What Are Pro-Life Democrats?

Well, to start with, they're Democrats. I'm not belaboring the obvious. It is vital to remember that "pro-life Democrats" add numbers to the entire Democratic majority. Single-issue abortion opponents tend to forget that simple fact, and it cost them dearly. Bart Stupak just proved that in order to remain a loyal Democrat, he was willing to take the most ridiculous of promises from a lying president in exchange for his yes vote on a health care bill that will quickly begin funding abortions.

My home state was sold out by two Democrats who exchanged their votes for a temporary 25% increase in water allocation to their water-starved and jobs-starved Central Valley districts. Stupak sold out for a meaningless executive order which may not even come to pass. They can try to cover their cowardice with proclamations of "doing it for their constituents," but the real fact is they did it because they're Democrats. Look at Stupak carefully. If he hadn't taken his early anti-abortion funding stand, would any moderate to conservative citizen have considered voting for him? Did anybody notice that Stupak enthusiastically embraced the socialist takeover of American health care, except for the abortion funding?

This is the danger of single-issue myopia and support for anti-abortion candidates who belong to a party that is dedicated to the dismantling of the Constitution and government control of our lives. They will ultimately prove unable to shed their political loyalties completely, and will cave in when given even the thinnest thread to hang onto from their leaders. Stupak might just as well have said "you knew I was a snake before you brought me in."

My point here is that for conservatives, it is far safer to trust a moderately pro-choice Republican than a nominal anti-abortion Democrat. Anti-abortion Democrats will support the statist Democratic Party over almost anything, including their own alleged principles. Look at the history of Democrats who used anti-abortion rhetoric, only to toss it to the winds when political opportunity came their way. Start with the early Bill Clinton. As a governor in a state and region which was largely anti-abortion, he spoke out against abortion itself, not merely funding of abortion. But as he wended his way to the presidential nomination, he realized he needed the votes of the pro-abortion states, so he turned the anti-abortion rhetoric down nearly to zero. In that inimitable Clintonesque way, he ultimately took the ridiculous position that supporting federally-funded unrestricted abortion would make abortion "legal, safe and rare."

For those of you who think of Joseph Lieberman as your "favorite Democrat," remind yourselves of this. Joe Lieberman is a devout orthodox Jew. He bravely stood against his party on abortion because of his religious convictions. And he took more than one serious hit for it from within his own party. And then the siren song began to be played. "Joe, you could be vice-president of the United States. Just stop opposing abortion." And Joe did just that. After a few closed-door sessions, Joe found out that orthodox Jews don't actually oppose abortion, they support a woman's right to choose. Most of my orthodox and conservative Jewish friends were mystified, but then they hadn't just been offered the vice-presidency (or they weren't Democrats).

Some of the pro-life Democrats simply switched sides, with little explanation beyond their belief in socialized medicine as being more important than a few million unborn babies. This gang includes Ben Nelson of Nebraska and Bob Casey of Pennsylvania. In the past, such illustrious Democrats as Jesse Jackson and Ted Kennedy were originally pro-life, but found political expediency to override any objections they might have to abortion. And let us not forget Al Gore's vote for legislation that would have defined an unborn baby as a person protected under the 14th Amendment. He relented in fairly short order when the possibility of the presidency loomed before him.

Dennis Kucinich (believe it or not) was anti-abortion until he sought the Democratic nomination for president in 2004. Oops, switch. He still opposed abortion funding until he got a ride on Air Force One. Another notable, if less well-known switcheroo was that of Congressman Tim Ryan of Ohio. He was a board member of Democrats for Life of America. He was elected largely on the single-issue votes and money of National Right to Life. He got caught lying when he introduced an "abortion reduction bill" that paid lip service to reducing abortion while providing vastly increased funding to the largest abortion provider in America--Planned Parenthood. He didn't even have the decency to resign from Democrats for Life of America, so they kicked him out. As Al Gore brilliantly announced a few years back, "a leopard can't change its [Democrat] stripes."

So why would a big government, Constitution-disdaining Democrat run as anti-abortion (or in some cases, anti-gun control)? The most common answer is that he or she really doesn't care that much about the issue, but it's hot-button in that district. A candidate could simply adopt that issue as his or her own, and dodge the other issues or waffle on them. Or maybe the candidate actually believes in the issue, but is so weak about it that a promise, any promise, no matter how weak, will convince the candidate to change his vote in exchange for some "greater good" (in Stupak's view, a foggy promise of a meaningless executive order overrides his objections to abortion so that he can get that socialized medicine he really wants).

In addition, as illustrated by multiple examples above, any Democrat who wants to rise to a level above the local district had better be ready to make major compromises on the single or double issues that originally got him or her elected. No truly pro-life Democrat candidate is going anywhere unless willing to abandon pro-life or the pretense of pro-life at some point. Anyone who votes for a pro-life (or pro-gun) Democrat is automatically voting for the overall liberal/socialist agenda of the Democratic Party. And for their efforts, they're likely to see their Democratic representative cave in on their single issue when the going gets tough. Nothing could prove that better than the vote last Sunday.

Turning the coin over, you will now see why I tend to believe that a moderate pro-choice Republican is preferable to a seemingly pro-life Democrat. Certainly our preference is for pro-life, conservative Republicans. But there's that single-issue problem again. (Cautionary note: I never include RINOs in my definition of "moderates," but for purposes of this discussion, they might even be included). Just as voting for a Democrat includes voting for the Democratic agenda, so voting for a Republican includes voting for the Republican agenda.

As a majority party, the party agenda becomes evermore important. In another time, with a Republican majority and a Republican President, the Stupaks in Congress might not have been nearly so willing to abandon their stated principles. But some Republican moderates (and possibly even some RINOs) might be convinced to change their views when the Speaker of the House, the Majority Leader of the Senate, and the President are all Republicans with the ability to pass out those goodies that the Democrats now control. Numbers count, and only when the two majority Congressional caucuses are in the "R" column can those goodies be dispensed and those political futures secured.

Just as abortion is a credo which all aspiring Democrats must embrace, so is anti-late term abortion in the Republican Party. Ditto for federal funding of abortions. So have general Republican principles on important issues ever affected the votes or political campaigns of Republicans? Mitt Romney is one example. As governor of Massachusetts, Romney took a nominal pro-choice stand. But he wanted to be the president of the United States. Oops, switch. He had no chance of national Republican support for his candidacy if he stuck to his pro-choice rhetoric. (Side note: Romney now has another albatross around his neck. The just-passed Senate health care reconciliation bill is nearly identical to the Massachusetts plan that Romney supported. He's got some 'splaining to do on that as well).

Rudy Giuliani was pure RINO when it came to partial-birth abortion. Right up until he was bitten by the presidential bug. Although he still hasn't become pro-life, he now condemns partial-birth abortion. His exact words when he first made the switch are telling. When asked during his presidential run how he would feel if the Supreme Court overturned Roe v. Wade, Giuliani replied: "It'd be OK." In 1996, Sen. Johnny Isakson of Georgia ran as pro-choice. Today he is pro-life, and campaigns for fellow Republicans who are also pro-life. And while he was at it, Isakson turned anti-gay marriage and pro-gun ownership.

So look at it this way. A pro-life Republican has no incentive whatsoever under a Democratic or Republican administration to change his views. A pro-life Democrat does when the Democrats are in control. A moderate pro-choice Republican might have a reason to switch in a Republican Congress, but none have any incentive at all to support federal funding in any form. Whatever their personal views, pro-life Democrats have an incentive to vote pro-choice in a Democratic majority, and pro-choice Republicans would have an incentive to vote pro-life in a Republican majority. Numbers count.

Any pro-life Democrat will ultimately be forced by circumstances into supporting the Party's overwhelmingly pro-choice candidates. Any pro-choice Republican will ultimately be forced by circumstances into supporting the Party's overwhelmingly anti-abortion on demand candidates. Those who seriously and consistently oppose the general Party principles and beliefs will find themselves without support from their own party, and either out of office or switching parties. The Democrats have known and imposed this reality for many years. The current Republican leadership is learning, fast.

As Adam Graham, a writer on PajamasMedia has said very well: "The goal of pro-life activists shouldn't be to elect dishonest and self-serving Republicans who only see the light after feeling the heat. The goal should be to elect sincere, committed statesmen who take a pro-life stance. However, to avoid the waste of money, credibility and patience brought about by pro-life sunshine soldiers like [Democrats] Bart Stupak, Ben Nelson and Tim Ryan, pro-lifers would do best to invest their efforts in the Republican Party only."

I'll close this post with a quote from Shakespeare aimed directly at the Bart Stupaks of this world: "How many cowards whose hearts are all as false as stairs of sand wear yet upon their chins the beards of Hercules and frowning Mars, who have inward searched, have livers white as milk." (The Merchant of Venice).
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Can They Pass DonkeyCare By Reconciliation?

The big question over the past few days has been whether or not the Democrats can pass their health care reform creature using the reconciliation process. Answer: It’s not clear. Indeed, the process will be much more difficult that people realize.

1. The Non-Filibuster Filibuster

We all know the Republicans can’t filibuster DonkeyCare if the Democrats go the reconciliation route, right? Actually, that’s not entirely true. While debate would be limited to only 20 hours, there is no limit to the number of amendments that can be offered to slow the process down. Republican Sen. Judd Gregg (R-NH) pointed this out in a letter a few months back, which the Democrats called “a manual on obstruction.” Sen. Jim DeMint (R-SC) has promised to offer enough amendments to delay any vote until November.

2. The Byrd Rule

Any reconciliation attempt will run smack dab into “the Byrd Rule” (Section 313(b)(1) of the Congressional Budget Act). The Byrd Rule is a Senate rule that determines what can and what cannot be done through reconciliation. If any part of the legislation does not satisfy the six part test created by the Byrd Rule, then that portion of the bill can be knocked out of the bill as the bill passes through reconciliation.

Of particular interest, the Byrd Rule provides that elements in bills that are not strictly designed to have a budget impact can be removed on points of order. Many believe this would prevent the Democrats from getting their abortion language through this process, and their attempts to impose requirements on private insurers. Without the insurance provision, this is nothing but a health care tax bill.

There is one caveat on this, however. To achieve this, the Republicans need to raise point of order motions against the individual pieces. These are decided by the Senate Parliamentarian. But Joe Biden could overrule the Parliamentarian. However, he would need to do so in direct opposition to parliamentary procedures and likely CBO conclusions. In other words, Slow Joe not only would need to lie, he would need to accuse the CBO and the Senate Parliamentarian of incompetence. And while worthless Joe is certainly shameless enough to make himself into a hated national joke, it is questionable whether many Democrats would be comfortable following his lead.

There are other exception, but they must be certified by the Senate Budget Committee chairman AND the ranking minority member, i.e. Mitch McConnell. So there is no chance of that.

4. Reconciliation Expires.

Right now, many on the right fear the Democrats will willingly sacrifice themselves with the idea that once a bill like this is passed, it will stay passed, i.e. the Republicans won’t have the nerve to repeal it. Thus, they win by shifting the country permanently to the left. This is wrong.

First, it totally misunderstands human nature. Current politicians will not sacrifice their careers so that their party can make ideological gains in the future. Indeed, as Rep. Jason Altmire (D-Penn) noted, “People who voted YES would love a second bite at the apple to vote NO this time, because they went home and got an unpleasant experience. On the other hand, I don't know anybody who voted NO who regrets it.” That hardly sounds like wagon circling.

But more importantly, everyone is forgetting that reconciliation bills expire. That’s right. Whatever the Democrats pass would need to be renewed (usually in either five or ten years), or it will repeal itself. It will take the Democrats more than ten years to recover from this debacle, which means renewal ain’t happening. Thus, when Democrats start to realize that they are being asked to sacrifice their seats for a half-bill that will expire a few years after they are cast out of office, Pelosi's support will collapse.

5. Pelosi doesn’t have the votes.

Finally, as I noted the other day, several Democrats are now starting to waver, and it’s fairly clear that Pelosi doesn’t have the votes to get this out of the House. With Pelosi losing four of her 220 votes already, she is now one short, barring further surprise. They have now announced that nine Democrats who voted NO may reconsider, but they have offered nothing solid to date. Moreover, this still only leaves Pelosi with a five vote margin before the other 216 Democratic YES's weigh in.

And Bart Stupak has indicated that his band of supporters cannot live with the Senate bill, and that the abortion language is just the first problem they see. Others are making similar noises about their pet peeves as well.

Further adding to the suspicion that Pelosi lacks the votes, she is now demanding that the Senate go first on the reconciliation process before she tries to pass this bill through the House. That's a pretty clear indication she lacks the votes.

Finally, let me finish with the very wise words of Republican Representative Marsha Blackburn (R-TN), who notes that: “If they had the votes, we wouldn’t have had the summit.”


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PelosiCare’s Pyrrhic Victory

Once again, the MSM has it wrong. The House voted 220-215 to pass PelosiCare and today the media is busy celebrating Nancy Pelosi’s “victory.” But I wouldn’t buy the confetti just yet. As I see it, last night made it much more difficult for the Democrats to pass any version of ObamaCare. What a shame. Consider the following. . .

1. The Senate Problem

Passing the Baucus bill was already going to be a challenge. As we discussed before, the Democrats lacked the support of two key Senators -- Snowe and Lieberman, with several more sitting on the fence.

The House bill goes much further than the Senate bill. Indeed, even noted RINO Sen. Lindsey Graham (R-Reid’s Lap) stated today that: “The House bill is dead on arrival in the Senate. It was a bill written by liberals for liberals.”

Joe Lieberman likewise re-confirmed that he would not allow any bill that includes a public option to reach a vote in the Senate:

“If the public option plan is in there, as a matter of conscience, I will not allow this bill to come to a final vote because I believe the debt can break America and send us into a recession that's worse than the one we're fighting our way out of today.”

If Lieberman is to be believed, he will not let a bill pass that could result in a public option after the bill is reconciled with the House bill. But the House lacks the votes to pass anything that doesn’t include a public option. Basically, it’s a stand off.

Moreover, seeing that the House does not have the votes to move toward the center, and the Senate will not move left to meet the House, one should expect opposition to grow in the Senate to even putting this thing to a vote. Why vote on something that cannot pass? Indeed, I’m suspecting that several Democrats are quietly sending thank you letters to Snowe and Lieberman as we speak.

Thus, Pelosi’s inability to play well with others, her unwillingness to compromise and her inability to seek consensus before acting, may have just made a Senate vote much less likely. . . which would kill ObamaCare.

2. Unresolved House Problems

Even aside from the Senate problem, passage in the House actually still remains in doubt. Indeed, this vote solved nothing, it just put off the moment of decision:

• The Abortion Problem

Abortion has been a serious problem throughout this entire process. As we stated before, there are a group of 40 or so House Democrats, led by Rep. Bart Stupak (D-Mich) who have stated that they will not vote for any bill that allows the use of public funds to pay for abortion. On the other side are a group of about 190 pro-abortion Democrats who will not vote for this bill if it does not cover abortion. Another stand off.

Pelosi “resolved” this dispute with a stupid bit of double-dealing. She let the anti-abortion group insert language (tougher than they even demanded originally) into the bill, but she simultaneously promised the pro-abortion group that this language would not be in the final bill. Indeed, Rep. Janice Schakowsky (D-Planned Parenthood) has already stated that if the restrictions imposed by Stupak make it into the final bill, “many of us couldn’t support it at the end of the day.” Rep. Diane DeGette (D-NARAL) called this “the greatest restriction of a women’s [sic] right to choose passed by Congress in our career. [sic]”

So the problem remains. Both sides have the power to kill the bill, and neither side will budge. And even if this can ultimately be resolved, do nervous Senators take that chance and put their votes on record?

By the way, let me credit the Republicans with backing the Stupak amendment and thereby keeping this controversy alive. Brilliant tactical move.

• Illegal Aliens

Both the House and the Senate bill explicitly prevent illegal aliens from using the new system. This is a requirement for the bill to pass. But then. . . Rep. Raul Grijalva (D-Mexico) said that Hispanic lawmakers got a pledge from the House leadership “to defeat” any attempts to insert language that bars illegal aliens from participation, and they would oppose the final bill if it contained such language. Hmm.

3. Why Support Will Fall, Not Rise

Further, don’t expect support for this bill to grow, as usually happens after a bill passes. Normally, Americans give the benefit of the doubt to bills after they pass, and give them a chance to work. But support for this bill will not rise, it will fall as more and more negative details keep slipping out. Take a gander at these. . .

• Insurance Is Too Expensive

Section 224 of the bill requires the HHS Secretary to decide what constitutes a qualified plan within 18 months. On November 2, the Congressional Budget Office estimated what these “qualified plans” would likely cost. An individual who earns $44,000 will need to pay $7,300 a year -- 17% of their pre-tax income. A family earning $102,000 will need to pay $20,300 -- 20% of its pre-tax income. That will go over like a lead balloon.

But the public option or the exchanges will save us right? Actually, no. According to the CBO the public plans “would typically have premiums that are somewhat higher than the average premiums” for private plans.

• Options? You Don’t Need No Stinking Options

Under Section 303, the bill appears to provide for three options -- basic, enhanced and premium levels. But those levels refer only to the co-pays and deductibles (and you thought those would go away?). The plans themselves will be “one size fits all” in terms of coverage.

• The Jail Thing

The House Joint Committee on Taxation has confirmed that Pelosi can send you to prison if you don’t get coverage. Anyone who does not get acceptable health insurance coverage and who refuses to pay the fine (2.5% of income) is subject to a fine of $250,000 and imprisonment up to five years -- about what you get for armed robbery.

Interestingly, House Majority Leader Steny Hoyer (D-FascismLand) notes that: “There’s just going to be some people who choose rather to pay the fine than to pay for health care. There’s going to be some people that just philosophically don’t want to buy health care.” And if they don’t, we make them political prisoners. . . for the good of the American Volk!

• The Uninsurable Problem

The biggest supporters of this bill are the five million uninsurable Americans who think they’re going to be covered. But they’ve just learned that they need to wait six months to be considered uninsurable. Said the American Cancer Society, “if you are a cancer patient and have cancer now, you can’t wait six months to go into a plan because your condition can go from bad to death.”

Moreover, they won’t be able to afford their insurance. PelosiCare lumps these people into pools with other uninsurables, which pools are supposed to be self-sustaining. Translated into English, your premiums will be thousands of dollars a month.

To cut this cost, the Democrats have allocated just $5 billion dollars. That works out to $1,000 subsidy per participant over a ten year period -- less than $10 a month. Any chance that’s all it takes to help pay for someone with an uninsurable condition? And if that’s all it takes, why not just get Sally Struthers to beg rich foreigners for $10 a month. . . “33 cents a day can change a life.”

• The Funding Problem

Even leaving aside who the Democrats plan to tax to pay for this -- currently an impassable point of contention between the House and Senate -- this bill contains a bizarre contradiction: it relies on people refusing to participate to pay for the bill. Indeed, the House assumes that millions of Americans will rather pay the fine than buy the health care, to the tune of $167 billion. If these people fool us and sign up for the bill, this money vanishes. Chaos ensues.

• The End of Medicare As You Know It

The bill also cuts $500 billion from Medicare, a program that already bankrupts doctors. But what’s worse, the bill fundamentally changes the way Medicare works by allowing Pelosi to dictate your treatment decisions.

Section 1302 of the bill introduces something called a “medical home,” which is euphemism speak for an HMO. Right now Medicare lets you choose your own doctor and the doctor is paid for each service provided. This new plan requires primary care providers to determine whether or not you can see specialists or get specific tests. The CBO says these medical homes will resemble “unpopular gatekeepers of 20 years ago.”

• Interest Group Payoffs

Finally, the bill is crawling with giveaways to left wing interests. For example, Section 299V gives money to community groups. Section 222 provides reimbursement for culturally and linguistically appropriate services. ¿Qué es eso? And Sections 2521 and 2533 establish racial and ethnic preferences in nurse training.

4. Democrats Exposed

This has all the makings of a pyrrhic victory. How pyrrhic? To give Pelosi her moment in the sun (not literally of course, because that would kill her. . . but figuratively), the Democrats have now exposed themselves to the American people.

The public hates this bill. Poll after poll shows support dropping like a stone in a lake -- 42% at last check. And the elections in Virginia and New Jersey demonstrated the level of anger the public holds. Even Owens in New York had to promise to oppose PelosiCare to get elected, a promise he promptly broke.

With this vote, the public now sees the Democratic Party laid out in all of its public-ignoring, healthcare-system-seizing, petty-tyrannical glory. Leftist bastards. There is no hiding anymore. No one who voted for this monster can claim to be a moderate. . . and, best of all, they exposed themselves for the sake of a bill that will never pass!

And let’s not forget the “Blue Dogs” who voted against this thing. They aren’t blameless. They could have stopped this thing long ago on numerous procedural votes. They also could have joined with Republicans to create real reform. . . but they didn’t. They are as complicit in this assault on America as if they had loaned Pelosi the crowbar.

Moreover, their vote was nothing but self-preservation. Of the 39 Democrats who voted against the bill, 31 represent (and I use that term loosely) districts that voted for Old Man McCain over Menthol Smooth B. Obama. Of the remaining eight, three are freshmen who defeated Republicans in 2008. One Democrat, Rep. Betsy Markey (D-FingerInTheWind) only voted “no” after it was clear the Democrats had the votes to pass the bill.

So in the end, while the left trumpets this as a victory, this could well turn out to be the most pyrrhic victory in the history of pyrrhic victories.

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Why The Baucus Bill Probably Won't Pass

For some time now, I have doubted that Obama would get ObamaCare. I did think, however, that he would get some face-saving version. The Baucus bill is that face saving version. But now I’m not so sure even that will pass. And even if it does, a Republican majority should be able to repeal it fairly easily. Let’s take this in two parts. Today is part one: why the Baucus bill might not pass.

There are five primary reasons that the Democrats might not be able to garner the support they need to pass this bill: (1) the lack of a natural constituency supporting the bill, (2) the cost, (3) disputes over how to pay for the bill, (4) disputes over the public option and (5) abortion.

1. The Lack Of A Natural Constituency Supporting The Bill

Before we delve too deeply into the Democrats’ errors, it is important to point out that legislation does not pass on its merits. Legislation passes when enough Congressmen/Senators think it is in their interests to support it.

It is difficult to support a bill that the public hates, and the public hates the Baucus bill: only 42% support the bill. Yet, widespread public opposition can usually be overcome in the legislative process by a motivated constituency. The Baucus bill, however, has no such constituency. Indeed, each of the attempts to create a constituency have failed:

(1) The Public. From the beginning, the Democrats promised to subsidize the cost of health care for nearly everyone in the country. They intended to undercut the public’s fears that this legislation would increase the cost of their health care. But they made two mistakes. First, while the Baucus bill promises subsidies to approximately 67% of Americans, individuals won’t see that money -- it will go directly to the insurers. That makes this a meaningless bribe because the public doesn’t know they will be getting it.

Secondly, the public does not believe this will help. They believe the subsidy (likely less than $200 a year) will not offset the increase in insurance cost (several thousand dollars a year). In fact, they don’t believe any part of the bill will be good for them.

If you examine the chart below, from Gallup, you will see that only 19% of the public believes this bill will improve the quality of the health care they receive, whereas 39% think it will make it worse. Only 22% think it will control the health care costs they pay, whereas 49% think it will make them worse. And only 20% think it will improve their coverage.

Even the bill’s supporters don’t think it will work:

Those numbers are guaranteed to scare every Democrat who faces reelection in the next cycle -- most of whom are already skittish.

(2) The Insurance Lobby. The Democrats blamed the insurance lobby for killing HillaryCare in 1992. So this time, they set out to make the insurance lobby an ally by promising insurers they would get to write policies for another 46 million Americans. This worked at first, until it became clear that the Democrats intended to create a public option or health care co-ops. This would be a disaster for most insurers.

Indeed, according to Republican Paul Ryan (R-Wisc.), who gave an impressive interview about this bill, this bill is likely to lead to the collapse of all but the largest insurers. He notes that the Baucus plan prevents insurers from using underwriting techniques to set rates (e.g. they can’t adjust policies to account for certain conditions). Because insurers need that flexibility to account for different expected costs, he reasons that most of the nation’s 1,300 insurers will be unable to issue profitable policies. Thus, they will be forced out of the business, leaving only a handful of large insurers to occupy the field.

Because of this potential disaster, the insurance industry has now abandoned their support and turned against the plan. Consequently, the Democrats are now threatening to attack the insurers with anti-trust laws, thereby guaranteeing the vehemence of the insurers’ opposition.

(3) Hospitals. The Democrats wanted to get hospitals on board (i) by increasing federal reimbursement for the “unreimbursed expenses” hospitals incur in treating the poor and illegal aliens and (ii) by cutting hospitals’ medical malpractice costs.

In 2008, hospitals provided $35 billion worth of uncompensated care (for the uninsured); 80% of this was reimbursed by the government. Most of this went to cover illegal aliens. But illegal aliens won’t be covered by Baucus, thus nothing will change for the hospitals. What’s worse, in July 2009, the White House announced (supposedly after reaching an agreement with hospitals) that it would be cutting the amount it reimburses hospitals under Medicare/Medicaid by $155 billion, to pay for ObamaCare. That’s a $190 billion loss from what hospitals had expected.

Moreover, while the GAO now confirms that medical malpractice reform could save $54 billion over 10 years, and while hospital groups including the American Hospital Association have been shopping malpractice reform plans, the Democrats have offered nothing more than a minor “demonstration project” to study the issue.

(4) Doctors. Democrats hoped to get doctors on board by promising increased reimbursements. But that has turned into a disaster. Here’s why. Medicare/Medicaid do not pay doctors enough to make it worth their time to treat those patients. Indeed, there are thousands of stories of doctors literally going broke trying to treat Medicare/Medicaid patients, and many now refuse to take such patients. In 2003, Congress tried to fix this by providing a temporary boost in the payment amounts until the system could be reworked. That boost runs out next year. If nothing is done, doctors (who already can’t afford to take such payments) will have their reimbursements cut by 21%, with a 40% cut following the year after. To prevent this happening, i.e. not fixing the problem but merely keeping the current reimbursement scheme, Congress must spend another $247 billion over the next 10 years.

However, if that amount is added to the bill, the budget promises made by the Democrats will collapse. So the Democratic leadership tried to sneak this change through as a separate bill. But that was voted down last week. It is not clear whether or not the Democrats will be willing to include these amounts in the current bill. Either choice could kill the bill.

(5) Old People. The Democrats proposed increasing the prescription drug benefit in Medicare to win over seniors. But they ended up scaring the heck out of seniors instead. And things are only going to get worse. Obama and Baucus have proposed cutting Medicare Advantage to save $10 billion. But this would cut the benefits of nine million seniors. Moreover, to pay for this bill, the Democrats are proposing an estimated $250 billion in Medicare/Medicaid cuts, which threatens the existence of both programs. Seniors remain very angry. . . and they vote.

(6) Big Business. The Democrats wooed employers, particularly big business and their union friends, by promising that the cost of employee health care would suddenly be covered by the government and that their smaller, more nimble competitors would be required to pay for benefits. None of that happens in the bill. At best, this bill will be neutral for employers.

(7) Illegal Aliens. This group was treated like a punching bag by the Democrats and gets nothing out of the bill. They are annoyed.

(8) The Hard Left. The hard left has been agitating for the Democrats to socialize medicine since forever. This bill doesn’t even come close to making them happy. In fact, this bill isn’t even a down payment on that. They are very upset.

(9) The Winners. There are only two groups that win under this legislation. The first group are people in the income range between 100% and 133% of the poverty level. They will now be eligible for Medicaid. This is approximately seven million people. The other group are the nation’s five million uninsurable persons. However, these groups lack financial muscle and already are loyal Democratic voters. Thus, their support is not comforting to the Democrats -- it’s like having your mom tell you that she likes your bill.

With no real constituency to support this bill, it will be difficult to pull together the votes needed to pass it.

2. The Cost

In addition to a lack of support among the rank and file, the bill is hemorrhaging support in Congress. The first cause of this falling support is the cost of the bill.

To get political cover, the Democrats have been working to convince everyone that the bill will cost less than one trillion dollars. Obama even set that limit in his daffy health care speech. But the Democrats now admit privately that the bill is understated by at least $150 billion. Moreover, the bill includes assumptions about cost cuts that won’t occur -- particularly the $247 billion in cuts to reimbursements to doctors under Medicare/Medicaid mentioned above. If these things are added back in, the bill will cost $1.268 trillion.

Going above the $1 trillion figure will lose the Snowe Rino and may lose many of the Blue Dogs.

More importantly, the bill was priced using the new (post-$247 billion cut) Medicare/Medicaid rates. Factoring those back out will cause the price tag to creep toward $2 trillion as the Republicans have been claiming. That would be a public relations nightmare, as it would have been cheaper just to buy everyone in the country private health care.

3. Disputes Over How To Pay For The Bill

In addition to the problem with the bill’s cost, there is a serious dispute among Democrats over how to pay for the bill. There is a currently a $200 billion shortfall, even in the fantasy numbers. To cover this, the House wants an income tax surcharge on the rich. The Senate, on the other hand, wants an excise tax on “Cadillac” benefits. And according to Paul Ryan, this could be the biggest problem for the bill because the surcharge “cannot” pass the Senate and the excise tax “cannot” pass the House.

Moreover, neither of these plans has strong support. In the House, the Democrats kept having to cut the rates to keep nervous Democrats in line. In the Senate, Baucus had to carve out exceptions to the excise tax for coal miners to get the support of Sen. Jay Rockefeller (D-Deliverance), unions to get the support of Sen. Debbie Stabenow (D-UAW) and John Kerry (D-Masshole), and for people in certain “hard hit states” to get the support of Sen. Chucky Schumer (D-Wall Street), Sen. Ron Wyden (D-Forrest Industry), and Harry Reid (D-SEIU), with others now demanding their own exemptions.

This could become the greatest challenge.

4. Disputes Over The Public Option

The most public dispute between the Democrats is whether or not (and to what extent) to include a public option. The Democrats furthest left have stated that they will not vote for a bill that does not include a public option. The Snowe Rino will not support a full public option, but will support a triggered public option. Sen. Ben Nelson (D-Neb) strongly opposes the public option. A few others have refused to commit.

This issue is significant because of the 100% (minus 1) Republican opposition, which means that Democrats will need Snowe and 59 of 60 Democratic Senators to pass this thing. It is unclear whether the current proposed solution of a public option that states could opt-out-of will satisfy enough Democrats to get that. I suspect it ultimately will, but it will be close.

5. Abortion

The Democrats also need 217 of the 256 Democrats in the House to support this bill. That’s where abortion comes in. Apparently, House Democrats have hit a wall on the issue of abortion. Rep. Bart Stupak (D.-Mich.) claims that he has organized a group of “about 40 likeminded Democrats” who will vote to kill the health-care bill over the issue of abortion. He says that the bill’s language that specifies that someone obtaining an abortion must use their own money, not money from federal subsidies, does not go far enough because it is impossible to segregate funds in that way. He wants to bar federal money from going to insurers who cover abortion. But other Democrats say they will not compromise any further on this issue. This standoff could kill this bill.


CONCLUSION

This bill faces widespread opposition in the public. There is no interest group left that supports this bill, most now angrily oppose the bill. The bill costs more than the magic number stupidly established by Obama, and the Democrats can’t agree on how to tax us to pay for it. All of this may make this bill impossible to pass. Add in the dispute over the public option and the abortion standoff, and this bill is rife for a surprise failure. The only question is, will the Democrats be more afraid of not passing this bill than they will be of passing it? Right now, I suspect they gut it deeply before passing it, i.e. they will pass a face saver version of the face saver bill.

Next time, why this bill can be repealed.

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