, carbon capture and storage, and renewable energy sources like wind and solar.

Why did cap and trade die? The short answer is that it was done in by the weak economy, the Wall Street meltdown, determined industry opposition and its own complexity ...

Two senators, Maria Cantwell, Democrat of Washington, and Susan Collins, Republican of Maine, have proposed an alternative that they call cap and dividend, under which licenses to pollute would be auctioned to producers and wholesalers of fossil fuels, with three-quarters of the revenue returned to consumers in monthly checks to cover their higher energy costs.

Ms. Cantwell said that cap and trade had been discredited by the Wall Street crisis, the Enron scandal and the rocky start to a carbon credits trading system in Europe that has been subject to dizzying price fluctuations and widespread fraud.

She said her bill would require every pollution permit to be auctioned rather than given away and was 39 pages long, compared with Waxman-Markey, which weighs in at some 1,400 pages.

The Cantwell-Collins plan is almost exactly what Mr. Obama proposed in the campaign and after first taking office — a 100 percent auction of permits and a large tax rebate to the public.

“He called our bill ‘very elegant,’ ” Ms. Cantwell said. “Simplicity and having something people can understand is important.”

Poll: "By Slim Margin, Americans Support Healthcare Bill's Passage"

Gallup:

Nearly half of Americans give a thumbs-up to Congress' passage of a healthcare reform bill last weekend, with 49% calling it "a good thing." Republicans and Democrats have polar opposite reactions, with independents evenly split.

The findings, from a March 22 USA Today/Gallup poll conducted one day after the bill received a majority of votes in the U.S. House of Representatives, represent immediate reactions to the vote.

Americans' emotional responses to the bill's passage are more positive than negative -- with 50% enthusiastic or pleased versus 42% angry or disappointed -- and are similar to their general reactions.

Although much of the public debate over healthcare reform has been heated, barely a third of rank-and-file citizens express either enthusiasm (15%) or anger (19%) about the bill's passage. However, only Democrats show greater enthusiasm than anger. Independents are twice as likely to be angry as enthusiastic, and Republicans 10 times as likely.

Bottom Line

Passage of healthcare reform was a clear political victory for President Obama and his allies in Congress. While it also pleases most of his Democratic base nationwide, it is met with greater ambivalence among independents and with considerable antipathy among Republicans. Whether these groups' views on the issue harden or soften in the coming months could be crucial to how healthcare reform factors into this year's midterm elections. Given that initial public reaction to Sunday's vote is more positive than recent public opinion about passing a healthcare reform bill, it appears some softening has already occurred.

Poll: Tea Party = GOP; Dems Trail 2-Way Races, But Win If Tea Party Runs

Quinnipiac University poll:

Only 13 percent of American voters say they are part of the Tea Party movement, a group that has more women than men; is mainly white and Republican and voted for John McCain, and strongly supports Sarah Palin, according to a Quinnipiac University national poll released today.

While voters say 44 - 39 percent that they will vote for a Republican over a Democratic candidate in this November's Congressional elections, if there is a Tea Party candidate on the ballot, the Democrat would get 36 percent to the Republican's 25 percent, with 15 percent for the Tea Party candidate, the independent Quinnipiac (KWIN-uh-pe-ack) University poll finds.

By a 28 - 23 percent margin, American voters have a favorable opinion of the Tea Party, with 49 percent who say they don't know enough about the group to form an opinion.

American voter opinion of the Democratic Party is 48 - 33 unfavorable, with opinion of the Republican Party 42 - 33 percent unfavorable.

While 70 percent of all voters are "somewhat dissatisfied" or "very dissatisfied" with the way things are going in America today, 92 percent of Tea Party members are dissatisfied.

Government does too many things better left to businesses and individuals, 54 percent of all voters say, while 42 percent say government is not doing enough. Tea Party members say 83 - 15 percent that government is doing too much.

"The Tea Party movement is mostly made up of people who consider themselves Republicans," said Peter A. Brown, assistant director of the Quinnipiac University Polling Institute. "They are less educated but more interested in politics than the average Joe and Jane Six-Pack and are not in a traditional sense swing voters."

"The Tea Party could be a Republican dream - or a GOP nightmare. Members could be a boon to the GOP if they are energized to support Republican candidates. But if the Tea Party were to run its own candidates for office, any votes its candidate received would to a very great extent be coming from the GOP column," Brown added.

Looking at voters who consider themselves part of the Tea Party movement:

74 percent are Republicans or independent voters leaning Republican; 16 percent are Democrats or independent voters leaning Democratic; 5 percent are solidly independent; 45 percent are men; 55 percent are women; 88 percent are white; 77 percent voted for Sen. John McCain in 2008; 15 percent voted for President Barack Obama.

A total of 19 percent of American voters trust government to do the right thing "almost all of the time" or "most of the time," compared to only 4 percent of Tea Party members.

While only 33 percent of all voters have a favorable opinion of Sarah Palin, 72 percent of Tea Party members have a favorable opinion of her.

"Overall, this survey paints a picture of the Tea Party movement that encompasses a broad swath of the American middle class, but clearly at this stage one that is a minority group. In essence their numbers equate to about the size of the African-American electorate overall," said Brown.

Only 4 percent of voters making more than $250,000 per year consider themselves part of the Tea Party movement, while percentages among all other age and income groups are close to the 13 percent overall Tea Party affiliation.

Post-Vote, Democrats Subjected To Threats & Violence

Wash Post:

The pitched battle over health care has unleashed a rash of vandalism and attacks directed at politicians, with at least 10 House Democrats reporting death threats or incidents of harassment or vandalism at their district offices over the past week.

More than 100 House Democrats met behind closed doors Wednesday afternoon with representatives of the FBI and the U.S. Capitol Police. The lawmakers voiced what one senior aide who was present described as "serious concern" about their security in Washington and in their home districts when they return this weekend for the spring recess.

Usually only the congressional leadership has regular personal protection from the Capitol Police. But at least 10 lawmakers have been offered increased protection by law enforcement agencies, said House Majority Leader Steny H. Hoyer (D-Md.).

Asked whether members are endangered, Hoyer said: "Yes. [There are] very serious incidents that have occurred."

Senate Sergeant-at-Arms Terrance Gainer e-mailed senators and staffers Wednesday telling them to "remain vigilant." Gainer, a former Capitol Police chief, said in an interview that the warning was meant to "assuage people's fears."

But House Democrats say they are unnerved.

"Our democracy is about participation," Hoyer said. "Our democracy is about differing and debate and animated debate and passionate debate. But it is not about violence."

The vandalism began last weekend, when the House debated the health bill for final passage. In Wichita, someone broke the window of a county Democratic Party headquarters with a brick that had "No to Obama" and "No ObamyCare" written on it. Lyndsey Stauble, executive director of the Sedgwick County Democratic Party, said she went to work Saturday morning to clean up the shattered glass around her desk.

"It was surprising and alarming to know that people, when they have so many opportunities for expression in this country, that somebody would resort to a brick," Stauble said.

Over the next 24 hours, thrown bricks shattered the glass doors and windows of party headquarters from Rochester, N.Y., to Cincinnati. A propane gas line at the Charlottesville home of Rep. Tom Perriello's brother was severed Tuesday after a self-identified "tea party" activist posted what he believed to be the Virginia Democrat's address on a Web site and urged opponents to "drop by" to convey their opposition to his yes vote on the health bill.

A brick was thrown through the Niagara Falls district office of Rep. Louise M. Slaughter (D-N.Y.), who also received a threatening voice-mail message referring to sniper attacks. The front door to the Tucson district office of Rep. Gabrielle Giffords (D-Ariz.) was shattered. And Rep. Bart Stupak (D-Mich.), whose last-minute negotiations to bar federal funding of abortion helped secure the bill's passage, received a fax with a drawing of a noose and an anonymous voice mail saying: "You're dead. We know where you live. We'll get you."

In Washington on Wednesday, the attacks were roundly condemned, with some congressional leaders wondering whether the long fight over health care had unleashed an ugly dimension to the modern political discourse.

Senator Grassley Touts Provisions In Health Bill He Voted Against

44 blog:

President Obama's senior advisers believe the new health-care law will be good politics for them.

Could they be right?

For all the unified, angry rhetoric from Republicans lately, there is some evidence of cracks in the GOP wall of opposition.

Take, for example, the following e-mail from the office of Sen. Chuck Grassley (R-Iowa), who had mocked the health-care legislation, gave encouragement to the "death panel" accusation, and abandoned bipartisan negotiations.

"The health-care legislation signed into law yesterday includes provisions Grassley co-authored to impose standards for the tax exemption of charitable hospitals for the first time," he said. "The provisions enacted in the new health-care law are the result of Grassley's leadership on tax-exempt organizations' accountability and transparency, including hospitals."

Yes, that's Grassley taking credit for the health-care bill. The same bill that some of his Republican colleagues say they want to repeal. The same bill that 13 Republican attorneys general say is unconstitutional.

"That Senator Grassley, who infamously declared that health reform would 'kill Grand Ma' and walked away from the negotiating table, would take credit for anything in this legislation is the most extreme form of hypocrisy imaginable," said Brad Woodhouse, the spokesman for the Democratic National Committee.

"To now take credit for a provision he says he 'co-authored' shows what a bind Republicans are in now that this law is proving popular with the American people," Woodhouse added.

Two Minor Matters Force Reconciliation Bill Back To House

While the main bill is a done, guaranteed deal, the GOP has been able to force another House vote according to the NY Times:

With the Senate working through an all-night session on a package of changes to the Democrats’ sweeping health care legislation, Republicans early Thursday morning identified parliamentary problems with at least two provisions that will require the measure to be sent back to the House for yet another vote, once the Senate adopts it.

Senate Democrats had been hoping to defeat all of the amendments proposed by Republicans and to prevail on parliamentary challenges so that they could approve the measure and send it to President Obama for his signature. But the bill must comply with complex budget reconciliation rules, and Republicans identified some flaws.

Under the reconciliation rules, provisions in the bill must directly affect government spending or revenues.

The successful parliamentary challenge did not appear to endanger the eventual adoption of the changes to the health care legislation. And Mr. Obama on Tuesday already signed the main health care bill into law.

Senate Democrats said that one of the provisions in question involved changes to the Pell grant program, which is part of an education section in the reconciliation bill. The bill would establish an automatic increase in Pell grant awards, tied to inflation, for students from low-income families. The disputed provision would prevent any reductions in the maximum award.

Before the discovery of the parliamentary issues, Democrats defeated more than two dozen Republican amendments or other proposals aimed at derailing the legislation or making changes that would delay it by forcing an additional vote in the House.

Shortly before 2:30 a.m., Senator David Vitter, Republican of Louisiana, put forward yet another amendment. Mr. Vitter’s proposal would have exempted mobile mammography units from paying a federal fuel tax.

In urging adoption of his amendment, Mr. Vitter declared, “This reconciliation bill is already going back to the House.” At the same time, Senate leaders from both parties were conferring animatedly on the floor.

At about 2:45 a.m., with the flaws in the bill identified, the Senate majority leader, Harry Reid of Nevada, brought the late-night session to a close. The Senate was to resume work on the bill at 9:45 a.m. Thursday.

The House adopted the Senate-passed health care bill on Sunday by a vote of 219 to 212, and Mr. Obama signed it into law on Tuesday, meaning the main components of the Democrats’ overhaul were guaranteed to go forward. Also on Sunday night, the House approved a package of changes as part of a budget reconciliation bill, by a vote of 220 to 211. That bill was sent to the Senate for its consideration.

Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, said that one problem with the bill was the formula for determining the maximum Pell grant awards. The second issue was a technical matter that Mr. Conrad described as mostly insignificant.

Mr. Conrad said a third issue was under review by the Senate parliamentarian.

The risk for Democrats in a parliamentary challenge is that Republicans could knock out key provisions of the legislation, or win a decision that upends the mechanisms Democrats rely on to pay for the measure.

“We see no impact on the score and very insignificant impact on any policy,” Mr. Conrad said, referring to a cost estimate of the legislation. “This is not going to be a problem.”

The GOP's Waterloo

David Frum:

Conservatives and Republicans today suffered their most crushing legislative defeat since the 1960s.

It’s hard to exaggerate the magnitude of the disaster. Conservatives may cheer themselves that they’ll compensate for today’s expected vote with a big win in the November 2010 elections. But:

(1) It’s a good bet that conservatives are over-optimistic about November – by then the economy will have improved and the immediate goodies in the healthcare bill will be reaching key voting blocs.

(2) So what? Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now.

So far, I think a lot of conservatives will agree with me. Now comes the hard lesson:

A huge part of the blame for today’s disaster attaches to conservatives and Republicans ourselves.

At the beginning of this process we made a strategic decision: unlike, say, Democrats in 2001 when President Bush proposed his first tax cut, we would make no deal with the administration. No negotiations, no compromise, nothing. We were going for all the marbles. This would be Obama’s Waterloo – just as healthcare was Clinton’s in 1994.

Only, the hardliners overlooked a few key facts: Obama was elected with 53% of the vote, not Clinton’s 42%. The liberal block within the Democratic congressional caucus is bigger and stronger than it was in 1993-94. And of course the Democrats also remember their history, and also remember the consequences of their 1994 failure.

This time, when we went for all the marbles, we ended with none.

Could a deal have been reached? Who knows? But we do know that the gap between this plan and traditional Republican ideas is not very big. The Obama plan has a broad family resemblance to Mitt Romney’s Massachusetts plan. It builds on ideas developed at the Heritage Foundation in the early 1990s that formed the basis for Republican counter-proposals to Clintoncare in 1993-1994.

Today's Health Care Cartoons: The GOP & Tea Party Opposition

Why The Health Reform Law Is Here To Stay. Hear That Supreme Court?

Jeffrey Tobin:

I will leave the waxing eloquent on this historic day to my colleagues. I have three brief observations about the legal implications of the passage of health-care reform.

1. Abortion. The negotiations between Congressman Bart Stupak and the White House over the executive order on abortion funding may rank among the most consequential inconsequential disputes in American history. It was important because it now seems likely that health care reform would have failed if Stupak and his allies had not voted for it. But the executive order itself is nearly meaningless as a legal and practical matter. Federal funding of abortion has been illegal under the Hyde Amendment for almost two generations. The health-care reform bill did nothing to disturb that status quo. Anti-abortion forces mobilized against the legislation but without ever establishing that it would affect abortion at all. In short, nothing happened on abortion—and, apparently, that made all the difference.

2. Constitutionality. Various states have threatened to go to court to assert that Congress acted outside its authority in passing the health-care reform bill. Even with a conservative Supreme Court, these challenges seem bound to fail. For decades, the Court has upheld the extensive federal role in health care through such programs as Medicare and Medicaid. This new law is a change in degree, not in kind, and courts will likely stay out of the way.

However, it’s also worth noting that the courts, including the Supreme Court, will be interpreting the new health-care-reform law for many years to come. Any new law raises a multitude of questions for interpretation, and this one will raise many. What’s covered? Who pays? How does the transition to the new system work? ...

3. The future. Liberals in particular have noted with frustration that the Senate has become a tremendous roadblock to legislative progress. Now that filibusters are routine on almost all Senate business, it takes sixty votes to do almost anything. That sclerotic process may look pretty good to liberals now, because it means that this piece of legislation is almost repeal-proof. It would take sixty-plus Republicans and a Republican President to get the job done (or undone). That’s not happening soon (or maybe ever). This law may turn out to be popular or detested, prescient or misguided—but it is here to stay.

Reactions To The New Health Law

Seth Masket:

[W]hile I don't think tonight will have an extraordinary effect on elections in the near or distant future, I do think this will have a profound impact on public policy.  Even if this bill seems watered-down to you, realize that from this point forward, the federal government is responsible for making sure people have health insurance.  The question is no longer whether government should do it; it's whether it's doing it well enough.  I heard somewhere that the two major votes tonight were symbolic ordered that way -- first they passed health reform, then they passed reconciliation to improve it.

Andrew Sullivan:

I watched Obama's rise from Hyde Park over the last 15 yrs. Two things stand out: his political rivals almost always, and fatally, underestimate the guy's abilities. I sense there's some racism there, and his opponents always try to smear him as a "radical black guy" but Obama has always positioned himself above racial street fighting. The fact is, Obama is not just smart, he's brilliant.

Second, the guy constantly fights a war of attrition, staying the course, keeping his cool, but applying constant steady pressure to the abutments of the opposition, and over time almost all of them crumble. 

I don't think conservatives have yet figured this out about a guy, who now, is their biggest danger to future political relevance. He's grinding them, slowly, into dust.

What determined the vote?

The length of Obama's coattails, according to Nate Silver (H/t the Daily Dish).

Robert Creamer:

I would argue, that by Election Day, there will be very few districts where a vote for health care reform is unpopular. But I would also argue, that this fall we will see clear evidence that courage itself is very popular.

Willingness to stand up for what you believe - and unwillingness to be swayed by political winds - is good politics. People love candidates who are not what they conceive as "typical politicians" that always have their fingers in the air or decide what they believe based on the latest poll.

The fact that many Members stood up tall - took on the insurance industry - and refused to be intimidated - is itself a great political narrative for Democratic candidates this fall.

And I predict that we will also learn the opposite is also true. The Democrats who decided to oppose health care reform because of political pressure - particularly those that voted yes the first time health care reform was considered by the House - will be in deep political trouble.

The flip-floppers will find that they will gain nothing with the hard core opponents of reform, their base will be demobilized, and the flip-flop charge itself will move independent voters to oppose them. Very dumb ...

Finally, this victory will invigorate the base of the Democratic Party and greatly improve the chances of victory for all Democrats this fall. Let's remember that Democrats lost control of the House in 1994 because Democrats didn't come out and vote after the failure of health care reform earlier that year. Last night's victory will have precisely the opposite effect.

Not only that, but voters like to support winners. Last night the Democrats in Congress, President Obama and the progressive forces in America won big. The Progressive band wagon has been freed from the mud and is moving once again. It will attract more and more followers as we get closer to the Election Day.

There was another big loser last night -- the "chattering class" of pundits. Turned out that health care, the Obama presidency, and the progressive movement weren't so dead after all.

"This time, fear struck out"

Paul Krugman:

The day before Sunday’s health care vote, President Obama gave an unscripted talk to House Democrats. Near the end, he spoke about why his party should pass reform: “Every once in a while a moment comes where you have a chance to vindicate all those best hopes that you had about yourself, about this country, where you have a chance to make good on those promises that you made ... And this is the time to make true on that promise. We are not bound to win, but we are bound to be true. We are not bound to succeed, but we are bound to let whatever light we have shine.”

And on the other side, here’s what Newt Gingrich, the Republican former speaker of the House — a man celebrated by many in his party as an intellectual leader — had to say: If Democrats pass health reform, “They will have destroyed their party much as Lyndon Johnson shattered the Democratic Party for 40 years” by passing civil rights legislation.

I’d argue that Mr. Gingrich is wrong about that: proposals to guarantee health insurance are often controversial before they go into effect — Ronald Reagan famously argued that Medicare would mean the end of American freedom — but always popular once enacted.

But that’s not the point I want to make today. Instead, I want you to consider the contrast: on one side, the closing argument was an appeal to our better angels, urging politicians to do what is right, even if it hurts their careers; on the other side, callous cynicism. Think about what it means to condemn health reform by comparing it to the Civil Rights Act. Who in modern America would say that L.B.J. did the wrong thing by pushing for racial equality? (Actually, we know who: the people at the Tea Party protest who hurled racial epithets at Democratic members of Congress on the eve of the vote.)

And that cynicism has been the hallmark of the whole campaign against reform.

"How Republicans Blew It"

Jonathan Chait:

From the standpoint of short-term political strategy, the Republicans have played their cards perfectly. Their slow withdrawal of any support excised the maximum political damage by forcing all Senate Democrats to agree, rendering the bill partisan and subjecting it to months of slow-bleed legislative wrangling. The Republicans will probably pick up more seats in November than they would have if they had pursued a bipartisan accord.

But the policy costs have been significant. As I wrote last December, "The Republicans may gain some more seats in 2010 by their total obstruction, but the substantive policy defeat they've been dealt will last for decades." David Frum chimes in, "Legislative majorities come and go. This healthcare bill is forever. A win in November is very poor compensation for this debacle now."

The funny thing is that this policy disaster was avoidable for Republicans. Many Senate Democrats started the debate believing that a bipartisan accord was the only morally legitimate path to major legislative change, and desperately hoping for bipartisan cover as they undertook wrenching change to the status quo. If they had put a compromise bill on the table, moderate Democrats would have leaped at the offer, and it would have taken just one Democrat to make such a deal and kill comprehensive reform.

The Republicans had another chance last month when President Obama convened a bipartisan health care summit. If some Republicans had come forward with a meet-you-halfway plan, or even meet-you-quarter-way plan, Democrats would have been in a bind. They let the opportunity pass. Why? Frum writes:

There were leaders who knew better, who would have liked to deal. But they were trapped. Conservative talkers on Fox and talk radio had whipped the Republican voting base into such a frenzy that deal-making was rendered impossible. How do you negotiate with somebody who wants to murder your grandmother? Or – more exactly – with somebody whom your voters have been persuaded to believe wants to murder their grandmother?

The Republican strategy of total opposition instead forced the Democrats into an all-or-nothing choice of passing a comprehensive bill or collapsing into catastrophic defeat. (Republicans tried desperately to convince them that letting the bill die was their best political strategy, but Democrats wisely rejected this awful advice.)  Let me be clear: I'm glad they did it. I'm willing to accept higher Democratic losses in exchange for a health care bill that really solves the pathologies of the health care market. The Republican strategy was an audacious gamble, and it could have worked, but it came up empty. Thank goodness.

"The Senate bill remains a careful contradiction ... comprehensive reform with an incremental soul ... routinely lambasted for being too big and comprehensive, but compared to the problems it faces, it is too small and too incrementalist"

Ezra Klein:

According to Rep. Henry Waxman, Barack Obama will sign the Senate bill within the next two days. At that point, the decades-long struggle to pass a universal health-care system into law will finish, and the decades-long work of building and improving our system will begin.

The politics of health-care reform have gotten enough attention in recent weeks, and I don't mean to give them much more. Minority leader John Boehner's closing scold was an angry, divisive capstone; his shouts of "hell no" on the floor of Congress were far more inappropriate, and far more embarrassing, than any yelp that ever escaped Howard Dean's mouth. The presiding officer's admonishment "to remember the dignity of the House" was a sad commentary on how much of it had already been lost. But he represented his members fairly: Earlier in the evening, Rep. Devin Nunes exhorted his colleagues to say "no to socialism, no to totalitarianism, and no to this bill."

It was a reminder of how far our politics have strayed, and how much more extreme our rhetoric has become, than the underlying legislation warrants. The deafening volume of the debate long ago drowned out its subject. Sadly, the Senate bill remains a careful contradiction that most people still don't understand. It is a comprehensive reform with an incremental soul, but neither side has done enough to explain it that way.

The legislation builds a near-universal health-care system, but it only uses the materials that our system has laying around. It leaves private insurers as the first line of coverage provision, but imposes a new set of rules so that we can live with -- and maybe even benefit from -- their competition. It spends $940 billion in the first 10 years and more than $2 trillion in the second decade, but its mixture of revenues, spending reductions, and cost-controlling reforms are projected to save even more than that. It is the most sweeping piece of legislation Congress has passed in recent memory, but it is much less ambitious than the solutions that past presidents have proposed. It is routinely lambasted for being too big and comprehensive, but compared to the problems it faces, it is too small and too incrementalist.

But it's a start.

Today's Health Care Cartoons

What's Next Politically?

NY Times:

The battle over health care is poised to move swiftly from Congress back to the country as Democrats, Republicans and a battery of interest groups race to define the legislation and dig in for long-term political and legal fights.

President Obama plans to open a new campaign this week to persuade skeptical Americans that the bill holds immediate benefits for them and addresses the nation’s shaky fiscal condition. Republicans said they would seek to repeal the measure, challenge its constitutionality and coordinate efforts in statehouses to block its implementation.

The politics of health care are fragile — and far from certain — in the eight-month midterm campaign that will determine which party will control Congress next year. But both sides steeled for a fight to extend well beyond November, involving state legislative battles, court challenges and, ultimately, the next presidential race.

Even before the final vote, Republicans began relentlessly assailing lawmakers who supported the legislation, suggesting Democrats are spendthrift and proponents of big government. Democrats said they would seek to capitalize on the momentum from their success and strive to move beyond the political arguments in hopes of demystifying the complicated legislation.

“We ought to focus on not the political stakes, but the stakes for the country,” David Plouffe, an adviser to Mr. Obama, said on ABC’s “This Week.” “We’re going to go out there and not just talk about what we’re for, but what the Republicans are voting against.”

The next chapter in the health care fight will play out not only in the midterm elections, but also in the courts. Attorneys general in three states — Virginia, Florida and South Carolina — have indicated they will file legal challenges to the measure, on the grounds that it violates the Constitution by requiring individuals to purchase insurance.

In an interview Sunday, the Virginia attorney general, Ken Cuccinelli, said he intended to base his challenge on two grounds: that the federal bill conflicts with a newly passed state law that says no Virginian may be compelled to buy insurance and that Congress does not have authority to impose the mandate under its powers to regulate interstate commerce, as Democrats contend.

“This is such an incredible federal overreach,” Mr. Cuccinelli said, but added that he did not plan to ask the courts for an order that would prevent the bill from going into effect because the individual mandate does not take effect until 2013. “On our basis for a constitutional challenge, there’s no rush,” he said.

The White House and Democrats were preparing to counter the legal arguments and coordinate a state-by-state response to any prospective challenges. For his part, aides said, Mr. Obama will lead the effort to define the bill, but also will shift his focus to the economy and jobs. A campaign, featuring Mr. Obama and examples of people who benefited from health care, will take place in the coming months.

Democrats were also beginning to form a permanent campaign, of sorts, to follow the bill through its various stages. Party strategists studied the public’s reaction to Medicare — it was not immediately positive — and were trying to create a friendlier climate for Mr. Obama when he faces voters again.

Roosevelt, Johnson & Now Obama: House Passes Historic Health Insurance Reform Bill

Analysis from the NY Times (also see how House members voted):

The House’s passage of health care legislation late Sunday night assures that whatever the ultimate cost, President Obama will go down in history as one of the handful of presidents who found a way to reshape the nation’s social welfare system.

After the bitterest of debates, Mr. Obama proved that he was willing to fight for something that moved him to his core. Skeptics had begun to wonder. But he showed that when he was finally committed to throwing all his political capital onto the table, he could win, if by the narrowest of margins.

Whether it was a historic achievement or political suicide for his party — perhaps both — he succeeded where President Bill Clinton failed in trying to remake American health care. President George W. Bush also failed to enact a landmark change in a domestic program, his second-term effort to create private accounts in the Social Security system.

At the core of Mr. Obama’s strategy stands a bet that the Republicans, in trying to portray the bill as veering toward socialism, overplayed their hand. Fueled by the antigovernment anger of the Tea Party movement, Republicans have staked much on the idea that they can protect the country by acting as what the Democrats gleefully call the “Party of No.”

Now, armed with a specific piece of legislation that offers concrete benefits to millions of people — and that promises to guarantee insurance for many who found it unaffordable or unattainable — the White House and Democrats believe they may have gained the upper hand.

“This only worked well for the Republican Party if it failed to pass,” David Axelrod, one of the president’s closest political advisers, said at the White House as he watched the vote count for the final bill reach 219 in favor. “They wanted to run against a caricature of it rather than the real bill. Now let them tell a child with a pre-existing condition, ‘We don’t think you should be covered.’”

But there is no doubt that in the course of this debate, Mr. Obama has lost something — and lost it for good. Gone is the promise on which he rode to victory less than a year and a half ago — the promise of a “postpartisan” Washington in which rationality and calm discourse replaced partisan bickering.

Never in modern memory has a major piece of legislation passed without a single Republican vote. Even President Lyndon B. Johnson got just shy of half of Republicans in the House to vote for Medicare in 1965, a piece of legislation that was denounced with many of the same words used to oppose this one. That may be the true measure of how much has changed in Washington in the ensuing 45 years, and how Mr. Obama’s own strategy is changing with the discovery that the approach to governing he had in mind simply will not work.

The GOP Is Throwing Everything They Can--No Matter How Inane Or Damaging To Themselves--To Stop Health Reform

Check out Rep Steven King's claim that today's vote is an "affront to God" and Rep Paul Broun as her refers to the Civil War as the "Great War of Yankee Aggression" (apparently it wasn't just extremists within the Tea Party whose racism was on display yesterday):

Visit msnbc.com for breaking news, world news, and news about the economy

Marlyand Wants To Secede From The South.

Visit msnbc.com for breaking news, world news, and news about the economy

The Cesspool From Whence The Tea Parties Draw Revealed: Democratic Reps Called Nigger & Fag

Assumption was replaced with proof yesterday as it's now indisputably clear where some of the Tea Party anger & vitriol has been coming from. From Prescriptions:

Thousands of opponents of the health care legislation circled the Capitol on Saturday waving signs and chanting slogans.

And while most of the invective was directed at the health care bill itself, several House members said there was an ugly tone to comments made by some demonstrators against three black lawmakers: Representatives André Carson of Indiana, Emanuel Cleaver II of Missouri and John Lewis of Georgia, all Democrats.

An aide to Mr. Lewis, a leader of the civil rights movement in the 1960s, said that as he walked to the Capitol, Mr. Lewis was called racial slurs. A spokesman for Mr. Cleaver said that a protester spat on the congressman as he was walking to the Capitol for a vote.

Democratic aides said some demonstrators made anti-gay remarks to Representative Barney Frank, Democrat of Massachusetts, who is gay.

The No. 3 Democrat in the House, Representative James E. Clyburn of South Carolina, said, “I heard people saying things today that I have not heard since March 15, 1960, when I was marching to try to get off the back of the bus.”

Watch the beginning of this video as Rep. Devin Nunes (R-CA) not only won't denounce the racist & homophobic slurs, he actually eggs them on by using incredible hyperbole (insuring 32 million people is tyranny? Really?):

Alf Landon & The Party Of No

Dana Milbank understands that once health reform is enacted, it is going to become exceedingly popular. It's too bad for the GOP, that they're unlikely to take his advice:

"This is the largest tax bill in history," the Republican leader fumed. The reform "is unjust, unworkable, stupidly drafted and wastefully financed."

And that wasn't all. This "cruel hoax," he said, this "folly" of "bungling and waste," compared poorly to the "much less expensive" and "practical measures" favored by the Republicans.

"We must repeal," the GOP leader argued. "The Republican Party is pledged to do this."

That was Republican presidential nominee Alf Landon in a September 1936 campaign speech. He based his bid for the White House on repealing Social Security.

Bad call, Alf. Republicans lost that presidential election in a landslide. By the time they finally regained the White House -- 16 years later -- their nominee, Dwight Eisenhower, had abandoned the party's repeal platform.

Circumstances are different now, as Republicans, assuming the Democrats' health legislation clears the House this weekend, prepare to campaign this year and in 2012 on the repeal of health-care reform. But the ghost of Landon should spook them as they do so: The health-care legislation, if passed, won't be repealed, and the politics of repeal may not work out as well as Republicans expect. You wouldn't think that based on the headlong rush to demand a repeal even before the health bill becomes law.

More than 20 Republican Senate hopefuls have tied their candidacies to repeal. Mark Kirk of Illinois promises to "lead the effort," while Sen. John Cornyn (Texas), head of the Senate GOP campaign effort, calls 2010 a referendum on repeal. Sen. Lamar Alexander (Tenn.), the No. 3 Senate GOP leader, sees "an instant spontaneous campaign to repeal it all across the country."

In the House, Rep. Paul Ryan (R-Wis.) vows to make the repeal of "H.R.1 and S.1" the No. 1 goal if Republicans take over Congress. The National Review has published a treatise called "The Case for Repeal," and the Club for Growth is already a couple of months into its "Repeal It" campaign.

Why Obama Believes "health care reform is a 2010 win for Democrats"

Time:

Barack Obama's top pollster, Joel Benenson ... Since August, he's had to deal with "death panels," the "cornhusker kickback" and daily proclamations of a "government takeover" of health care. He has watched Obama's approval rating fall from the high 60s to the high 40s, while opposition to Democratic health care reforms have inched above 50% in many polls. Recently, he's even had Republican leaders declare that Democratic hopes for the November elections will collapse if health care reform becomes law. "Do you really think the Republicans are out there trying to save Democrats from themselves?" he asks. 

Through the worst days, Benenson's message has remained the same. Push forward. Get it done. Three years ago, Benenson, a former New York Daily News reporter from Queens, went head to head with one of the best in the business, Hillary Clinton's pollster Mark Penn, challenging a candidate of "experience" with a candidate of "change." His team toppled conventional wisdom. Now he tells wavering Democrats in Congress to take their own leap of faith: Look past the numbers that show widespread dismay at the health care debate and a nation deeply divided over the Democratic bill. Believe that health care reform is a 2010 win for Democrats.

His argument flows in several directions at once. First of all, he says, the details of reform, as Democrats hope to frame it, are far more popular than the package as a whole. Americans overwhelmingly want to end the insurance industry's practice of denying coverage for pre-existing conditions. They want to be able to afford coverage when they are between jobs. They want seniors to have more help with prescription-drug costs.

Second, he says, the worst fears of Americans will never be realized. "Is somebody's elderly parent or relative going to be put to death by a death panel?" he asks. "No. It doesn't exist." Third, a sizable chunk of those who oppose the current bill — roughly 1 in 6 in a January CNN poll — want the bill to be even more liberal.

But perhaps most important of all, Benenson believes the current polls confuse a skepticism about health care reform with broad discontent over the political process in Washington. "This is what people don't understand," he says. "People are frustrated that Congress doesn't seem able to work together to do the job that people think they sent them there to do." A solution to this problem is action.

This view is widely held within Obama's inner circle, and it is the reason that the White House has done the unthinkable in the first three months of an election year. After extended agony in 2009, with the gritty legislative ticktock undercutting the new President's glistening promise of change, Obama decided to double down in February, forcing more weeks of painful process discussions and bewildering ruminations on parliamentary procedures like "reconciliation" and "self-executing" rules.

"As passage of health reform nears, a historic chance to help fix Washington, too"

Steven Pearlstein:

It's shaping up to be a great weekend here in Washington.

I'm not just talking about the spectacular weather or another upset-filled NCAA basketball tournament. I'm talking about the prospect of a quasi-climactic vote in the House that would finally have the United States join the rest of the industrialized world in offering health insurance to all its citizens.

Sometimes, those of us who live here and participate in political life can get a bit cynical. We tend to focus on the process or the gamesmanship or the unsavory compromises. Which is why it is important at moments such as this to get your head out of the weeds, look at the Capitol dome in the distance and remember how lucky you are to have a front-row seat to one of the world's longest-running historical dramas.

What strikes me about the lead-up to this weekend's health-care vote in the House is how quiet things actually are.

If, as Republicans would have us believe, Americans are so up in arms about the prospect of "Obamacare," why aren't there angry hordes marching on the Mall or jamming the halls of the Rayburn Building?

If the plan really represents a wholesale government takeover of one-sixth of the economy, why are so many associations representing private doctors, hospitals and drugmakers either supporting the legislation or staying relatively neutral?

And if this Democratic version of health reform is such a threat to economic prosperity, why are stocks, bonds and the dollar all rising this week as odds of passage increase?

One of the silliest Republican talking points is that Democrats are "ramming health-care reform down the throats of the American people." In fact, we've been talking about it, on and off, for decades, ultimately winding up with a solution that is not only remarkably centrist but also not all that different from the compromise nearly reached between Ted Kennedy and the Nixon White House in the early 1970s.

Indeed, although you'd never know it from the overheated rhetoric, the remarkable thing about the final proposal is how little it would change things, at least initially, for most Americans. That's no accident -- in fact, it's by political design. This plan is more like a time-release tablet meant to reform the system slowly from the inside out rather than surgically from the outside in.

Health Reform Legislative Roundup

• "House Democrats initiated a 72-hour countdown Thursday on their yearlong effort to overhaul the health care system, unveiling a nearly final version of the legislation that promptly won additional support with a promise that the bill would more than pay for itself over the next decade.

Armed with detailed legislative language and a report on the bill’s costs from the Congressional Budget Office, Democratic leaders and White House officials kicked off a new round of arm-twisting to line up the votes they will need to pass the legislation when it comes to the House floor in the face of intense Republican opposition on Sunday." Read this NY Times story.

• Wondering how the final bill's estimated cost so closely matched the targets President Obama set out? Here's how.

• Curious to see how Pelosi decides which House Dems to put the screws to and which she will allow to vote no? Read about her approach.

• "Raising the bar on Republican opposition maneuvers in the Senate, Mr. Coburn on Thursday threatened to put future holds on any Democratic House members who switch their vote in favor of the health care bill, lose their election as a result next November, and then are rewarded with a high-ranking job in the Obama administration.

“If you voted no and you vote yes and you lose your election and you think any nomination to a federal position isn’t going to be held in the Senate, I’ve got news for you, it’s going to be held,” said Mr. Coburn" Read this The Caucus post

• "President Obama moved closer to achieving one of his top policy goals Thursday as congressional Democrats joined forces behind legislation that would cut funding to private student lenders and redirect billions of dollars in expected savings into grants to needy students.

  The proposal, in a bill released Thursday afternoon, has been overshadowed by the health-care debate. But it is moving swiftly now and could benefit from a maneuver that packages it with Obama's health-care plan. The two initiatives central to the president's domestic agenda could pass simultaneously in what are expected to be largely party-line votes. The House could act by Sunday, lawmakers said, and the Senate soon after, under rules that require only a simple majority vote for passage. But obstacles remain in both chambers. Read this Wash Post story.

DNC Targets Senator McConnell In New Ad

Arizona Fixes Its Budget Woes On The Backs Of 47k Poor Children

NY Times:

Arizona on Thursday became the first state to eliminate its Children’s Health Insurance Program when Gov. Jan Brewer signed an austere budget that will leave nearly 47,000 low-income children without coverage.

The Arizona budget is a vivid reflection of how the fiscal crisis afflicting state governments is cutting deeply into health care. The state also will roll back Medicaid coverage for childless adults in a move that is expected to eventually drop 310,000 people from the rolls.

State leaders said they were left with few choices because of a $2.6 billion projected shortfall next year. But hospital officials and advocates for low-income people said they were worried that emergency rooms would be overrun by patients who had few other options for care, and that children might suffer enduring developmental problems because of inadequate medical attention.

The cuts also mean the state will forgo hundreds of millions of dollars in federal matching aid, and could lose far more if Congress passes a health bill that requires states to maintain eligibility levels for the two programs.

Ms. Brewer, a Republican, has warned that more cuts will be needed if voters do not approve a referendum in May to raise the sales tax by a penny for three years, to 6.6 cents per dollar ...

The Republican-controlled Legislature passed the budget last week, based largely on a proposal from the governor that included deep cuts to both health care and education. With state revenues down a third since 2007, the $8.9 billion budget reduced spending by about $1.1 billion.

Three states, including Arizona, had in the last year capped enrollment in the Children’s Health Insurance Program, financed jointly by states and the federal government. But two of those states — California and Tennessee — quickly removed their caps, said Jocelyn Guyer, co-executive director of the Center for Children and Families at Georgetown University.

“They really are standing alone in cutting children off during the downturn,” Ms. Guyer said. “It’s going to have long-term consequences that will be there for kids long after Arizona’s budget situation gets better.”

The Electoral Logic Behind The Right's Constant Harping About Process

It heats up their base. Jonathan Chait:

The controversy over the "deem-and-pass" strategy will probably end very quickly. (I expect Democrats to conclude it's not worth the hassle.) But it's another telling episode in the health care saga. Conservatives have spent the last day in a fit of outrage at the prospect that House Democrats might enact the Senate health care bill and changes to it in one vote rather than two. ("We have entered a political wonderland, where the rules are whatever Democrats say they are," huffs the Wall Street Journal.

Congressional scholar Norman Ornstein has a sharp riposte:

Any veteran observer of Congress is used to the rampant hypocrisy over the use of parliamentary procedures that shifts totally from one side to the other as a majority moves to minority status, and vice versa. But I can’t recall a level of feigned indignation nearly as great as what we are seeing now from congressional Republicans and their acolytes at the Wall Street Journal, and on blogs, talk radio, and cable news. It reached a ridiculous level of misinformation and disinformation over the use of reconciliation, and now threatens to top that level over the projected use of a self-executing rule by House Speaker Nancy Pelosi. In the last Congress that Republicans controlled, from 2005 to 2006, Rules Committee Chairman David Dreier used the self-executing rule more than 35 times, and was no stranger to the concept of “deem and pass.” That strategy, then decried by the House Democrats who are now using it, and now being called unconstitutional by WSJ editorialists, was defended by House Republicans in court (and upheld). Dreier used it for a $40 billion deficit reduction package so that his fellow GOPers could avoid an embarrassing vote on immigration. I don’t like self-executing rules by either party—I prefer the “regular order”—so I am not going to say this is a great idea by the Democrats. But even so—is there no shame anymore?

As I said, this latest procedural outrage is likely to die down soon. Before that, though, conservatives were apoplectic that Democrats might approve health care despite opposition. Here's a disgusted reaction from Redstate:

ObamaCare is not popular.  The people don’t want it.  The people have rejected it.  Yet President Barack Obama, Speaker Nancy Pelosi (D-CA) and Senate Majority Leader Harry Reid (D-Nev.) are going to ram it down the throats of the American people using a special Congressional procedure that avoids a filibuster in the Senate - The Health Care Nuclear Option.  The Obama Administration and Leaders in Congress have shown contempt for the opinions and views of the American people.  They just don’t get it and they don’t care what people think about this plan.

.... Recently, though, the polls have swung back in favor of health care reform. Last night's NBC/Wall Street Journal poll shows 46 % in favor of Obama's plan and 45% opposed. The public is now split on passing Obama's bill. So what about those intense arguments about public opinion and democratic consent?

The striking thing about this debate is the degree to which Republicans have devoted the bulk of their energies to putting forth disingenuous arguments. The have deep-seated reasons to oppose health care reform, but they spend an enormous amount of time on arguments that they would never were the situation reversed. I don't doubt that there's some political benefit to this -- the GOP base already opposes health care reform on the merits, so the way to keep them whipped into a state of outrage is to produce a stream of new process arguments about how the Democrats are doing violence to the beloved system of the Founding Fathers. Swing voters, meanwhile, do favor both the general proposition of health care reform and most of the provisions of the plan, but have recoiled at the process. So there's a logic behind the constant stream of process complaints from the right. It's just created a stupid debate.

And to illustrate Chait's point, and show how Fox News' role is to whip up the right (not report news) watch Brett Baier repeatedly interrupt President Obama with the Right's process obsessed talking points:

Read the Wash Post's report on the Fox News interview.

In Rare Bipartisan Vote, Senate Approves Jobs Bill

Dow Jones:

The U.S. Senate voted Wednesday to give final approval to $17.5 billion legislation creating a payroll tax credit for employers who hire unemployed Americans in what Democrats say will be several election-year job-creation bills.

The Senate vote was 68-29, with a handful of Republicans joining the Democratic majority to support the measure.

The legislation has bounced back and forth between the House and Senate, but with the Senate vote will now be sent to the White House for President Barack Obama's signature.

The centerpiece of the bill would excuse business owners from having to pay their 6.2% of federal payroll taxes for the rest of 2010 on new employees they hire that have been out of work for at least two months.

If the worker is still on an employer's books in a year, the business owner would receive a further $1,000 tax credit.

Democrats hope the measure will convince private-sector employers to begin hiring again. Despite firm indications that an economic recovery is gradually gaining steam in the U.S., the jobs market has continued to lag behind.

The unemployment rate stands at 9.7%, more than two percentage points higher than January 2009 when President Barack Obama was sworn into office.

Heading toward what most expect to be a tough mid-term election season for the incumbent Democrats, the party's leaders are aware of the need to be seen tackling the jobs crisis.

Senate Democrats said the bill is the first of at least four pieces of legislation aimed at stimulating growth in the moribund jobs market they will pass in the coming months.

The new employee tax credit has already come under criticism from some economists who doubt whether it will make much difference in employers' hiring plans. They argue a 6% tax break won't make much difference to business owners uncertain about the direction of the economy.

The legislation also contains an extension of federal subsidies towards state government costs incurred through road and bridge construction and repairs.

It extends an expense write-off provision for small businesses, and modestly expands so-called "Build America Bonds" used by local governments to fund public works projects.

Democrats said the full $17.5 billion cost of the bill is fully offset by savings elsewhere in the federal budget, primarily by delaying the implementation of a measure that would allow U.S. multinational companies to deduct more of their worldwide interest income from their U.S. income.

Poll: Passing Health Reform Key To Dems Chances In November

Wall St Journal (poll details):

The pending health-care overhaul remains unpopular with a broad swath of the public, but core Democrats the party needs to show up and vote in November are strong backers, a new Wall Street Journal/NBC News poll finds.

The survey found that opinions have solidified around the health-care legislation, with 48% calling it a "bad idea" and 36% viewing it as a "good idea" when presented with a choice between those two. That gap is consistent with surveys dating to the fall.

At the same time, Democratic voters strongly favor the legislation being pushed by President Barack Obama, particularly constituencies such as blacks, Latinos and self-described liberals. Those groups mobilized in 2008 to help elect Mr. Obama, but are far less enthusiastic than core Republicans about voting in this year's midterm elections.

The survey found a 21-point enthusiasm gap between the parties, with 67% of Republicans saying they are very interested in the November elections, compared with 46% of Democrats. "If the Democrats are going to close that gap, they've got to get their people excited. And I don't see how you get those people if you vote no" on the party's health-care legislation, said Democratic pollster Peter Hart, who conducted the survey with Republican Bill McInturff.

"I don't think it's about winning the middle. It's really about alienating the base," Mr. Hart said of Democratic lawmakers' calculations about the upcoming health-care vote.

The survey found that Mr. Obama's job-approval rating of 48%—as opposed to the 47% who disapprove—has remained steady since its precipitous drop last summer, which coincided with rising public opposition to the health-care initiative.

Where the health-care debate has been a drag for Mr. Obama's numbers, it also has been an anchor for Congress, which now has an anemic 17% approval rating. Half of Americans, if they had the choice, would vote to replace every member of Congress, including their own representative, the survey found.

On health care, the results underscore the argument from liberal activists that the bill's demise would dissuade the Democratic base from voting in November. The Journal/NBC survey shows that majorities of African-Americans and liberal Democrats, as well as a plurality of Latinos, would be less likely to vote for their representative in Congress if he or she voted against the health-care plan.

Further complicating the calculation for all lawmakers is that a clear plurality of Americans wants the issue addressed in some form. Forty-seven percent of poll respondents said they wanted Congress to consider significant health-care legislation "immediately" if the Obama plan fails, while another 23% wanted that done at least within the next couple of years ...

No matter what happens on the vote this week, the survey points to political challenges facing both parties as they weigh how to talk about health care on the campaign trail this fall.

Thirty-six percent of voters said they would be less likely to support their member of Congress if he or she voted for the bill, but 34% said they would be less likely to support their representative if he or she voted against it. While Republican leaders have said they would encourage GOP candidates to campaign for repeal of the legislation should it pass, the survey showed voters split on that possibility: 37% were more likely to back a candidate who embraced repeal and 33% less likely.

More broadly, the survey showed continued gloominess among all voters about the country's direction, with nearly six in 10 saying it is on the wrong track. Adding to Democrats' election-year concerns: Voters are souring on the party's ability to deal with the country's economic troubles.

As an issue, handling of the economy has favored the Democrats in the past four election cycles. But now, by a 10-point margin, registered voters with the highest interest in the November elections said they believe the GOP is better at dealing with the economy.

Some of Mr. Obama's highest ratings relate to his work on foreign policy, an area that had been a weakness when he was a presidential candidate. Clear majorities said they approve of Mr. Obama's handling of the war in Afghanistan and the situation in Iraq. In both cases, 53% of respondents said they approved of his work.

The high numbers reflect the support by many Republicans and independents for the president's decision to boost troop levels in Afghanistan. Liberal activists have blamed that stance for adding to the decline in enthusiasm among core Democratic voters.

On another foreign-policy matter confronting the White House, a 51%-38% majority in the survey supported initiating military action to destroy Iran's ability to make nuclear weapons if Tehran continues its nuclear program and is close to developing a weapon. Thirty-nine percent said they strongly supported military action.

Today's Health Care Cartoons

For Fiscal Hawks, The ""risk of doing nothing" exceeds the risk of passing the bill"

Ron Brownstein:

... For fiscal hawks, [the above cost control elements of the Senate bill are] a powerful incentive for action. But equally compelling could be the price of inaction. If Obama's plan fails, as President Clinton's did, it's likely that no president will attempt to seriously expand coverage for many years. The independent Medicare actuary has projected that under current trends the number of uninsured will increase by 10 million, to about 57 million, by 2019. Providing uncompensated care to so many uninsured people would further strain physicians and hospitals -- and inflate premiums as those providers shift costs to their insured patients.

Some fiscal conservatives want to attack rising costs without expanding coverage. But that approach looks impractical, politically and economically. While Republicans controlled Congress after the 1994 election, they never built enough of a consensus to pass the cost-control ideas they are now pressing on Obama, such as medical malpractice reform. Meanwhile, Nichols warns that imposing meaningful cost control on hospitals without reducing the number of uninsured patients they must treat "would bankrupt many and strain most to the breaking point."

Weighing such factors, Nichols concludes that the "risk of doing nothing" exceeds the risk of passing the bill. In interviews, Emory University's Kenneth Thorpe and Stanford University's Alan Garber, two other leading health economists, guardedly echoed his conclusion. Both men believe that the current proposal could move faster to control costs. But both also agree that it contains valuable first steps and establishes what Garber calls "a good platform" for further reform. By contrast, Thorpe says, "under the do-nothing scenario, everything gets worse." For Democratic fiscal hawks uncertain that approving Obama's plan will cure what ails U.S. health care, the real question may be whether defeating it guarantees that the system's chronic afflictions will metastasize further.

"Most sweeping overhaul of financial regulations since the Depression" To Be Unveiled Monday

Talk about doubling down and standing by your principles. In light of all the drama and politics around the health care bill, it's great that Obama and the Dems are still pushing for dramatic changes to education (Obama Proposes Sweeping Changes To 'No Child Left Behind' Law) and, as reported by the  NY Times here, financial regulation (and in the latter, they're still willing to go the Democrat-only route to get what they want):

The chairman of the Senate Banking Committee will unveil on Monday a proposal to revamp the nation’s financial regulations that would empower shareholders to have advisory votes on executive pay and to nominate directors for the boards of public companies through company proxy ballots, several people briefed on the draft legislation said Saturday.

The shareholder provisions, which have been vigorously opposed by many corporations and by Republicans, will be part of a bill that would amount to the most sweeping overhaul of financial regulations since the Depression. In one of the most fiercely debated provisions, the bill would create a consumer financial protection agency under the umbrella of the Federal Reserve, a move certain to disappoint liberal Democrats who believe the Fed failed to safeguard consumers in the years leading up to the banking meltdown.

With no Republican support yet for the proposal, Democratic lawmakers and the White House have been gearing up for a potentially bitter partisan fight.

The impending proposal by the chairman, Christopher J. Dodd of Connecticut, hews in many ways to a proposal advanced last summer by the White House, the people briefed on the legislation said.

Mr. Dodd said Thursday that Democrats would proceed on their own after months of stop-and-start negotiations with Republicans over a bipartisan compromise yielded little progress.

As Senate aides worked through the weekend on drafting the legislation, key elements became clear, according to the people briefed on the negotiations, who spoke on the condition of anonymity because the situation was still fluid.

The consumer financial protection agency would have a director appointed by the president and the ability to write rules governing mortgages, credit cards, payday loans and a wide range of other financial products.<Continue reading.>

Today's Health Care Cartoons

"Democratic" Pollsters Unmasked

Jonathan Chait responds to the "Democratic pollsters" in If The Dems Aren't Willing To Take A November Hit, They Deserve To Lose In November:

Pollsters Doug Schoen and Pat Caddell have a Washington Post op-ed urging the Democrats to abandon health care reform out of their own self-interest:

As pollsters to the past two Democratic presidents, Jimmy Carter and Bill Clinton, respectively, we feel compelled to challenge the myths that seem to be prevailing in the political discourse and to once again urge a change in course before it is too late. At stake is the kind of mainstream, common-sense Democratic Party that we believe is crucial to the success of the American enterprise.

Bluntly put, this is the political reality:

First, the battle for public opinion has been lost.

Schoen, of course, had made the same argument, minus the professions of abiding love for the Democratic Party, in a Tuesday Wall Street Journal op-ed co-authored with Scott Rasmussen. There, Schoen made the slightly more specific claim that health care reform has held "steady." This is clearly incorrect -- as I've noted, public opinion has clearly moved in a favorable direction for reform in recent weeks:

Now, the claim that the battle has been "lost" is more subjective, and of course the answer is unknowable -- we can't tell if the recent favorable trend will continue, level off, or reverse itself. It is odd for pollsters to make such a definitive statement about the future of public opinion. They are presenting as settled fact something about which they can only guess.

To evaluate their credibility in passing off this guess as settled fact, it's worth exploring exactly who these two Democratic pollsters are. Schoen is a former Clinton pollster who, like Dick Morris, has taken a sharp rightward turn since leaving Clinton's employ, though not quite as sharp as Morris. He's the author of a manifesto, "Declaring Independence," which calls for a centrist third party to challenge the Democrats and Republicans. Here's Schoen in mid-April 2008, well after the delegate battle had been lost, urging Hillary Clinton to attack Barack Obama as an unqualified ultraliberal whose "values are out of step with voters."

His role as a pundit now consists largely of appearing in right-wing media making conservative arguments. Here he is following Obama's election win, authoring a Wall Street Journal op-ed entitled "Democrats Should Overinterpret A Victory Mandate." Two months after Obama's inauguration, he was writing another Journal op-ed, with conservative pollster Scott Rasmussen, arguing that Americans "support a different agenda and different policies from those that the Obama administration has advanced." Here he is in January writing another Journal op-ed with Caddell attacking Obama's "unprecedented attempt to silence the media." He seems to appear regularly on Fox News offering agreeable analysis to the likes of Sean Hannity.

Caddell, meanwhile, has shifted even further to the right. Appearing on Glenn Beck's show, he declared that Obama practices "gangster politics that will make Al Capone so happy." You can watch him here with far right David Horowitz, declaring, among other exotic theories, his belief that the environmental movement is a plot to "deconstruct capitalism."

In short, Schoen and Caddell's professed Democratic self-identification, to the extent that it would be interpreted as some sympathy for the party's electoral success and broad policy goals, seems highly misleading. Their analysis of public opinion on health care likewise appears to be an outgrowth of their ideological opposition rather than a fair-minded read of the data. Especially given that Schoen made a virtually identical argument in a national newspaper just three days earlier, it's hard to figure out what this op-ed is doing in the Washington Post.

Texas' Education Standards

"In St. Louis area, Obama pounds drum for health-care initiative"

Where was this guy, and his approach, 1 year ago? Wash Post:

President Obama made an impassioned case Wednesday for his health-care proposal, delivering a folksy, partisan argument for reform as industry groups prepare a multimillion-dollar advertising campaign to defeat it.

Stripping off his suit jacket and pushing up his sleeves within minutes of entering a stuffy high school gym in this St. Louis suburb, Obama criticized his Republican opposition, Washington's wasteful spending and rising insurance premiums. He spoke with evident anger about "political gamesmanship" in Washington leading to "terrible consequences," as he evoked the outsider's message that he delivered successfully in his 2008 campaign.

"Congress owes America an up-or-down vote," he said over raucous applause, which greeted his remarks at several points. "The time for talk is over. It's time to vote."

Obama's appearance at St. Charles High School was the most visible element of his endgame strategy to push through health-care legislation. Unfolding inside and outside the Capital Beltway, the effort is designed to revive the sense that passage is inevitable, a feeling that evaporated when Democrats lost their filibuster-proof Senate majority in January. One senior administration official described the final phase as "working both sides of the street."

Obama is visiting media markets that touch multiple congressional districts, particularly in swing states such as Missouri and Pennsylvania, which he visited earlier this week. He might head to Cleveland early next week for a town hall-style appearance to discuss health care, White House aides said Wednesday.

The president is delivering to his audiences a sharply populist warning that doing nothing about the health-care system would reward the insurance industry and Wall Street investors, easy targets in communities anxious about the economy. He is also calling on the public to make its opinion known to members of Congress as he works to secure enough House votes to pass the measure before he leaves the country late next week.

Wavering Democrats

At the same time, Obama intends to lobby wavering House Democrats to vote for a Senate version of the legislation and to support the subsequent reconciliation process, which Republicans have characterized as an unjustified use of majority power. Among the rewards Obama is ready to offer, White House officials said, are election-year visits to competitive congressional districts, where a presidential appearance can bring in hundreds of thousands of dollars in campaign funds.

"The president has breathed some new life into this effort," said Dan Pfeiffer, the White House communications director. "The opportunity to get this done exists, but it won't last forever."

For much of the past year, the White House health-care strategy revolved around maintaining momentum behind the politically vulnerable initiative. The effort faltered, though, as Republican critics convinced more and more Americans that it was an unwieldy and expensive government intrusion. When Democrats lost a special election in Massachusetts, and with it the Senate supermajority, the health-care bill appeared moribund.

But late last month Obama introduced his own 11-page health-care proposal. He then followed it up with a seven-hour televised work session with Democratic and Republican congressional leaders, indicating at its conclusion that he would do whatever it takes to pass a bill.

"We will continue this momentum, as you've seen in the last few weeks," said Rahm Emanuel, the White House chief of staff. "And we must keep people focused on the price of failure."

In recent days, Obama has reduced his argument to a simple campaign-style choice with a clear set of campaign-style opponents, namely insurance companies, a recalcitrant Republican opposition and a Washington political culture he campaigned against in 2008.

As he did in suburban Philadelphia earlier this week, Obama framed the debate in his 35-minute speech in St. Charles as a choice between doing something about the health-care system or leaving it unchanged, even as insurance companies announce double-digit rate increases.

Though The Reasons Differ, Divided Congress Mirrors Divided American Public On Obama's Health Reform

From Gallup (read actual pollee comments):

As President Obama begins a final push on healthcare reform, slightly more Americans say they would advise their member of Congress to vote against rather than for a healthcare reform bill similar to the one the president has proposed.

These results, based on a new Gallup poll conducted March 4-7, confirm the generally divided nature of public opinion on healthcare legislation that Gallup has found in recent months. The high point in public support was 51% in October.

"Supporters of healthcare legislation commonly cite a moral imperative as a reason for their support."

President Obama has called for a final up-or-down vote on healthcare legislation, which has dominated the domestic agenda for much of his presidency. Most of the Republican leadership in Congress would prefer that Congress begin work on a new bill rather than try to pass Obama's proposal, which is based largely on a bill the Senate passed last year with no Republican support.

The poll finds that Americans who oppose passing a healthcare bill like the one Obama has proposed do so more because they disagree with that specific approach, rather than the efforts to reform healthcare more generally. Sixty-two percent of Americans who oppose the bill would prefer that Congress start over on new legislation, while 37% say Congress should not work on healthcare legislation at this time.

Reasons Behind Support or Opposition

The poll sought to assess why Americans support or oppose healthcare legislation similar to President Obama's by asking them to say in their own words why they hold the position they do. The actual verbatim responses for all poll respondents are shown here, allowing the interested reader to review in detail the actual words Americans use to discuss their positions on healthcare reform.

Supporters of healthcare legislation commonly cite a moral imperative as a reason for their support. The most frequent specific response -- mentioned by 29% of supporters -- is that people need health insurance and there are too many without it. Another 12% specifically cite a moral obligation to provide it. An additional 4% say it would help senior citizens and 3% say it would help the poor.

Beyond moral concerns, 18% of supporters say more generally that the healthcare system is broken and in need of repair. About one in five cite cost or affordability, including 12% who say costs are out of control and 10% who believe the legislation would make healthcare more affordable.

These views have not changed greatly since September, when Gallup last asked Americans to say why they supported healthcare legislation. At that time, slightly more said there were too many uninsured and slightly fewer cited a moral obligation to provide health insurance.

There has been greater change in opponents' stated reasons for wanting to defeat the president's proposed healthcare legislation. Now, 20% of opponents say it will raise insurance costs, up from 9% in September. Nineteen percent currently believe the legislation will not address the real problems in the system, up from 10% in September.

Fewer Americans today than last fall cite a lack of information about the details of the legislation or cite general concerns about "big government."

New DNC Ad: Republicans Are Part Of The Problem

Might The Senate Bill Have To Become Law Before Reconciliation Can Occur?

I hope not. The NY Times:

The White House and Democratic Congressional leaders said Tuesday that they were bracing for a key procedural ruling that could complicate their effort to approve major health care legislation, by requiring President Obama to sign the bill into law before Congress could revise it through an expedited budget process.

An official determination on the matter could come within days from the House and Senate parliamentarians, and could present yet another hurdle for Mr. Obama and Democratic leaders as they try to lock in support from skittish lawmakers in the House.

Meanwhile, Congressional leaders and top administration officials met in the offices of the House speaker, Nancy Pelosi, on Tuesday evening trying to resolve outstanding policy differences between the chambers.

House leaders were still navigating potential pitfalls, including a dispute over provisions related to insurance coverage of abortion, while opponents of the legislation, including a leading business group, planned a new onslaught of television advertisements attacking the proposal.

Many rank-and-file House Democrats are reluctant to approve the Senate-passed health care measure without a guarantee that the Senate would follow up with changes in a budget reconciliation bill. The Senate measure included a number of provisions House members dislike, including special deals intended to secure the support of individual senators, like extra Medicaid money for Nebraska.

Democratic leaders had been contemplating an intricate legislative two-step, by which the House would approve the original Senate health care measure and both chambers would adopt a package of changes in a budget reconciliation bill. Both measures would then be sent to Mr. Obama for his signature.

Some officials said House leaders were holding out hope for a favorable ruling by the parliamentarians that would allow them to proceed as planned — or to circumvent the problem.

But Senator Kent Conrad, Democrat of North Dakota and chairman of the Budget Committee, said the reconciliation instructions in last year’s budget resolution seemed to require that Mr. Obama sign the Senate bill into law before it could be changed.

“It’s very hard to see how you draft, and hard to see how you score, a reconciliation bill to another bill that has not yet been passed and become law,” Mr. Conrad said. “I just advise you go read the reconciliation instructions and see if you think it has been met if it doesn’t become law.”

The procedural maneuvering highlighted the acute sensitivity around virtually every step in the Democrats’ push to achieve Mr. Obama’s top domestic priority.

As Democrats considered the potential parliamentary maneuvers, a coalition of business groups announced Tuesday that it was beginning a television advertising campaign to stop the health care legislation.

The advertisement says “we thought Washington understood” that jobs and the economy should be the top priority for Congress. But instead, it says, “Congress is trying to use special rules to ram through their same trillion-dollar health care bill,” with “billions in new taxes and more mandates on businesses.”

Goldman Sachs Investment Analysis Of Insurance Industry To Play Prominent Role In Health Care End Game

NY Times (read the Goldman Sachs report):

To bolster the case for a far-reaching overhaul of the health care system, the Obama administration is seizing on a new analysis by Goldman Sachs, the New York investment bank, recommending that investors buy shares in two big insurance companies, the UnitedHealth Group and Cigna, because insurance rates are up sharply and competition is down.

White House officials on Saturday said that the Goldman Sachs analysis would be a “centerpiece” of their closing argument in the push for major health care legislation. The president and Democratic Congressional leaders are hoping to win passage of the legislation before the Easter recess. Republicans remain fiercely opposed to the bill.

The Goldman Sachs analysis shows that while insurers can be aggressive in raising prices, they also walk away from clients because competition in the industry is so weak, the White House said. And officials will point to a finding that rate increases ran as high as 50 percent, with most in “the low- to mid-teens” — far higher than overall inflation.

The analysis could be a powerful weapon for the White House because it offers evidence that an overhaul of the health care system is needed not only to help cover the millions of uninsured but to prevent soaring health care expenses from undermining the coverage that the majority of Americans already have through employers.

Republicans, however, could also point to the analysis as bolstering their contention that Democrats should be focused more on controlling costs and less on broadly expanding coverage to the uninsured.

The research brief is largely based on a recent conference call with Steve Lewis, an industry expert with Willis, a major insurance broker.

In the call, Mr. Lewis noted that “price competition is down from a year ago” and explained that his clients — mostly midsize employers seeking to buy health coverage for their employees — were facing a tough market, in which insurance carriers are increasingly willing to abandon existing customers to improve their profit margins.

“We feel this is the most challenging environment for us and our clients in my 20 years in the business,” Mr. Lewis said, according to a transcript included in the Goldman brief. “Not only is price competition down from a year ago,” he added, “but trend or (health care) inflation is also up and appears to be rising. The incumbent carriers seem more willing than ever to walk away from existing business resulting in some carrier changes.”

The report also indicated that employers are reducing benefit levels, in some cases by adding deductibles for prescription drug coverage in addition to co-payments, and raising other out-of-pocket costs for employees as a way of lowering the cost of insurance without increasing annual premiums and employee contributions to them.

Kathleen Sebelius, the secretary of health and human services, is expected to discuss the Goldman analysis on two Sunday television talk shows, “Meet the Press” on NBC and “This Week” on ABC ...

Romney As A Marker To Show How Far Right The GOP Has Shifted

Johnathan Chait:

James Pethokoukis has a column pointing out that Mitt Romney's support for TARP is going to cost him support in a contested Republican primary. Likewise, Tim Noah had a terrific piece in Slate pointing out that Romney's health care position in Massachusetts was nearly identical to President Obama's. (Noah has a fun quiz mixing and matching Obama health care quotes with Romney health care quotes, and challenging readers to identify who said what.)

Romney is a useful marker in the frightening right-wing turn of his party. The GOP has been moving rightward for the last thirty years, but that shift has dramatically accelerated just since the fall of 2008. After Obama won the presidency, Republican officeholders and conservative pundits decided almost-unanimously was that the party's failure had stemmed from being too moderate.

The sudden ideological isolation of Romney is a case in point. During the 2008 GOP primary battle, he took a lot of heat for his former socially liberal positions. But his health care plan in Massachusetts attracted very little controversy. It was a classic moderate Republican plan, and one could very easily imagine Romney implementing something like it -- which is to say, something resembling the Obama plan -- had he won the presidency. Now it's seen as socialism, if not the end of American freedom. Likewise, the Bush administration and most Republicans favored TARP, but it, too, is now widely seen among Republicans as some dystopian attack on free enterprise ripped straight out of an Ayn Rand novel.

Are The Holocaust Musuem, IRS & Pentagon Murderous Attacks The Logical Extension Of Extreme Right Wing Anger Against The Feds?

Wash Post:

The setting was seemingly random: an outer gate at the Pentagon at evening rush hour. But John Patrick Bedell's violent rampage Thursday made him only the latest in the growing ranks of the disaffected and disturbed to take aim at a symbol of official Washington.

The shooting contained jarring echoes of other recent attacks, from last month's plane crash at an IRS building in Texas to the shooting last June of a museum guard at the U.S. Holocaust Memorial Museum in the District. Although the circumstances differ greatly, all were acts of rage by men who blamed their personal misfortunes on what they perceived to be sinister forces within the government.

All three also appear to have drawn ideological nourishment from the same well: online communities of like-minded people who validate and amplify extreme views. Today, more than in recent years, such communities are tapping into a broad undercurrent of anti-government discontent fueled by economic recession, joblessness and concern over the growing federal deficit, according to experts who have studied the phenomenon.

For Bedell and others like him, Washington and its institutions are an irresistible target -- the "ultimate symbol of power for the powerless," said Jerrold Post, a professor of political psychology at George Washington University.

"We've always had individuals who strike out at the giant 'system' when they're feeling a sense of powerlessness and insignificance," said Post, author of "Political Paranoia: The Psychopolitics of Hatred," a book on extremist movements. "Now we see an alarming tendency in which these same individuals can find substantiation online for almost any point of view."

Researchers who track violent groups see Bedell's rampage as a distorted manifestation of the anti-Washington view that has driven the rise of right-wing militias. A report last week by the Southern Poverty Law Center found that the number of such organizations jumped 244 percent since the election of President Obama, from 149 groups to 512, including 127 militias. At the same time, the number of extremist attacks in the United States that resulted in deaths has fallen since the 1990s.

White House officials declined to comment for the record about increased militia activity and noted that the two most recent incidents, at the Pentagon and in Austin, were perpetrated by men who had specific gripes with the government that appeared to be unrelated to the president personally.

But current and former officials privately acknowledge that the toxic political climate has heightened concerns about increased attacks. "Are we headed into a climate similar to Oklahoma City? It isn't clear," said one former administration official, referring to the 1995 attack on a federal building that killed 168 people.

A similar surge in militias and hate groups occurred during the mid-1990s, but this time the groups are interlinked to a much greater degree by the Web and mainstream radio and TV talk shows that echo many of the same viewpoints, said Mark Potok, author of the Southern Poverty Law Center report.

"People are bringing completely groundless conspiracy theories into the mainstream, and they are doing it for purely opportunistic reasons," Potok said. "To some, it may be only a ratings game, but the danger is that some people actually believe these tall tales and a few will actually act on them."

Yet the motivations for the attacks differ greatly. Joseph Stack, who flew a small plane into an IRS building in Austin, was inspired in part by the anti-tax movement. Bedell's anti-government views were more libertarian, and some were from the radical left, such as his belief that the Sept. 11, 2001, terrorist attacks were a U.S. government conspiracy. Conservative bloggers Friday sought to label Bedell as leftist extremist, noting his online tirades against President George W. Bush's administration.

"Tea party" leaders reject the notion that their movement fosters violence. "It is extremely unfortunate that certain elements are trying to malign, distort and misrepresent a movement that supports fiscal responsibility, constitutionally limited government and free markets," said Jenny Beth Martin, a national coordinator for Tea Party Patriots.

Although concern about anti-government groups has grown, the number of ideologically motivated attacks by extremists that led to deaths in the United States has not.

Senator Byrd Defends Use of Reconciliation

Prescriptions:

Senator Robert C. Byrd, 92, Democrat of West Virginia and a fierce protector of Senate rules and precedents, is defending the Democrats’ plan to use a parliamentary maneuver called budget reconciliation to finalize major health care legislation.

Mr. Byrd, the most senior senator, famously refused to support former President Bill Clinton’s effort to use reconciliation to pursue health care legislation in 1993.

But in a letter to the editor of the Charleston Daily Mail, he rejected criticism of the Democrats’ plan as short-cutting the normal legislative process. Reconciliation would allow the final changes to the health care bill to be approved by a simple majority and would circumvent a Republican filibuster in the Senate.

“I continue to support the budget reconciliation process for deficit reduction,” Mr. Byrd wrote. “The entire Senate- or House-passed health care bill could not and would not pass muster under the current reconciliation rules, which were established under my watch.”
 
He continued, “Yet a bill structured to reduce deficits by, for example, finding savings in Medicare or lowering health care costs, may be consistent with the Budget Act, and appropriately considered under reconciliation.”

Mr. Byrd also reprimanded the newspaper’s editorial board in some colorful prose.
 
“With all due respect,” he wrote, “the Daily Mail’s hyperbole about ‘imposing government control,’ acts of ‘disrespect to the American people’ and ‘corruption’ of Senate procedures resembles more the barkings from the nether regions of Glennbeckistan than the ’sober and second thought’ of one of West Virginia’s oldest and most respected daily newspapers.”

RNC Director, Not A "low-level staffer," Behind Tea Party Style Fundraising Pitch

In case you missed the story about the RNC's repugnant, Tea Party style pitch, you can read about it here.

From the Wash Post:

In the three days since the leak of a confidential and crude Republican fundraising pitch, the party's leaders have scrambled to distance themselves from the 72-page PowerPoint depiction of President Obama as a socialist Joker -- and from the man behind it. Michael S. Steele, the Republican National Committee chairman, declared the pitch inappropriate and said it was the work of a "staffer."

But Rob Bickhart, who presented the document during a retreat at a Florida resort, is no low-level staffer.

He's the RNC's finance director -- and a veteran operative in party politics at the national level. During a career that spans more than 30 years, he has served in senior jobs in the Reagan administration, the Senate and the regional transit authority in Philadelphia. In between, he has raised piles of cash for campaigns and earned lucrative fees as a hospital lobbyist.

When Steele hired Bickhart, 53, in May, he praised "his political savvy, extensive campaign experience and rock-solid reputation as a fundraiser" as "indispensable assets" for a party hungry to take back power in the Senate and the House.

Since then, the RNC has paid Bickhart and a consultancy he owns $370,000, according to Federal Election Committee records. At the RNC's winter retreat last month in Hawaii, Bickhart gave several presentations, including one to reporters on the impact of the Supreme Court decision overturning a key law that restricted corporate giving.