Health-Care Reform's Winners and Losers
It doesn't take a rocket scientist—or even an alleged expert such as this reporter—to see that the big political winner in tonight's House vote is the president of the United States. After more than a year of fitful but increasingly focused effort, Barack Obama is able to claim victory in an effort that he had made the emblem and focus of his entire presidency. In some ways, the win was a negative one: the humiliation of a defeat would have made him look powerless and inept. And in Washington, appearances beget reality. But, hey, as teams in the NCAA basketball tournament can tell you, a win is a win.
The list of winners and losers only begins with the president. Here is my sense of who they are, in both political and real-life terms.
WINNERS
Obama: He staked everything on this and, like the long-distance runners from his father's homeland, he made it (barely) across the finish line.
Nancy Pelosi: They said she knows how to count votes, and she does. They can't stand her in Tea Party America, and some liberals are angry at her, but she knows how to deliver.
Rahm Emanuel: The White House chief of staff was tasked by Obama with the job of getting this done, and Emanuel, whose effectiveness and commitment have been questioned, has just taken a major step toward showing that he was the right guy for the job.
Near-poverty Americans not covered by Medicaid: Some 15 million more Americans than currently have it will get health care through Medicaid.
Middle-class families who can't afford to buy insurance: Some 15 million will eventually get subsidies.
Policyholders: For the first time, the federal government will impose rules designed to control some of the risk-avoiding (and profitmaking) strategies of the insurance companies.
Drug companies: They kicked in $80 billion to help make the bill work, but stand to make 10 times that amount in revenues from added government and government-subsidized business.
Tea partiers: They are crying havoc (outside the Capitol) and now have their cause, apocalypse and all.
LOSERS
Insurance industry: The health-care industry grew out of insurance, which has never been subject to direct and thorough national regulation by the federal government. It stayed aloof from a deal, and ended up losing the game of musical chairs, even though it will get new customers.
Blue Dog Democrats and Democrats from GOP districts: There is still time for them to recoup—Election Day is still eight months away. But this vote is a loser for many of them, and they know it.
Wealthy and semi-wealthy taxpayers: Those making $200,000 individually or $250,000 as families are going to get squeezed—and they should know it. The bill makes big assumptions about spending cuts. Most realistic and neutral observers believe that those "savings"—in Medicare, for example—will never happen, which means more deficits.
The Republican Party: It will gain seats in the midterms for sure, but not necessarily as many as it is assuming. For one, the world is not going to end if and when the bill becomes law. In fact, nothing much at all will happen. That will be a relief to many, and no grist for the GOP. The Dems will have something to run on, and the Democratic president will look like a winner.
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Howard Fineman is Newsweek's Senior Washington Correspondent and Columnist, senior editor and deputy Washington bureau chief. He is the author of "Living Politics," a column that began on MSNBC.COM and Newsweek.com and that now also appears in the print magazine. An award-winning reporter and writer, Fineman also is an analyst for NBC News and MSNBC, appearing regularly on "Countdown with Keith Olbermann," "Hardball with Chris Matthews" and "TODAY." The author of scores of Newsweek cover stories, Fineman's work has appeared as well in The New York Times, The Washington Post and The New Republic. His 2008 national best-selling book, "The Thirteen American Arguments," was released in paperback by Random House in the spring of 2009.
One of the nation's leading political reporters, Fineman has interviewed every major presidential candidate from (then-vice president) George H.W. Bush in 1985 to (then senator) Barack Obama early and often in the 2008 campaign cycle. His current work focuses on the Obama Administration and its top officials, as well as on Congress and politics throughout the country. Although based in Washington, Fineman travels widely in the U.S. and has covered politics and other events in 49 of the 50 states.
Fineman's work has produced many milestones and awards. A cover story in November 2001 featured President George W. Bush's first extensive interview after 9/11. Another cover, "Bush and God," was part of a series of articles that won the 2003 National Magazine Award for General Excellence. His reporting has helped Newsweek win many honors from the Magazine Publishers Association and the American Journalism Review. Other awards include a "Page One" from the Headliners Club of New York, a "Silver Gavel" from the American Bar Association and a "Deadline Club" from the Society of Professional Journalists (SPJ). In 2006 he received the Alumni Award from Columbia University's Graduate School of Journalism.
As a reporter and writer, Fineman ranges widely. Besides campaign-year covers, other projects have included: race and politics, the impact of digital technology on society, the influence of Hollywood on politics, the rise of the religious right and of conservative talk radio. He has interviewed business leaders such as George Soros, Bill Gates, Steve Case and Robert Rubin and entertainment figures such as Warren Beatty, Jane Fonda and Jay Leno.
Although now under exclusive television contract to NBC, Fineman over the years has appeared on major public affairs shows, such as Nightline, Face the Nation, Fox News Sunday, Larry King Live, Charlie Rose and the NewsHour. He was a regular panelist on Washington Week in Review on PBS (1983-95) and on CNN's Capital Gang Sunday (1995-98). He worked with Ted Koppel on Nightline specials, and has been a guest on Comedy Central's "The Daily Show with Jon Stewart" and "The Colbert Report."
A native of Pittsburgh, Fineman began his career at The Courier-Journal in Louisville, covering the environment, the coal industry and state politics before joining the newspaper's Washington bureau in 1978. He moved to Newsweek in 1980, was named chief political correspondent in 1984, deputy Washington bureau chief in 1993, senior editor in 1995 and senior Washington correspondent and columnist in 2008.
Fineman holds an A.B., Phi Beta Kappa, from Colgate, an M.S. in journalism from Columbia and a J.D. from the Brandeis School of Law at the University of Louisville. His legal education included a year as a visiting student at the Georgetown University Law Center. He received Watson and Pultizer Traveling Fellowships for study in Europe, Russia and the Middle East, and has traveled to more than 40 countries, among them China, Vietnam, Japan, Ukraine, Israel, Turkey and the West Bank Palestinian Territories.
Fineman is married to Amy L. Nathan, a senior counsel at the Federal Communications Commission. They live in Washington with their two children, Meredith and Nicholas.
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