So at 10:43 EDT, the 216th vote was cast for the Senate’s health care bill, which means, no matter what happens on the reconciliation bill later tonight in the House or later in the year in the Senate, the largest health reform legislation since the enactment of Medicare in 1965. The final vote was 219-212, or three votes more than the minimum necessary.
As Jerry Garcia might have said: “What a long strange trip it’s been!”

We’re now minutes away from the first vote on the Rule for consideration of health care reform in the House, with all the signs pointing towards victory, particularly now that the White House has cut a deal with Rep. Bart Stupak involving an executive order that the abortion provisions of the Senate bill mean what they say and do not involve some back-door unravelling of the long-standing Hyde Amendment prohibiting use of federal funds for abortions.
If you get restless during the debate that will unwind for the next several hours, you could check out an episode of Bloggingheads TV wherein my friend Sarah Posner and I discussion the relationship between the Tea Party Movement and the Christian Right. We agree that the two movements are more compatible than they sometimes appear; that they are feeding on each other’s extremism; and that perpetual predictions of the Christian Right’s demise remain premature.

As we count down towards the health reform vote(s) in the House, it’s clearer than ever that there are two distinct but mutually reinforcing conservative takes on the bill. The most obvious, of course, is the bizarre construction of “ObamaCare” that the Right has been building for nearly a year now, based on distortions, fear-mongering, a few outright lies, and sweeping smears, all in order to make legislation pretty close to what moderate Republicans have promoted for years seem like a socialist revolution if not a coup d’etat. This is the hard sell, and it will continue up to and well beyond this weekend’s votes.
But then there’s the soft sell, beloved of today’s model of “moderate” Republicans, such as they are, which involves lots of tut-tutting at the unedifying spectacle of the health reform debate, constant if unsupported claims that there are plentiful opportunities for a bipartisan “incremental” approach, and above all, phony concern for what Barack Obama is doing to his party and his country. This approach typically ignores or rationalizes the hard sell that most conservatives have undertaken, and the lockstep obstructionism of the congressional GOP, and blames Obama and Democrats for all the problems they are encountering in getting this legislation done.
A pitch-perfect example of the soft sell is Peggy Noonan’s latest Wall Street Journal column, presumably her final pre-vote expression of contempt for the president in the guise of respect for the presidency, which alas, isn’t what it used to be when her mentor, Ronald Reagan, stood astride Washington and the globe like a colossus.
The column begins with an extended expression of horror that Obama would postpone a trip to Indonesia and Australia in order to lobby for this little domestic bill that would deal with the trifle of health coverage for 40 million or so Americans:

And to do this to Australia of all countries, a nation that has always had America’s back and been America’s friend.
How bush league, how undisciplined, how kid’s stuff.

It’s characteristic that Noonan does not mention that Obama is trying to give Americans the universal health coverage that Australians have and take for granted, or that final passage wouldn’t have been delayed until now if Scott Brown hadn’t come to Washington pledging to kill “ObamaCare.”
Noonan then engages, with the air of someone examining an especially loathsome insect, in a lengthy attack on the procedural issues involved in House passage of health reform, asserting that Obama’s trying to hide something in the legislation via the “deem and pass” (which she suggests sounds tellingly like “demon pass”) mechanism that House Democrats are apparently going to deploy this weekend. She endorses as self-evidently correct the complaint of Fox News’ Bret Bair, in his obnoxious interview of the president last week, that “deem and pass” means nobody will know what’s in the bill that’s “deemed” and “passed.” Like Bair, Noonan doesn’t seem to understand the simple fact that the underlying bill we are talking about here is exactly the same bill passed by the Senate in December–long enough even for Peggy Noonan to have gotten wind of it. The changes in the bill–namely, the reconciliation measure–were made available, along with a CBO scoring of their impact, before the votes were scheduled, and will be voted on explicitly by the House (and later the Senate). Yes, this is complicated, but you’d think someone with Noonan’s experience and pay grade would be able to figure it out, and again, Democrats would have never resorted to this approach if Republicans weren’t using their 41st Senate vote to thwart the normal process after a majority in the House and a supermajority in the Senate had already passed similar legislation.
But whatever; Republican obstruction is never much mentioned in Noonan’s stuff on health reform. And so it is entirely in character that Noonan concludes her column by blaming Obama for the rudeness exhibited by Bair in last week’s interview, and hence for diminishing the presidency! Ah, if only we had a real president like you-know-who:

[W]e seem to have come a long way since Ronald Reagan was regularly barked at by Sam Donaldson, almost literally, and the president shrugged it off. The president—every president—works for us. We don’t work for him. We sometimes lose track of this, or rather get the balance wrong. Respect is due and must be palpable, but now and then you have to press, to either force them to be forthcoming or force them to reveal that they won’t be. Either way it’s revealing.

I’d say it’s hardly as revealing as Peggy Noonan’s inveterate habit of not only ignoring conservative hubris, but attributing it to its victims.

Over at TNR, congressional expert Sarah Binder provides a very useful and detailed explanation of the procedures the House will go through this weekend in dealing with health reform. There will be (assuming things go as planned and Democrats have their votes) four separate votes: one on a Republican motion to recommit the rule for consideration of the reconciliation bill, one on the rule itself, one on a Republican motion to recommit the reconciliation bill, and one on the reconciliation bill. If the first or third motions pass, or the second or fourth votes fail to pass, health reform will have been defeated, at least for the moment if not forever.
But it’s the vote on the rule that will (assuming the Rules Committee goes in the direction Speaker Pelosi has indicated is likely) “deem” the Senate health care bill as having been enacted. This “self-executing rule” is what all the yelling and screaming on the Right is about. But since everybody understands what’s going on, it is fundamentaly erroneous to say that the House is trying to avoid a vote on the Senate bill. The vote on the rule is a vote on the Senate bill, and will have exactly the same effect as an explicit vote on the Senate bill, no more and no less.
That fact obviously does raise the question of why the House leadership is utilizing the “deem and pass strategy,” since anyone voting for the rule is actually voting for the Senate bill. I can’t answer that question, but presumably this basically meaningless distinction matters to at least one House Democrat. But in any event, the conservative charge that the House is going to enact the Senate bill without voting on it just isn’t true, and is simply part of the fog Republicans are trying to spread over the fact that by the end of this process (again, if all goes as planned), majorities in both Houses will have twice approved health reform.

There’s been some interesting talk going on this week involving assessment (in the wake of the collapse of progressive resistance to the final health reform bill) of “the Left’s” strategy on health reform, particularly in terms of the ultimate emptiness of threats from progressive House Democrats that they would vote against any bill that didn’t include a “robust” public option.
Glenn Greenwald argues that progressives have once again exposed–and possibly even increased–their “powerlessness” within the Democratic Party. Chris Bowers challenges the premise by arguing that progressives did secure significant changes in the Senate bill, most notably the agreement to “fix” it, which certainly wasn’t the path of least resistance.
Meanwhile, Armando of Talk Left has compared the lack of leverage of progressives over items like the public option to the success of the labor movement in forcing concessions on the “Cadillac tax.” And Nate Silver has responded by arguing that progressive threats didn’t work because they weren’t credible in the first place.
I think everyone in this debate would agree that it’s generally a bad idea in politics to make threats you are entirely unwilling to carry out, but the real division of opinion on on whether such threats should be tempered or in fact intensified. But Nate makes one point that bears repeating: the political value of aggressiveness and posturing can and often does get exaggerated.

It feels good to assert that progressives just need to be tougher — perhaps even to the point of feigning irrationality. These arguments are not necessarily wrong — a reputation for being tougher bargainers would help at the margins — but it misdiagnoses the problem on health care. The progressive bloc failed not because of any reputational deficiency on the part of the progressives but because their bluff was too transparent — they claimed to be willing to wager enormous stakes (health care reform) to win a relatively small pot (the public option). That would have been beyond the capacity of any poker player — or activist — to pull off.

I’ve never much liked the strain of progressive analysis that endlessly promotes “fighting” and “spine” and “cojones” as the answers to every Democratic political problem. Sometimes “brains” or “heart” are more important, and moreover, if politics is reduced to a willingness to project brute force, the bad guys are going to win every time; it’s like getting into a selfishness competition with the Right–we’ll never win. But in any event, however you feel about the Will to Power theory of politics, Nate’s right, people aren’t all stupid, and macho posturing by progressives when it doesn’t make sense isn’t going to convince anybody. Poker playing is a relatively small and overrated part of politics. Real conviction and strategies based on conveying those convictions to friends and potential friends are the best building blocks for successful strategy.

After the exhausing and endlessly complicated process of developing and reacting health reform legislation, it’s natural to think of the final bill as an unholy mess, full of deals and compromises all but forgotten. But in a fundamental way, the bill is actually something of a thing of–well, not beauty, but certainly impressive craftmanship. Here’s Ezra Klein’s excellent summary of the accomplishment:

This was a hard bill to write. Pairing the largest coverage increase since the Great Society with the most aggressive cost-control effort isn’t easy. And since the cost controls are complicated, while the coverage increase is straightforward, many people don’t believe that the Democrats have done it. But to a degree unmatched in recent legislative history, they have.

Add in the fact that the bill reduces the federal budget deficit (which Republicans didn’t even attempt to do with their own major health care legislation of the last generation, the Medicare prescription drug benefit), and it really does offer something to both liberals and conservatives. And that’s why its opponents are so often resorting to lies (death panels), slurs (claims that the nonpartisan CBO is somehow cooking the books), threats (intimidation of vulnerable members of Congress) and meaningless agitprop (“socialism,” “government takeover of one-sixth of the economy”). We’re now well beyond the point of persuading much of anyone on the merits, but those Members of Congress who vote for this bill have reason to feel proud, for all the agony and sometimes disappointment that has accompanied the process. When you get down to brass tacks, it’s a major accomplishment.

If you need a good chuckle today, or just a defense mechanism against the high-pitched chattering whine of conservative spin against health care reform, check out Joe Conason’s reality check about the accuracy in recent years of Dick Morris’ political predictions:

During the 2008 election cycle, Morris offered many forecasts, none of which were right. Early on he picked Hillary Clinton and Rudolph Giuliani as almost certain nominees of their respective parties and trashed John McCain as a sure loser. In January 2007, he told an audience of conservative journalists: “I think what’s going to happen in the world is that Hillary’s going to be the next president.” Not too long after that, he and wife Eileen McGann wrote a column for the New York Post headlined “It’s Now a Rudy Romp.” A year later, he was predicting that Clinton would crash and burn in the New Hampshire primary, right up to the evening before that election. Her tears had proved to voters that she was unfit to serve as president, he explained. When she won the following night, he overreacted again by predicting that she would surely go on to secure the nomination. (Back when Clinton was running for the U.S. Senate from New York in the 2000 cycle, Morris similarly made one delusional prediction after another, claiming that she would never run, withdraw, falter, lose, and so on. She ran and won, of course.)
Among Dick’s wackiest blunders in recent years was his confident assertion — on the eve of the 2006 midterm election — that North Korea would become the overriding issue in that campaign, eclipsing taxes, the war in Iraq, and Republican corruption

Since Morris is now probably the shrillest prophet of perpetual doom for Democrats if health reform passes (after, as Conason points out, predicting in the wake of Scott Brown’s election that Obama would never have another significant legislative victory), it’s worth knowing that the man rarely knows what he’s talking about–or if he does, he’s supressing that knowledge in the interest of spin.

Given the importance of Rep. Bart Stupak (D-MI) and his allies in the struggle for health care reform in the House, it’s worth thinking a bit about what actually makes him tick. A very revealing moment came yesterday, when Stupak blew off a communication from Catholic religious orders representing 59,000 Catholic nuns urging approval of the health reform bill. According to Fox News’ report of Stupak’s reaction:

The conservative Democrat dismissed the action by the White House saying, “When I’m drafting right to life language, I don’t call up the nuns.” He says he instead confers with other groups including “leading bishops, Focus on the Family, and The National Right to Life Committee.”

Stupak’s meaning couldn’t be clearer: in figuring out his position on health reform, he’s not identifying with fellow Catholics who are struggling to balance various ethical considerations; he’s acting as an agent for the Right-To-Life Movement and its often-machiavellian political game plans. It’s particularly interesting that he mentioned Focus on the Family, the right-wing evangelical Protestant “ministry,” as a greater influence on him than 59,000 nuns.
Why does this matter? Well, aside from the fact that any serious ethical review of the bill has to include the positive impact of reform on maternal and childhood health, it’s also pretty clear that the net effect of the bill will be to reduce federal subsidies for abortion. As Matt Yglesias reminds us today, current law massively subsidizes abortions via the tax exclusion for employer-sponsored private health insurance, which frequently includes abortion coverage. By encouraging (especially over time) people to move from employer-sponsored coverage to the new health exchanges for individual coverage, which under the Senate language will make insurance for abortion exceptionally inconvenient, it’s a sure bet that the overall use of federal money to pay for policies that include abortion services will decline. Indeed, a group of twenty-five prominent pro-life Catholic and Protestant leaders recently penned a letter describing claims that the pending bill would expand abortion subsidies as “misinformation.”
So official right-to-lifer opposition to the health reform bill isn’t really “about” abortion. It’s “about” the desire of the Right-To-Life political movement to score a big symbolic triumph, and it’s “about” the non-abortion political agenda of some of the movement’s constituent members. For a group like Focus on the Family, to which Stupak listens so closely, that agenda includes the Republican takeover of Congress and a wide variety of right-wing policy measures that have zero to do with abortion.

So finally, the Congressional Budget Office is issuing its cost estimate of the final health care package (the Senate-passed bill plus the reconciliation “fix”) today, clearing the way for a crucial House vote. The numbers are very encouraging, showing the package will save more than either House or Senate bills (particularly in the “out years”), and cover more Americans (95%) than the Senate bill.
According to Ezra Klein, this should make it possible for the House to vote on Sunday. There will actually be two votes: one on the “rule” for passage of the reconciliation “fix,” which will in effect be a vote on the Senate bill (since it’s the rule that will “deem” the Senate bill as having passed if the reconciliation bill passes), and a second on reconciliation itself. If both measures pass, then action will move on to the Senate, where Republicans are planning to use amendments to delay passage of the reconciliation bill as long as is possible, but where the final result is pretty much assured.
The teeth-grinding frenzy of the next 72 hours will be a sight to behold.

There’s been a lot of buzz, mostly in the progressive blogosphere, over the news that the proprietor of the notable right-wing RedState blogging site, Erick Erickson, of Macon, Georgia, has been given a perch on a new CNN show hosted by John King.
Most of the talk has featured some of Erick’s more colorful utterances, particularly his description of Supreme Court Justice David Souter as well, a child molester who also enjoys carnal knowledge of certain barnyard animals, and his reference to First Lady Michelle Obama as a “Marxist harpy.” As a fairly regular reader of RedState, if only to get the juices going on slow days, I can say I’m most impressed with the casual cranky extremism of Erick’s stuff on a day-in, day-out, basis, and particularly his bully-boy determination to play a role in Republican primaries around the country. His obsession, for example, with the defeat of Republican Sen. Bob Bennett of Utah, a pretty conventional conservative by most standards, has long since passed Carthago delenda est levels and must be viewed as a matter of sheer ego, if not a clinical disorder. The sheer-ego interpretation finds support in another recent Erickson encyclical, wherein he judiciously gave Mitt Romney a partial indulgence for his endorsement of Bennett upon the news that the Mittster had also endorsed RedState favorite Nikki Haley, a candidate for governor of South Carolina (in the real world, Romney predictably endorsed both for the obvious reason that they both endorsed him in 2008).
Last month I spoke at a municipal association meeting in Georgia, and was asked by a lot of people there how seriously Erick, a city councilman in Macon, was taken by national political types (much as Georgians used to ask me the same question about Newt Gingrich when he first exploded on the national scene). Seems he was already letting it be known that he was entertaining various national media offers, and was about to go big-time. I have a hard time begrudging any blogger a shot at mainstream media exposure. But it’s a sign of the times that CNN filled a mandatory conservative slot with a guy like Erick, who seems to alternate between moods of blind rage and smug triumphalism, and who (like me) also has a face made for radio.
We’ll see how ol’ Erick handles the transition to a national audience composed of people who don’t already agree with him. But he couldn’t have been happy with CNN’s press release, which lauded him as a spokesman for small-town values “who still lives in small-town America.” This will not go over well in Macon, a proud old city whose metropolitan area has a population of close to a quarter million people.