Since even before Barack Obama's inauguration, much of the political press has been looking forward to a falling out between Obama and his fans on the progressive left. This week, they seem to have gotten what they've been looking for. The dispute itself is mostly kabuki, but the consequences for health care—for better or for worse—will be quite real.
Left-wing groups, including the activist blog FireDogLake and MoveOn.org have been pressing moderate Senate Democrats to explicitly endorse the inclusion of a robust public-insurance option in a health-care-reform package. The inclusion of such an option was an Obama campaign promise, but not all Democratic legislators are on board, and other Democrats, including the critical Senate Finance Committee Chairman Max Baucus (D-MT), seem inclined to compromise it away in the hopes of securing Republican support.
Most likely, the Obama-MoveOn spat is a bit of kabuki. Obama got to tell senators what they want to hear while in practice doing nothing to quiet the left.
Then on July 4, when no normal people were reading the newspaper, came a Ceci Connolly article in The Washington Post suggesting that Obama was displeased with MoveOn's efforts on behalf of his own idea. According to Connolly, while strategizing with congressional leaders on health reform, Obama "complained that liberal advocacy groups ought to drop their attacks on Democratic lawmakers and devote their energy to promoting passage of comprehensive legislation." Obama, in other words, wants his friends fighting for whatever it is that Congress wants to call "health-care reform" rather than fighting about what health-care reform looks like.
Things really heated up when Rahm Emanuel told The Wall Street Journal that the administration would be open to a compromise idea in which a public plan would come into play only if a "trigger" is reached. The theory behind the trigger is that private insurers ought to be given a chance to lower costs and improve quality without facing competition from the public sector. If they fail, then a public plan might come into play at some future point. Public-plan supporters deem this idea unacceptable. They observe that the health-insurance market is already highly concentrated. In small rural states, in particular, it's typical for the top two insurers to control a huge share of the market. In Alabama, Blue Cross Blue Shield alone has an 83 percent market share. This means that in any real sense, the "trigger" for more competition should already have been tripped, and the inclusion of a legislative trigger mechanism is seen as simply a way to kill the plan. With legislation passed, the public mobilization around health reform will fade away, and special interests can ensure that the trigger is never pulled.
MoveOn responded by having its members hit Emanuel. Public-plan supporters on the Hill, like Chuck Schumer (D-NY), were clearly taken aback, and the White House had Obama issue a statement that kinda sorta walked back Emanuel's comments without really contradicting him.
There is, however, likely less to this matter than meets the eye. With regard to Emanuel's remarks, I wasn't thrilled with them. At the same time, if Congress passes a bill that subjects the insurance industry to tighter regulation, expands eligibility for Medicaid, establishes new health-insurance exchanges to make it easier for the self-employed and small businesses to get insurances, offers subsidies to make insurance more affordable, and also provides for a public plan to be implemented via a trigger mechanism, does anyone really think Obama would veto that bill? Certainly I don't. Back in February, Obama outlined eight principles for health reform and anything that arguably hits all eight—or even six or seven—would have to be judged a bill worth signing. Similarly, if Obama really wants MoveOn to stop, he picked an odd way of going about it. A private but direct message to the MoveOn leadership might have persuaded them. Comments to members of Congress that are conveyed through The Washington Post, by contrast, in practice make it impossible for MoveOn to stop without looking ridiculous in the eyes of its membership.
Most likely, this is a bit of kabuki. Obama got to tell senators what they want to hear—that he’s protecting them from their left flank—while in practice doing nothing to quiet the left. As Ezra Klein put it, his warning is "a bit like one of those Captain Morgan ads where they loudly and publicly advise you to 'drink responsibly' while still, you know, selling alcohol in large quantities."
The real issue here is that reasonableness is a losing quality in legislative negotiations. It doesn't make sense to kill an otherwise good health-care bill just because it doesn't include a public option. But by the same token, it also doesn't make sense to kill an otherwise good health-care bill just because it does include a public option. But if legislative leaders know that one side is willing to be reasonable and the other side isn't, then they'll ensure that it's the unreasonable side that wins. Congressional leaders, at the end of the day, are about assembling majorities by any means necessary, not about logic or consistency. And progressive activists, by threatening to be unreasonable, are starting to make progress.
Just yesterday, Senate Majority Leader Harry Reid unexpectedly told Baucus to stop chasing Republican votes and try to put together a bill that Democrats can support. And there's similar talk from the House of Representatives, where leaders are trying to communicate to the White House and the Senate leaders that only a bill with a public plan can pass.
This is all to the good if it works. But it is a dangerous game. Way back in 1974, a scandal-weakened Richard Nixon was prepared to agree to a universal-health-care compromise plan brokered by Ted Kennedy. But ultimately congressional liberals and left-leaning interest groups killed the plan, anticipating better times to come after the midterm elections. Thirty-five years later, you don't see anyone who thinks that was a smart move. A credible threat to do something irrational, in other words, can be a powerful force in politics. But actually following through can be a huge mistake.
Matthew Yglesias is a fellow at the Center for American Progress Action Fund. He is the author of Heads in the Sand: How the Republicans Screw Up Foreign Policy and Foreign Policy Screws Up the Democrats.
