The Democrats are determined to expand the federal governments portfolio beyond the Post Office, Amtrak, and General Motors, by adding the entire health-care industry to its holdings. But before they can subject what will soon be one-fifth of our economy to the federal governments command-and-control model, Democrats must clear three major obstacles. And they have to do so without losing even three of the 220 votes that Obamacare received in the House or even one of the 60 votes it received in the Senate. In short, they have essentially no margin for error.
The Democrats three major hurdles are as follows:
(1) The public option. The House has previously insisted upon it; the Senate cant pass it. Early indications are that the House will ignore the calls of Howard Dean and others and will quietly and meekly acquiesce to the Obama administrations lobbying and coercing. But this could change, and even the slightest dissent within the House Democratic flock could kill the bill.
(2) Abortion. Obamacare supporters conveniently seem to be forgetting that Obamacare wouldnt have passed the House without the Stupak Amendments prohibition on taxpayer funding of insurance plans that cover abortions. Senate Democrats, who are more universally committed to public funding of abortion than Democrats in the House, rejected that approach.
There is no real middle ground between these two positions. One side or the other will have to cave. The very pro-abortion Obama administration will push hard to make the House members give ground. President Obama and Rahm Emanuel are more than happy to sacrifice several handfuls of anti-abortion Democrats in swing districts. But its not remotely certain that those members will be willing to sacrifice themselves. True, most of them will be pleased that the public option will have been jettisoned, but that wont go very far in helping them to explain an abortion flip-flop to their constituents. This is a serious hurdle, and it will almost certainly result either in the defeat of many Democratic members or of Obamacare itself.
(3) Public opinion. Poll after poll has shown that, both in terms of sheer numbers and intensity of sentiment, Americans dont want Obamacare. The Democrats must therefore hope to clear the first two hurdles and pass this unpopular legislation, and then be rewarded by voters with a return trip to Congress and the White House so that they can implement it in 2013 or later. To say the least, thats a tall order.
And public opinion is likely to continue to move further against them, the more that Americans realize how much Obamacare would politicize medicine. The exemption of the longshoremans union from the excise tax on Cadillac plans, the survival of full Medicare Advantage benefits in Florida but nowhere else, and the loophole that says that Nebraska wouldnt have to continue paying into Medicaid while the other 49 states would, are all quite glaring examples of how a shift from private to federal control would politicize health care in an ugly and unseemly way.
Any one these three hurdles can fatally trip up Obamacare. So, at this point, the only thing that would ensure Obamacares victory is if its opponents quit running the race. On some level, Obamacare supporters know this, which is why they are already declaring victory and trying to demoralize an opposition that they think lacks resolve. But if Obamacare opponents are determined to match its supporters will to win, and if they are determined to run this race for as long as it takes, the smart money is on one of these three hurdles taking Obamacare down.