With Republican Chuck Grassley now saying health-care reform may come by November, John Avlon argues that centrist Blue Dog Democrats are the president's best hope to save his plan. Avlon is the author of Wingnuts: How the Lunatic Fringe Is Hijacking America.
President Obama’s health-care overhaul efforts—and his overall poll numbers—are suffering from bailout backlash. Fifty percent of Americans disapprove of the president’s health-care efforts to date, compared to 44 percent who approve—echoing the 55 percent who disapprove of Obama’s handling of the federal deficit. The Gallup poll sums up these findings neatly by saying: “Americans are concerned about the long-term implications of increased levels of government spending and the expansion of government's role in society.”
Liberals are giving into the same hyper-partisan temptations that led to the repudiation of Tom DeLay’s conservative Congress. It might be emotionally satisfying, but it’s bad long-term politics.
This should be a wakeup call for both the Obama administration and congressional Democrats. But the only people who seem to be listening are the Blue Dog Democrats, and a small bipartisan group of Senate centrists.
Attacked as villains by liberals and accused of slowing down the legislation’s passage, they are the unsung heroes of health-care reform. They are not trying to kill Obama’s initiative; they are trying to save it.
Barack Obama’s 2008 victory was not a liberal ideological mandate but a vote against the Bush era’s polarizing play-to-the-base politics. Congressional centrists are trying to help the president follow through on his rhetoric about a new era of bipartisan consultation and cooperation. They are doing the heavy lifting of trying to forge the broadest possible coalition of support, while liberal leaders encourage a narrow play-to-the-base party-line vote. In the process, congressional centrists are pragmatically looking out for President Obama’s interests in the larger electorate.
No one should know this better than Obama’s chief of staff, Rahm Emanuel, who recruited many of these centrist Blue Dogs as congressional candidates in 2006. Their selection led directly to the Democrats’ recapture of Congress after the conservatives’ ideological over-reach.
The pendulum swing of politics has a funny way of self-perpetuating. Emanuel remembers the way that Bill Clinton’s unified-Democratric control of Congress evaporated after perceptions of a left-wing lurch amid the last Democratic attempt at health-care reform. The Blue Dogs are the emissaries of this received wisdom; they are Barack Obama’s best friends on Capitol Hill right now.
The Blue Dogs are 40 or so Democrats, largely from swing districts in the South and Midwest, led by Tennessee’s Jim Cooper and Arkansas’ Mike Ross. In the Senate, centrist efforts are being led by a bipartisan group chaired by Finance Committee Chairman Max Baucus and Republican ranking member Chuck Grassley. Together, across the divisions of Congress, these two groups are consistent in their commitment to fiscal responsibility at a time of unprecedented spending.
They may be the only ones in Washington taking President Obama at his word that any health-care plan must be deficit neutral. House Democrats took a hit when the Congressional Budget Office announced that the liberal plan would add billions of new annual costs to the current system. Congressman Charles Rangel’s (D-NY) proposed surcharge tax on top earners likewise ran counter to desired narratives when it became evident that it meant the top combined tax rate in states like New York and California could approach 60 percent, feeding into Republican campaign-era claims about Obama’s incipient socialism. Centrists helped kill the surcharge and expanded the number of small businesses that would be exempted from providing compulsory coverage. And a proposed Independent Medicare Advisory Board would establish a bipartisan framework to recommend "entitlement" overhaul savings that would be presented to the president directly, helping achieve the promised deficit reduction.
But perhaps the most significant contribution of this centrist coalition to the health-care debate might be the replacement of the controversial “public option” with a nonprofit private cooperative plan, based on American models that have existed at the community level for decades. This simple switch would single-handedly defang conservative fear-mongering about the national socialization of health care. It would likewise achieve many of the practical goals of the public option, without acquiescing to the larger ideological goal advanced by liberals. This should be considered a clear win-win proposition.
Still more can be done to build a bill that incorporates good ideas from both sides in an attempt to depolarize the health-care debate for the good of the country. Individuals should be allowed to purchase health insurance across state lines, bringing the kind of increased competition that has proven its ability to reduce consumer costs. And likewise, the president should see that medical-malpractice reform long championed by Republicans is not only a way to increase support from the medical community but also a clear way to reduce the defensive medicine he rightly decries as increasing costs passed on to consumers.
With a filibuster-proof 60-seat majority in the Senate and a 256-seat majority in the House, it's no wonder that some liberal Democrats want to flex their legislative muscle with a partisan bill that ignores the need to reach out to the center. But they would be giving into the same hyper-partisan temptations that led to the repudiation of Tom DeLay’s conservative Congress. It might be emotionally satisfying, but it's bad long-term politics.
They should also be chastened by a look at American history. Every major entitlement expansion or overhaul in the past enjoyed broad bipartisan support. FDR’s Social Security Act earned the support of 81 House Republicans and 16 GOP senators. LBJ’s expansions in 1965 had the support of 70 House Republicans and 16 Senate Republicans. Even the Newt Gingrich-led 1996 Welfare reform enjoyed the support of 101 Democratic votes.
To have as historically significant and difficult a piece of legislation as health-care reform pass only along party lines would not only undercut Obama’s centrist appeals, it would constitute a considerable long-term practical obstacle to the legislation’s implementation. It would make health-care reform a lasting political division.
Despite missing the overly ambitious August deadline, President Obama still has reason to feel confident about a health-care bill’s chances of passage—precisely because he has compiled a broad coalition of support, including the historically opposing American Medical Association. The Blue Dogs and Senate centrists are the president’s best allies in terms of fulfilling his post-partisan promise on this signature piece of legislation.
The American people want a health-care overhaul that reduces consumer costs, but there is no mandate for artificial urgency or ideological purity. With legislation that has been debated since Harry Truman had it close to passage, Democrats should remember to not make the perfect the enemy of the good—or as their Founding Father, Thomas Jefferson, once wrote: “What is practicable must often control what is pure theory.”
John P. Avlon is the author of Independent Nation: How Centrists Can Change American Politics. He writes a weekly column for The Daily Beast. He served as chief speechwriter for New York City Mayor Rudy Giuliani and was a columnist and associate editor for The New York Sun.