Those were the critical numbers for the Affordable Care Act to assemble a minimal winning coalition in 2010.
The actual winning coalition was 219-60-1-5 on everything except mandatory Medicaid expansion.
I am of the opinion that Nancy Pelosi probably had a few extra votes in her back pocket if she needed them, but this is pure specualtion that caps the spare votes out at five or six votes. I am of the opinion that President Obama would be willing to sign something significantly more liberal. That leads the binding constraints on a changed PPACA minimal winning coalition to be both the Senate as any defector from the aye to the nays could kill the bill, or Chief Justice Roberts.
When I think of PPACA within this framework, my analysis quickly leads me to assume that there were very few tweaks that could have been passed with a sufficient minimal winning coalition that were not already included in the bill. So when I see Senator Harkin say the following, I want to pull my hair out:
He wonders in hindsight whether the law was made overly complicated to satisfy the political concerns of a few Democratic centrists who have since left Congress.
“We had the power to do it in a way that would have simplified healthcare, made it more efficient and made it less costly and we didn’t do it,” Harkin told The Hill. “So I look back and say we should have either done it the correct way or not done anything at all.
“What we did is we muddle through and we got a system that is complex, convoluted, needs probably some corrections and still rewards the insurance companies extensively,” he added….
“We had the votes in ’09. We had a huge majority in the House, we had 60 votes in the Senate,” he said.
He believes Congress should have enacted “single-payer right from the get go or at least put a public option would have simplified a lot.”
“We had the votes to do that and we blew it,” he said.
There were never the votes for Medicare for All in 2009 if we assume the minimal winning coalition is 217-60-1-5. I agree with Senator Harkin that it would have been better, more efficient and much smoother implementation to go for Medicare for All. However, as we saw with the proposal to drop the Medicare buy-in age to 55, there were multiple veto players (Sen. Lieberman of CT) who were not even willing to extend a successful single payer system at all to a logical target population.
The choice was not Single Payer or PPACA in 2010, the minimal winning coalition for PPACA included multiple veto players who would have vetoed Single Payer in the Senate and the House. The choice was PPACA or something extremely close to PPACA (you can convince me about a tweak here or there plus drafting fixes would have passed with the same coalition) versus nothing. And since we only had PPACA instead of a fine tooth combed revised PPACA, the actual choice was PPACA or nothing given the minimal winning coalition built.
Is PPACA perfect. Fuck no. Is it a massive improvement over the status quo. Fuck yeah.
Was single payer a passable option in 2010 — fuck no. So let’s take a good win when we can and celebrate it.
mk3872
Man, for even a sitting Dem senator to say “we had 60 votes in the senate” is just mind blowingly ignorant.
The Dem caucus in 2009 included a senator who ran AGAINST Obama (Lieberman), a former Repub in Arlen Specter and conservadems like Ben Nelson.
No WAY they would vote to break a filibuster to even allow a vote on a single payer mechanism.
Any it is absolutely false that the Dems always had 60 reliable votes in 2009.
pat
Harkin, Schumer, Reid…. Are all these turn-coats just stupid?? Don’t they remember anything?
I have to step away from the computer now. It’s just too depressing.
Jim, Foolish Literalist
His co-Senator is Chuck Grassley, his successor is Joni Ernst, his Democratic Senatorial neighbors in real time included Tim Johnson, Ben Nelson and Claire McCaskill. I like Harkin, agree with him on the abstract issue, I share his broad frustration, I think we would have a better country if there were more like him, but.. the fucking point is… WE FUCKING DON”T. Just amazes me how these people can live in such a gauzy bubble. This is the New Dealer version of the old bull Dems who opposed filibuster reform. I just cannot imagine a Repubilcan doing this, or what Schumer did last week.
Bobby Thomson
There weren’t even 50 votes to pass single payer. And there’s no way it would have made it past the five.
ETA: And of course, there were 60 D/S/CFL Senators for only about four months due to Norm Coleman’s deliberately running out the clock. Not to mention the chaotic almost-retreat after the Scott Brown election that would have effectively neutered the Obama presidency and set us back 15 years. Hard to believe Harkin was even there at the time.
Cacti
@Bobby Thomson:
There probably weren’t even enough votes to get it out of the Senate finance committee.
Just Some Fuckhead
No, it was never a massive improvement. It was the Republican “free market” plan plus a Medicaid expansion. The Medicaid expansion was gutted by the Supreme Court.
RSR
>>Sen. Tom Harkin, one of the coauthors of the Affordable Care Act, now thinks Democrats may have been better off not passing it at all
With all due respect Senator, it’s not really about whether dems would have been better off, it’s about millions of Americans who are better off than they would have been ‘holding out.’
Bill Arnold
@mk3872:
If a few hundred more people had voted for Al Franken, American politics would be in a different place.
Cacti
Then you had Joe Lieberman whose extortion tactics got any public option removed from the final bill, in exchange for his cloture vote.
And he did it for no other reason than to wave his ass at the liberals who defeated him in his last CT Democratic primary.
Matt McIrvin
I suppose one could sympathetically read his remarks to imply that he’s using “we” expansively and the conserva-Dem opposition to single payer is what he means by “blowing it.”
But these people have no message discipline at all.
FlipYrWhig
If only this Tom Harkin character had been a Senator at the time, maybe he could have convinced more people to do what he thought was right!
Cacti
@Matt McIrvin:
After getting their clocks cleaned for the second time in 6-years, while running on a national message of “we’re sorry for existing, please don’t hurt us,” Senate Dems think more apologizing is the answer.
Gin & Tonic
@Cacti: No, he did it because he’s the Senator from Connecticut, insurance capital of the USA. He knows which side his bread is buttered.
Liberty60
@Cacti:
Yep- that could easily be the brand slogan for the conserva-dems; the ones who cringe and curl up in a fetal position anytime someone yells “liberal”, or “union!”
I think its telling how their chief regret revolves around their own careers and committee assignments, rather than the millions who are healthy today because of ACA.
MomSense
@mk3872:
It took a while to seat Franken as there was at least one recount. I also remember there was an issue with the Senator from Illinois. I think there were only a few months when everyone was seated (including Lieberman, Nelson, Bayh, Baucus and the other conservadems) before Kennedy died. I also seem to recall that Byrd was in the hospital and was wheeled from the hospital to vote on the PPACA. I remember this because there was some online conservative group praying he would die before the vote.
askew
Once again proving me right that the Dem Party outside of Obama is pretty much worthless. They are more interested with being in power and giving us empty promises of single payer than actually passing legislation to give millions of Americans health care. Obama pushed and pulled Congress to not give up on ACA after Brown’s election. He convinced them that doing the right thing was more important than keeping political power and doing nothing. For a brief moment, the Dem Party didn’t actively suck. That’s why I shake my head and laugh when I hear people saying that Hillary would have gotten just as much done as Obama as president. Because she’s just like the rest of the Dem Party. Make empty promises, deliver on nothing, because holding political power is more important than actually improving people’s lives.
FlipYrWhig
Yeah, just “a few centrists.” Who were they again?
Baucus
Bayh
Begich
Byrd
Carper
Casey
Conrad
Dorgan
Feinstein
Johnson
Landrieu
Lieberman
Lincoln
McCaskill
Nelson (FL)
Nelson (NE)
Pryor
Tester
Warner
Webb
How many left-of-center people does he think there were?
askew
@Liberty60:
Harkin isn’t a conservative Dem. He’s a liberal and he still cares more about his and his pals political power than in actually doing anything.
richard mayhew
@Just Some Fuckhead: It is a massive improvement for about 15 million people even after the sadists on the court took their pound of flesh. That is a win even if it is not the style of win that you want.
SatanicPanic
@Just Some Fuckhead: It’s not the Republican plan. The Republican plan is nothing.
Violet
I’m so grateful we have it at all. Fuck those losers who are Monday morning quarterbacking the law. Fuck them all.
FlipYrWhig
@askew: I don’t think it’s that. I think it’s that he has that longing, much in evidence online, to see “Democrats” as “liberals” and use a bunch of woulda-coulda-shoulda to paper over the differences between Democratic liberals and Democratic moderate/centrist/non-liberals. There are A LOT of the latter. They believe things. They have policy preferences. Whether they’re cynical or sincere, they have interests and act on them.
SatanicPanic
@Violet: This plus 10000000000
Elizabelle
@FlipYrWhig:
I was looking for the “like” button on your comment. Four stars.
I wonder if Senator Harkin regrets not contesting his Senate seat. It might have been more honorable to fight it out, win, and stand down in time for a new Senator to be chosen in the 2016 election. (If Iowa permits that.) Or fight it out and lose.
Sherparick
It is also typical MSM meme reporting (conveniently forgetting to even look at “The Hill” stories at the time about how difficult it was to get all the Democratic votes on board. See Otherwise a complete blank. I would say this. A contractor employee who wants to claim status as joint employee has to pursue counseling under 29 CFR 1614 informal complaint process and if she has not done that within the 45-day period or filed a formal complaint within 15-days of receiving a final interview notice has not exhausted her administrative remedies. So getting the Army dismissed as a party from any lawsuit should be pretty simple in that case. ” See the Hill Story from October 2009. http://thehill.com/homenews/senate/62207-finance-vote-on-healthcare-scheduled-for-tuesdayje
You know Tom Harkin, Chuck Schumer, Bernie Sanders, etc. the Affordable Care Act would be a lot more popular if, you know, Democrats would would go out and actually defend it and point out all the good it has done. Defend it as a great first step, but stop fucking apologizing and saying it was a mistake.
FlipYrWhig
@Violet: @SatanicPanic: Plus, I guarantee that this happens in the alternate universe: “Wow, we lost in that election in 2010 and 2014. We probably shouldn’t have done that stuff that we thought would help the economy but got scaled down, became controversial, and ultimately barely passed. That hasn’t helped enough people! Instead, we should have done something about health care, because everyone knows _that’s_ a pressing problem, even Republicans!”
Bobby Thomson
@Just Some Fuckhead: Nope, it’s not the Heritage plan.
Also, too, chewing gum doesn’t take seven years to digest.
SatanicPanic
@FlipYrWhig: hehe, yup. “Why are they spending all this time chasing after white working class people?”
aimai
@Just Some Fuckhead: No:because the Medicaid expansion was an ENORMOUS benefit to single adults. Meanwhile the subsidies were not in the so called “Republican plan” nor were all th eother goodies like guaranteed issue or busting the caps on annual or lifetime treatment costs. You don’t know what you are talking about.
japa21
There were a lot of liberals/progressives (at least they called themselves that) at the time who blamed the President for not pushing single payer and/or giving up on the public option.
They were also calling themselves members of the reality based community, to which they obviously did not belong. Any attempt to insist that either be included would have meant no reform then and probably no reform for decades to come.
I don’t know anybody who thinks what was passed is perfect or the end all of reform, including Obama. But neither was SS when it passed or Medicare when it passed. The latter two have had many tweaks and adjustments and will continue to do so. So will the PPACA. And eventually, we will have single payer, probably after a public option is created.
And no, it is not a Republican plan because what the Heritage Foundation proposed back in the 90’s was never meant to be enacted, it was just something thrown out there to show the GOP was serious about reform. Notice how the GOP never even attempted to do anything when they had power enough to do something?
Matt McIrvin
Once again, too, he’s not making the connection between the ACA and deficit/”entitlements” worry. I guarantee that in the world where the ACA was not passed, everyone would be screaming their heads off about the Entitlements Crisis right now because of exploding Medicare costs. And it’d also play right into the hands of the people who equate all discussion of “the economy” with saying “the government is broke and we have to do something about it”.
Tone In DC
@MomSense:
I truly hope this is more humor.
Sherparick
Edsall’s column and Schumer, I think are looking at the political consequences of the Affordable Care Act less then the policy. Unfortunately, as a matter of political analysis, I have to agree that between Republican obstructionism and the failure to recognize in real time how deep the plunge was (along with the appointment of Tim (Only Banks Need Bailouts) Geithner as Treasury Secretary, the meme was created that Affordable Care Act was a means of transferring benefits from “us” to “those people.” I think the Democrats would still have been in trouble in 2010 because the economy still would have been tanked (Geithner, Blue Dog Democrats, and Republicans in House and Senate all opposed further stimulus and Obama did not propose because he was distracted by ACA, but because he went along with Geithner in his debates with Summers and Romer. http://www.huffingtonpost.com/2012/02/14/escape-artist-noam-scheiber_n_1276998.html
If the Supreme Court scuppers the Affordable Care Act, I am afraid the lesson for Democratic politicians going forward will to be not to touch heath care with a 10 foot pole again for a generation or more.
Turgidson
Does Harkin have dementia? Wasn’t he, you know…there during the interminable sausage-making process that gave us the ACA? How the bloody hell does he think they could have just passed single payer or a public option and been done with it? Leave the revisionist history to the knuckledraggers on the other side.
Citizen_X
@Just Some Fuckhead:
Citation needed.
And you’re about 40 very detailed posts behind Richard on that argument, so get cracking.
FlipYrWhig
@Turgidson: Giving him the benefit of the doubt, I think it’s a “should” argument rather than a “could” one. But as with all “should” arguments, it founders on how you make the “should” into “did.”
SatanicPanic
@Sherparick: I am starting to wonder how much Roberts wants to push his luck here. Republicans in the House or even the Senate can be assholes day in day out because in the end, they know that you can’t really run a country without some sort of legislative body. If SCOTUS were to, say, declare the ACA fully and totally unconstitutional, and say that no state can run anything similar… how do they enforce that decision? If California or Massachusetts says ” we’re going to keep our exchange running”- what happens then? Civil War? Not likely. We just start ignoring SCOTUS wholesale and I don’t think Roberts wants that.
low-tech cyclist
The ‘correct way’ was impossible. And either way, Harkin’s saying that doing nothing would have been preferable to passing the ACA.
Something like 12 million people with real health insurance who otherwise wouldn’t have had any, that’s worse than doing nothing?
Fuck that shit.
dubo
Blaming Obama’s lack of leadership for GOP obstruction is dumb because they’re happy to torpedo the country out of spite so he has no leverage
But Obama and the Dem leadership DO have leverage over their own party, and the recent election is a stark example of how they can exert influence by withholding support and funding for candidates. Hell, they were strongarming holdouts like Kucinich with threats during the ACA debate itself
IF Obama and Pelosi were set on single payer or public option (and that’s a big if) and let the Raucous Baucus Caucus run roughshod and defy them, there’s no way that’s not, in part, a failure of leadership.
Maybe letting the conservative Dems have their way on the ACA in order to keep the Democratic party in cohesion for everything else they had to do was the right choice. But don’t pretend we couldn’t have gotten the votes for a public option if Obama and Pelosi were devoted to it.
pat
@Sherparick:
Exactly the point I wanted to make. The ACA is a big f-ing deal, and I just don’t understand why these abject cowards can’t come out and SUPPORT it. Sheesh.
Betty Cracker
Harkin’s track record indicates that he’s generally neither stupid nor evil, so my guess is he thinks the political blowback from the ACA will be so grave that it will be a net negative in the long run. That’s the only way his “better no loaf at all than a quarter loaf” proposition makes sense.
Personally, I think he’s wrong about that, and obviously he’s wrong about what was possible back when the ACA was being cobbled together. He must realize that. This is political showmanship, and a particularly dumb example of it, IMO. Or maybe he’s trying to tee up an issue for Hillary Clinton.
low-tech cyclist
@Bill Arnold:
I don’t see how. Remember the timeline: The Dems started 2009 with 58 Senators. That effectively dropped to 57 in March 2009 when Ted Kennedy’s illness rendered him unable to participate in the Senate. Then Arlen Specter changed parties at the end of April – back up to 58. Then during the summer, Franken was declared the winner in Minnesota and sworn in – up to 59. Finally, when Kennedy’s replacement was sworn in (in September) shortly after his death, the Dems got to 60. The Dems had a ‘filibuster-proof’ majority for about 14 weeks, IIRC, before Scott Brown’s win in January 2010. And it’s in quotes on account of Lieberman, Ben Nelson, etc.
There’s no point at which an earlier win by Franken would have caused the needle to move from 59 to 60 any earlier.
MomSense
@Tone In DC:
I think what happened was that Coburn spoke on the Senate floor asking Americans to pray that someone would miss the vote. This was after Dems asked to move the vote earlier because Byrd was so ill in the hospital.
Then some tea party groups decided to kick it up a notch on Coburn’s vague prayer and prayed that Byrd would either die or be too sick to show up for the vote.
Byrd actually pumped his fists after voting for the ACA. Ah those were good times back in the days before Obama’s Executive Order on Immigration forced Republicans to stop working with the President.
Jim, Foolish Literalist
Definitely not evil, and usually not stupid, but saying this was stupid, especially now, so soon after Gruber-gate and the elections, adding to the RWNM and its Beltway echo chambers. Like I said, I get his frustration, and I’m not an 80 year old who’s spent his life fighting for this stuff long after the tall grass beckoned, and Harkin’s done far more good than bad in his career. But even giving him every benefit of the doubt, there was no reason to say this, and a lot of reasons to wait six months, if not forever. And it’s just so fucking typical of Democrats stepping on their own and each others’ toes, it makes me crazy. I think it was Casey Stengel who used to throw equipment in the general direction of his players and scream “Can’t anybody here play this fucking game?” after a bad day. That’s how I feel right now. I expect to feel that way with people like Chuck Schumer or Bill Nelson, and Joe Manchin and Mary Landrieu are playing a different game all together, but from Harkin, this is exasperating.
Lee
@low-tech cyclist:
I was thinking the same thing. I’m glad my memory is correct.
What would have made a difference then would have been a Scott Brown loss. But then we probably would not have Sen Awesome.
Bugboy
It was my understanding that under single payer, the insurance industry would have been crushed. They were not about to allow the gravy train to come to a halt. So, it simply wasn’t going to happen.
Obama needed to secure the cooperation of the insurance industry in order to make ACA happen.
Turgidson
@dubo:
I don’t think any amount of ballbusting from Obama/Reid would have created 60 votes in the Senate for a public option. Maybe the administration and major players traded it away too early, but I don’t think that changed the head count. I suppose they could have nuked the filibuster to get a public option passed, but that would have caused mass hysteria in its own way and Reid was way too old-fashioned and chickenshit to do it at that point.
Pelosi actually did pass a bill with a (modest) public option in it, if I remember correctly, so she wasn’t part of the problem. And she did the right thing passing the Senate bill when it was either that or nothing. For all the grief Pelosi gets, from various directions, she always had the fucking votes (granted, no filibuster in the House), and was extremely effective. It’s a shame she didn’t have a couple more years to get things done.
Barbara
Just adding my two cents to those like Schumer (and others) who seem to think that the ACA doesn’t help the middle class or ameliorate income inequality. It’s just mind blowingly simple to refute this argument, and it’s unbelievable Schumer doesn’t understand this so I have to assume there is an ulterior motive. To an employer, money is money. If you pay someone $30,000 in salary but are also paying another $1000 in monthly benefit costs, you are paying them $42,000 (we’ll just forget tax issues — very real issues — for a moment). If, over a decade, you see 10% or more annual inflation in health care, so that 10 years later (with some other adjustments), you are now paying $1500 per month ($18,000), that money isn’t going to go to increases in salary. And the lower on the pay scale you are located, the more likely it is that the money that might have gone to raise your take home wages is going to pay for increased benefit costs. Health care inflation is one of the reasons (not the only, but certainly an important one) why wages stagnated over the last 30 years. And the last real boom period, the 90s was also — duh — the most recent decade with low rates of health care inflation. Obamacare is helping to reduce the trajectory of health care inflation as well as to decouple health care form employment. Doubling down on these trends is crucial to helping all people, even those covered by non-Obamacare coverage. Chuck “Carried Interest” Schumer can kiss my ass if he thinks I believe anything he has to say about the unequal distribution of wealth or helping the middle class.
NCSteve
@mk3872: Truthfully, once Specter switched, he was a fuck of a lot better Democrat than Joe Lieberman (*spits on ground*), Mary Landrieu, Ben Nelson, Blanche Lincoln, Evan Bayh, or Kent Conrad ever dreamed of being, Really not fair to include him in that crowd. I really think that by that point, between his need to show fidelity to Reid and the party he’d just joined and his own total conversion to a “fuck you and the horse you rode in on” attitude about the GOP, he’d have voted for single payer in a heartbeat if he’d had a chance.
rikyrah
this hindsight makes me wanna slap someone. I don’t live in DC, and I know how hard it was for POTUS to pass this in both Houses of Congress.
And none of these muthaphuckas speaking up now were saying SHYT while all this was going down.
FlipYrWhig
@dubo: I’ll refer you to my list of people who either expressed outright or implicitly had misgivings about something in the vein of single payer or even the public option. 40 people can’t twist the arms of 20. They’ll call your bluff. That’s what happened. We all saw it. Don’t give me the “devoted” bit. If they _really_, REALLY tried, surely they would have gotten it, ergo they didn’t really try? Come the fuck on.
Tripod
@FlipYrWhig:
Just repeat “Howard Dean, fifty state strategy” enough times and blue dogs in marginal districts become socialist revolutionaries.
JoyfulA
@NCSteve: Specter’s first vote as a Democrat was against cram-down.
NCSteve
@JoyfulA: I didn’t say he was a perfect Democrat. I just said he was a better Democrat than Lieberman, Nelson, Landrieu, Lincoln, Conrad, and Bayh. That’s hardly a high bar. And given that the cram down amendment was defeated 51-45, he was hardly the only Senate Democrat giving bankers a hummer that day. I’m too lazy to look it up, but i’d be surprised if as many as one of the others listed didn’t join him.
The fact remains that on the ACA, Specter made no trouble. Unlike the other assholes on that list.
Tripod
@Betty Cracker:
That certainly depends on one’s pov. For rural butternut Democrats of the mid-west and mid-south, it may very well be Obamageddon. Not being Travis Childers, I don’t give a shit, because I think the party and the nation will be better off in the long run.
mattH
Never stop posting Richard, never.
Bill Arnold
@low-tech cyclist:
Your memory is better than mine, sorry. One other consideration is that 59 votes for closure at the beginning of the year would have been tempting for any Republican Senator inclined to break ranks.