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POLITICS: Sustainable Health Reform Will Take Sustained Bipartisanship

April 9, 2008 - 2:35pm

As almost anyone who lived through the Clinton-era health reform efforts will tell you, health reform will require bipartisan leadership and broad-based support from the American people. But why? Could pursuing a Democrat-only strategy work? And more importantly, if health reform were approved with support from only one party, would it be sustainable over time? Would reform lacking bipartisan support lead to yearly battles about how to undermine or even repeal it?

It is no coincidence that in our very first blog post we emphasized two numbers: 47 million (the number of uninsured Americans) and 60 votes (the number of Senators it takes to break a filibuster). Yet, in light of the 2006 Democratic electoral gains, some are dreaming that Democrats could sweep the elections in November and hold 60 seats in the 111th Congress.

Not likely, according to political analyst Jennifer Duffy of the Cook Political Report, quoted in today’s Politico. Duffy says that even if Democrats gain seats (Duffy estimates between three and six, bringing total Democrats to 54 to 57), “On the hard stuff, [Democrats] would still need Republican votes.” Needless to say, health reform qualifies as “hard stuff.”

Short of the basic algebra (a three-or-six seat gain leaves Democrats six and three votes shy of the necessary 60), a Democrat-only strategy has another central flaw. Sixty Democrats doesn’t automatically translate into 60 votes for a specific health reform measure. Given past voting records, some Republicans are actually more likely to back certain broad policy changes than a number of Democrats. Therefore, a Democrat-only strategy risks alienating potential supporters among Republicans. Not a good idea.

For a major reform to be truly sustainable over time, both parties must have some skin in the game. To gain the public’s trust, it is likely that any health reform plan would need to be supported by at least some members of each party. Any purely partisan approach could be dismissed flippantly by voters as political posturing rather than sound policy. Or it could be overturned or scaled back significantly by a shift in Senate control.

Finally, we would be remiss not to recognize that there is talk of a 51 vote strategy, whereby health reform could be approved by the Senate with a simple majority vote. However, we will excuse our readers from the annals of Senate procedure, and save the debate about “reconciliation” and the Byrd Rule for another day…for now.