Victory at What Cost?

"The most troublesome task of a reform president," Henry Adams wrote in his autobiography, is "to bring the Senate back to decency." President Barack Obama did not accomplish that task this year, far from it. But what he and other Democrats did accomplish this morning is something that eluded every reform president before him and is, in a sense, all the greater an accomplishment for the fact that the institution -- not just the Senate itself but the Washington culture that surrounds it -- was at its most indecent.

Every major policy victory, even though it creates momentum and potentially strengthens the president who leads it, inevitably comes with a cost. The cost may be an expenditure of political capital, a political concession due in the future, a sacrifice of a constituency, a compromise on some other policy, or a compromise within the policy itself. It's hard not to feel in one's gut that this victory came at a considerable price. But it's also hard to put one's finger on exactly where the cost is.

The cost is certainly not in the policy itself. The legislation is imperfect, compromised, and in many ways insufficient. (It can be improved slightly in conference with the House, through the addition of the House's mild employer mandate or a change in the financing, but everything will have to be cleared with the 59th and 60th most liberal senators.) But the answer to Jane Hamsher of the blog Firedoglake's "Ten Reasons to Kill the Bill" did not need actually need an item-by-item response, although it's useful that Ezra Klein provided one. It would have been sufficient to say simply that everyone who will be affected by the bill will be far better off. And that the bill as it has passed provides the basic components needed to construct a workable system of near-universal health coverage, and all that is outstanding -- implementation and legislative improvement -- can be accomplished without anyone needing to beg at the feet of a gleefully sneering Joe Lieberman or Ben Nelson.

Many on the left were tempted to use the budget reconciliation process, which would limit the time for debate and thus require only 50 votes, to pass a more expansive bill. But that would have required major pieces of the legislation to be left behind, in the hope that they could be enacted later, though they would still need 60 votes, and the tactic would have alienated even many Democrats, making the next steps impossible. Instead, by passing a compromised but complete bill with 60 votes, Democrats will have plenty of room to expand its provisions, and even add ideas like the Medicare buy-in for older workers, using the budget reconciliation process in the future. (This strategy was unstated, as it should have been, but it's in effect just what I proposed in July.)

The bill is flawed, but only by comparison to some hypothetical piece of legislation that could never have passed. The same could be said of any successful legislation, from the first progressive income tax to Social Security and Medicare to the Clean Air Act. And conservatives would say the same about their own legislative achievements. This is How A Bill Becomes A Law. And while some of the compromises that helped the legislation dodge the vicious attacks that killed the Clinton plan in 1994 were cooked up by the White House, other were baked into the consensus even before Obama took office. That insurance companies would benefit from an expansion of the base of the insured is built in to any approach other than single-payer, and the price of requiring insurers to cover anyone always had to be that we require everyone, in turn, to be covered.

A more plausible price of victory is the emergence of a left opposition to Obama and to mainstream Democrats. In some ways, it is surprising such a faction did not emerge earlier. Expectations were irrationally high at the beginning of the administration, and many on the left read their own aspirations, and above all their own strategies, onto the new president. Disappointment is the predictable flip side of the enthusiasm that swept Obama into office a year ago. And yet, an opposition that consists of Hamsher and former Democratic Party Chair Howard Dean is not exactly Ted Kennedy challenging Jimmy Carter in 1980! Indeed, the disappointment feels rather like that expressed by the anxious faction that doubted and seemed to simply dislike Obama all through his march to the presidency. As Paul Krugman, who was the most articulate voice in that faction, noted this week, this is the WYSIWYG presidency. If anyone thought that Obama's language about bipartisanship and compromise were just a ploy to get elected, and the fierce passionate liberal would then pull away the mask, they were deluded.

To me, Obama's open, bipartisan and cross-ideological tone was never just a pose. It was how he intended to govern, defining a mild, modified liberalism as centrism and putting the opposition on the defensive. A fierce, aggressive liberalism, the counterpart to the high point of conservative exercise of institutional power in the middle of this decade, was not going to succeed. Recall, that such an approach ultimately failed conservatism.

However, Republican senators' refusal to participate in any meaningful way in the health-care conversation, with the small and notable exception of Maine Sen. Olympia Snowe's single, hesitating vote when the bill was before the Finance Committee, is a painful revelation that Obama can't govern the way he campaigned. And that revelation is in itself a kind of cost, a useful illusion now lost. As recently as a few weeks ago, every savvy Hill insider would tell you that health reform might get 58 votes and fail, or it might get 61 or 62 votes. But it wouldn't, couldn't get exactly 60 votes, just because some Democrats -- Ben Nelson, Blanche Lincoln, Mary Landrieu -- would insist on Republican cover. The biggest surprise of the last week is that health reform had to hit that 60-vote target exactly, and that it did.

Health care's passage shows exactly how small the target is for any future Obama initiative, from cap-and-trade to financial reform. With no room for bipartisan compromise, and also no room to tell Joe Lieberman what everyone surely wants to tell Lieberman, the path forward is hard to see. As long as Republican opposition holds, even with the occasional press-release exception such as Sen. Lindsay Graham on cap-and-trade, there will be no room to the right and even less room to the left. That will be true even on measures that could be constructed to avoid a filibuster, because there will be plenty of legislation -- again, cap-and-trade comes to mind -- that has such disparate regional impact that it will be a struggle to get even 50 Democratic votes.

The reason it feels like a loss is simply that fact, that any sense of movement or possibility in our political institutions -- and again, I mean mostly the Senate but not only the Senate -- is gone. Getting exactly 60 votes, on an issue where the ground has been prepared, is possible only on rare occasions. That Obama, and Harry Reid and his allies, hit that small target on the single issue that has eluded every progressive president before him is wonderful for both the health-care system, and for those millions who need care, but still, it does not bode well for our political future.

I've always argued that Obama viewed his central domestic mission as changing the culture and practice of American politics. The passage of health reform is a revelation of just how desperately that change is needed and how difficult it will be to achieve.

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