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Major P.R. Push To Assure Observers That Health Care Bill Is A Done Deal

There’s a major push by House leaders today to judge the health care bill a fait accompli and ensure everyone that the deal put together by both chambers of Congress and the White House, which could be topped off in the next few days, will have no problem passing the House. Expect to see a run on words like “perfect,” “enemy” and “good.” Here’s Anthony Weiner:

“I think it’s going to pass,” Weiner told me. “There are a lot of people who have drawn lines in the sand that they’re erasing furiously today.”

Weiner cautioned there was still a key sticking point: He said the bill still needed to be tweaked so that every state should get the same level of assistance from the Federal government on Medicaid funding that Ben Nelson’s Nebraska is getting. He said he needed to see this fix before he could support the bill.

But he spoke about the overall bill almost like a foregone conclusion. “There are still some various and sundry things, but it’s mostly done,” he said, referring to efforts to merge the House and Senate bills. Negotiators will produce a final bill within days.

“A lot of people recognize that we can’t let the perfect be the enemy of the good,” Weiner added.

Lynn Woolsey said basically the same thing yesterday. And this Hill article is full of the same kind of quotes.

I think there’s one thing underlying this. Democrats want health care to be over. They want to pivot away from an issue that, remarkably, is sapping at their governing capacity, after being the party associated with health care for decades. So institutionally speaking, there’s an overriding interest to rubber stamp whatever gets decided and move along. That’s why you see Joe Courtney, the point person on the excise tax, “conditionally embrace” the labor deal from yesterday. It’s why you see Woolsey saying that the final deal will be “as good as we’re going to get.” There’s exhaustion in the caucus, more than anything. Negotiators were up until 2 in the morning last night working on the bill; figuratively, it must feel like 5AM all the time.

So there’s a little theater in saying that the bill will pass. But let’s be clear that the deal isn’t done. And financing remains a problem, even with the excise tax out of the way.

Mr. Obama continues to insist that the health care bill not add to future deficits. According to the budget office, the Senate bill would reduce future federal deficits, over 10 years, by $132 billion. But when revenue from a new long-term care insurance program is set aside to pay future benefits, along with money for Social Security, the Senate bill would reduce future deficits by less than $10 billion.

So the change in the excise tax quickly put policymakers in an approximately $50-billion hole. And that hole is expected to grow even bigger as top White House officials and Congressional leaders work through other issues that will raise the cost of the legislation […]

Officials are considering a number of steps that would broaden the Senate’s increase in the Medicare payroll tax. One would be to apply the payroll tax to capital gains and other “passive” or “unearned” income. Another would be to dial up the increase in the payroll tax rate itself […]

But with so much pressure on Democrats to increase the size of the legislation, and raise subsidies to make insurance affordable, there is little room to maneuver. Officials are already looking at ways to extract more savings from the pharmaceutical industry, and scouring the landscape for other provisions known in Capitol Hill lingo as “pay-fors.”

Financing is among the many outstanding issues, including the shape of the exchanges.

And then, of course, there’s that abortion issue, which isn’t going away because House and Senate negotiators wish it would.

Pelosi seems to think that she’s got a dozen Blue Dogs willing to flip their votes from no-to-yes, ensuring passage no matter what. I’m just not convinced. I could see some of the retiring Dems, like Bart Gordon and Brian Baird, changing their vote, but anyone up for re-election faces that same troubling dynamic of voting for, by all accounts, an unpopular bill in their districts.

AND, all of this becomes much more of a moot point if Martha Coakley stumbles up in Massachusetts, and the Democrats suddenly have only 59 votes in the Senate.

So before the victory laps are taken, I’d advise everyone to a) see if there’s an actual bill, and b) see if that bill can really get the expected support.

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David Dayen

David Dayen