Will Democrats Get A Health Bill This Year?

Robert Laszewski, a trusted inside-the-Beltway political consultant, has concluded we will “almost certainly not” get a health bill this year.

Laszewki says three powerful contradictory forces made him come to this conclusion.

• One, on the upside for passage, Democrats are absolutely committed to producing a bill. They are desperate. If they do not, they are likely to lose the House in November 2010 and maybe in the presidency in 2012. Obama’s whole domestic agenda rides on getting a health reform bill in 2009. Keep in mind Congressional approval rating are noW 21%. Ironically, the odds for passage may rest in the hands of a Republican Senator, Olympia Snowe, who is opposed to th Democrat's most cherished prize – the public option - which could be ultimate gateway to single-payer. SomeDemocrats are in a mood of quiet desperation.

• Two, on the downside for passage, are the American public – who are anxious about losing their current private plans and Medicare benefits, as shown by the town halls, tea parties, and the polls. The public is not convinced Obamacare will benefit them persibally or improve the quality of thier care. Obama’s approval on health care handling is in the low forties, and his disapproval is in the mid-fifties. The public is not buying the argument you can expand coverage to 25million uninsured, subsidize those below the poverty line, cut Medicare by $500 billion, stamp out fraud, abuse and waste, and tax health plans, drug companies, device makers, and others without these companies passing along increased prices to them - the middle class.

• Three, there's another downside, and it’s a big one. Democrats don’t have a bill yet. To make matters worse, the jerry-rigged Obama coalition – built behind closed White House doors – has suddenly gone wobbly. AHIP (America Health Insurance Plan) and the Blue Cross Association fired a warning shot by accouncing commissioned studies showing Obamacare would double premiums over the next 10 years by $4000 per family of 4 per year. AMA members, furious that the Senate Finance Committee, only suspended Medicare doctor pay cuts for one year, to be followed by a 25% cut the next year, are in open revolt and will say so in their annual November Houston meeting. The AFL-CIO, and other unions, bitterly oppose taxes on “Cadillac health plans,” which cover many of their members. The Chamber of Commerce, representing small business, is running TV ads attacking Democrat proposals. State governors, Democrats as well as Republicans, say their budgets will not withstand expanded Medicaid benefits. Blue Dog Democrats, up for re-election in many affluent districts, fear more taxes on the “rich” will destroy their chances for re-election.

Put it all together, and what have you got?

You’ve got a recipe for probable bipartisan political failure when you go to the floor for a final vote .

You’ve got the makings of a political disaster that frightens even the most optimistic Democratic forecaster.

You’ve got a fascinating intraparty battle to head off a possible political death rattle.

You’ve got an expansion problem of raising $500 billion to pay for expanding access without expanding taxes, without expanding your list of political enemies, without expanding the federal debt.

You've got eight legislative procsses to worm through, each laden with political landmines, to reach your objective on the biggest piece of legislation since Social Security and Medicare.

It will fascinating to see if this can be done.