One of the topics I’ve been covering regularly at Washington Monthly has been the politics of health care reform above and beyond the disposition of “ObamaCare” by the Supreme Court, which is likely to be announced in the next two weeks.
If the Court does strike down or disable the Patient Protection and Affordable Care Act of 2010, then the GOP’s alleged “replacement” plans will get considerable attention. And it’s important for Democrats to understand that Mitt Romney’s overall health care agenda–including his endorsement of the Ryan Budget and of legislation designed to disable state insurance regulation–would represent a large step back from the health care status quo ante, which would be bad enough for many millions of Americans.
Moreover, Romney’s claims to support “popular” reforms associated with ObamaCare, such as the prohibition of exclusions for pre-existing conditions, are completely bogus.
The stakes in November with respect to health care cost, coverage and quality go well beyond the simple yes-or-no questions about ObamaCare. It will represent a choice between a systematic effort to create a rational system of universal access to affordable health insurance, and a big step back towards the 1950s.
This year’s big media narrative has been the confirmation saga of Neera Tanden, Biden’s nominee for director of the Office of Management and Budget. At New York I wrote about how over-heated the talk surrounding Tanden has become.
Okay, folks, this is getting ridiculous. When a vote in the Senate Homeland Security and Governmental Affairs Committee on the nomination of Neera Tanden was postponed earlier this week, you would have thought it presented an existential threat to the Biden presidency. “Scrutiny over Tanden’s selection has continued to build as the story over her uneven reception on Capitol Hill stretched through the week,” said one Washington Post story. Politico Playbook suggested that if Tanden didn’t recover, the brouhaha “has the potential to be what Biden might call a BFD.” There’sbeen all sorts of unintentionally funny speculation about whether the White House is playing some sort of “three-dimensional chess” in its handling of the confirmation, disguising a nefarious plan B or C.
Perhaps it reflects the law of supply and demand, which requires the inflation of any bit of trouble for Biden into a crisis. After all, his Cabinet nominees have been approved by the Senate with a minimum of 56 votes; the second-lowest level of support was 64 votes. One nominee who was the subject of all sorts of initial shrieking, Tom Vilsack, was confirmed with 92 Senate votes. Meanwhile, Congress is on track to approve the largest package of legislation moved by any president since at least the Reagan budget of 1981, with a lot of the work on it being conducted quietly in both chambers. Maybe if the bill hits some sort of roadblock, or if Republican fury at HHS nominee Xavier Becerra (whose confirmation has predictably become the big fundraising and mobilization vehicle for the GOP’s very loud anti-abortion constituency) reaches a certain decibel level, Tanden can get out of the spotlight for a bit.
But what’s really unfair — and beyond that, surreal — is the extent to which this confirmation is being treated as more important than all the others combined, or indeed, as a make-or-break moment for a presidency that has barely begun. It’s not. If Tanden cannot get confirmed, the Biden administration won’t miss a beat, and I am reasonably sure she will still have a distinguished future in public affairs (though perhaps one without much of a social-media presence). And if she is confirmed, we’ll all forget about the brouhaha and begin focusing on how she does the job, which she is, by all accounts, qualified to perform.
