Amidst the understandable relief among Democrats at the passage of health care reform by the House, there’s been relatively little talk about the Democrats who still voted “no.” But 34 of them did, and fortunately, Nate Silver of 538.com took a close look at factors that might have explained the residual defections.
Nate concludes that Obama’s 2008 share of the vote in each Members’ district, their general ideology, and their views on abortion, were the variables most highly correlated with a “no” vote. Variables that didn’t make as much difference include the competitiveness of the Members’ own races, the number of unisured in their districts, and campaign contributions by insurance industry lobbyists.
It’s not that surprising that all 12 House Democrats representing districts where Obama won less than 40% of the vote in 2008 voted “no,” or that 61 of the 63 representing districts where Obama won over 60% voted “yea.” But 13 of the 30 from districts where Obama won more than 40% but less than a majority voted “no.”
Despite Bart Stupak’s decision to support the bill at the last minute, it’s significant that 24 of the 34 “no” votes in the House were Members who voted for the original Stupak Amendment. Putting it another way, supporters of the Stupak Amendment split 37-24 in favor of the bill, while opponents split 182-10.
Ideologically, Nate uses the Poole-Rosenthal system to break down Democrats, and shows that “roughly the 110 most liberal Democrats voted for the health care bill.” That’s pretty amazing when you consider the unhappiness over the bill expressed by so many self-conscious progressives once the public option dropped out. Those categorized as “mainline Democrats” in the Poole-Rosenthal typology went for the bill 48-2, and “mainline-moderates” voted for it 44-7. In the most rightward category–“moderate-conservative”–Members split right down the middle, 25-25.
All the other variables don’t quite have the salience of Obama vote share, ideology, or abortion position. That should be at least mildly comforting to those Democrats who feared that pure political self-protection or insurance industry money were the major motivating factors for those voting “no.” And it’s very clear that the Democratic Left’s decision to support the bill despite concerns over its composition was absolutely crucial.

Yesterday’s edition of the Savannah Morning News has an interesting and instructive article by Patrick Rodgers about U.S. Rep. John Barrow (D-GA12) catching hell from African American community leaders in a conference phone call just before the Saturday vote on health care reform. An excerpt:

This past Saturday afternoon, Congressman John Barrow held a conference call with more than 50 African American faith and community leaders from Savannah and Augusta. The call, which lasted nearly an hour, was to discuss his planned vote against healthcare reform the following day…Several callers said they would pray for him to change his mind and told him stories of their own struggles with the current healthcare system.

Barrow, whose district includes 44 percent African Americans, held fast to his opposition, citing the Blue Dog litany of concerns, and adding, according to Rodgers, “I’m not against the bill, but I can’t vote on a concept. I have to vote on specific legislation,” Barrow told the group. “I want the good that’s in this to pass, but I’m not willing to accept the collateral damage.” Apparently, it fell a little flat:

Most of those in attendance were unwilling to accept his reasoning…”You’re voting to hurt people by doing nothing,” said one caller who explained how she lost her benefits after leaving her last job, and hadn’t been able to afford to get them back since opening a small business.
Savannah City Council members Mary Osborne and Van Johnson were part of the call as well.
“You’ve got districts suffering from persistent poverty,” Alderman Johnson told Barrow. “Unless you have another plan, we need you to support this.”…”Do you expect us to support you in the next general election?” one caller asked about 45 minutes into the conversation.

Although they weren’t able to flip his vote, Barrow may pay a high price for his intransigence. The Democratic Party is not rigged like the G.O.P. to invoke party discipline for those who buck the Party’s majority and leadership on major legislation. But the African American community leaders of GA-12 have provided an instructive example of how progressives can pick up the slack. Barrow will be lucky if he doesn’t draw a formidable primary opponent.

Ron Brownstein’s post, “Obama And The Supertanker” at The National Journal takes a look at the President’s overall philosophy and strategy of change and offers some illuminating observations about his leadership style. Brownstein begins by noting Obama’s consistent advocacy of “comprehensive, big bang” health care reform in response to his chief of staff’s more cautious incremental recommendations:

…Emanuel said he has intermittently provided Obama his assessment of “the equities” in more- and less-ambitious approaches, especially “given everything [else] we’re trying to do.” He continued, “This is what I’m supposed to do as chief of staff. But he has… always said, ‘This is what needs to be done,’ and he has said he is willing to pay the political price to get it done.”
…Win or lose, Obama has pursued health care reform as tenaciously as any president has pursued any domestic initiative in decades. Health care has now been his presidency’s central domestic focus for a full year. That’s about as long as it took to pass the Civil Rights Act of 1964, originally introduced by John F. Kennedy and driven home by Lyndon Johnson. Rarely since World War II has a president devoted so much time, at so much political cost, to shouldering a single priority through Congress. It’s reasonable to debate whether Obama should have invested so heavily in health care. But it’s difficult to quibble with Emanuel’s assessment that once the president placed that bet, “He has shown fortitude, stamina, and strength.”

Brownstein sees Obama as a big-picture thinker, whose

…aim is to establish a long-term political direction — one centered on a more activist government that shapes and polices the market to strengthen the foundation for sustainable, broadly shared growth. Everything else — the legislative tactics, even most individual policies — is negotiable. He wants to chart the course for the supertanker, not to steer it around each wave or decide which crates are loaded into its hull.
Obama’s core health care goals have been to establish the principle that Americans are entitled to insurance and to build a framework for controlling costs by incentivizing providers to work more efficiently. He has been unwavering about that destination but flexible and eclectic in his route. He has cut deals with traditional adversaries, such as the drug industry, and confronted allies to demand an independent Medicare reform commission. But Obama has also waged unconditional war on the insurance industry. He has negotiated and jousted with Senate Republicans. He has deferred (excessively at times) to congressional Democratic leaders but has also muscled them at key moments. He has pursued the liberal priority of expanded coverage through a centrist plan that largely tracks the Republican alternative to Clinton’s 1993 proposal.

Browstein quotes Yale University political scientist Stephen Skowronek, who argues that Team Obama embraces both a “consensual and confrontational” leadership style, “bringing everybody to the table [for] rational, pragmatic decision-making,” followed by “wrenching confrontation” — such as that embraced by “the most consequential presidents,’ including Lincoln and FDR.
Brownstein believes that Obama “…will continue to seek broad coalitions on some issues (education, energy, immigration) while accepting, even welcoming, greater partisan conflict on others (financial reform)…” But overall, says Brownstein, “The constant is Obama’s determination to turn the supertanker — and his Reagan-like willingness to bet his party’s future on his ability to sell the country on the ambitious course he has set.”
It appears we have a President who is also a strategic thinker, and today the results look very good indeed.

Today we learn that a coalition of State Attorneys General–12 so far–plan to launch a constitutional challenge to the just-passed-but-not-yet-signed Senate health reform bill on grounds that imposing an individual mandate to buy health insurance is not justified by the powers Congress enjoys under the Commerce Clause of the U.S. Constitution.
Interestingly enough, the media reports I’ve seen on this story do not mention that eleven of the twelve AGs in question are Republicans. The one Democrat, Drew Edmondson of OK, is running for governor in this very conservative state.
FWIW, few constitutional experts find any merit for a Commerce Clause challenge to health reform. But the proposed suit is probably part of a longstanding conservative legal effort to slowly chip away at the expansive view of the Commerce Clause, which has been the basis for a variety of important congressional actions, including the Civil Rights Act.
While the challenge is unlikely to get anywhere, it is worth remembering that there wasn’t much if any precedent for the decision in Bush v. Gore, either.

Just over a month ago, Jon Chait of TNR predicted that conservatives would “freak out” if and when health reform legislation was indeed enacted. Aside from the fact that many of them have been drinking their own kool-aid about the allegedly totalitarian implications of a health care system that would maintain America’s uniquely capitalist orientation towards health services, conservatives spent far too much time and energy celebrating the death of reform to accept its resurrection.
I don’t believe in spending too much time on schadenfreude, but it has been interesting to see the absolute shock with which some conservatives and tea party activists have reacted to last night’s vote. My favorite reaction is this from Newt Gingrich, posted on the Human Events site:

This will not stand.
No one should be confused about the outcome of Sunday’s vote
This is not the end of the fight it is the beginning of the fight.
The American people spoke decisively against a big government, high tax, Washington knows best, pro trial lawyer centralized bureaucratic health system
In every recent poll the vast majority of Americans opposed this monstrosity
Speaker Pelosi knew the country was against the bill. That is why she kept her members trapped in Washington and forced a vote on Sunday.
She knew if she let the members go home their constituents would convince them to vote no.
The Obama-Pelosi-Reid machine combined the radicalism of Alinsky, the corruption of Springfield and the machine power politics of Chicago.
Sunday was a pressured, bought, intimidated vote worthy of Hugo Chavez but unworthy of the United States of America.
It is hard to imagine how much pressure they brought to bear on congressman Stupak to get him to accept a cynical, phony clearly illegal and unconstitutional executive order on abortion. The ruthlessness and inhumanity of the Obama-Pelosi-Reid machine was most clearly on display in their public humiliation of Stupak.

Hugo Chavez! Saul Alinsky! A six-adjective sentence (“big government, high tax, Washington knows best, pro trial lawyer centralized bureaucratic health system”)! The end of civilization as we know it!
This is the same Newt Gingrich, mind you, who led a Republican-controlled Congress over the brink in 1995 and 1996 in the pursuit of extremely unpopular policies, arguing he had a mandate from the electorate to carry out a conservative revolution. And this is the same Newt Gingrich who increased the power of the Speaker’s Office to levels not seen since the days of “Czar” Reed, all but abolishing the seniority system and making loyalty to the Speaker and the Caucus’ agenda the only criterion for advancement. As for “intimidation”: wonder what Gingrich thought of those Republicans who placed photos of defeated 1994 Democrats on the seats of wavering Democratic Members yesterday?
Gingrich’s crocodile tears for Bart Stupak are even more ludicrous. Stupak made himself a national celebrity by creating a symbolic fight over essentially inconsequential language differences in the House and Senate provisions on abortion. Yesterday he accepted a symbolic victory that was equally inconsequential, and folded his tent. I can’t imagine how Obama, Pelosi and Reed were guilty of “ruthlessness and inhumanity” by accepting his face-saving deal.
Newt was almost certainly playing for the galleries where his heart really lives these days: among potential 2012 caucus-goers in Iowa, a right-tilting crowd if ever there was one. And speaking of Iowa Republicans, Rep. Steve King outdid Gingrich in his remarks to a crowd of Tea Party protestors outside the Capitol last night:

“You are the awesome American people,” said King. “If I could start a country with a bunch of people, they’d be the folks who were standing with us the last few days. Let’s hope we don’t have to do that! Let’s beat that other side to a pulp! Let’s chase them down. There’s going to be a reckoning!”

It’s interesting how King alternates between a threat of violence and a threat to leave this godless socialist country behind and take the “real Americans” with him.
Let’s hope Republicans get a grip over the next few days.

Step back a minute, take a deep breath and tune out all of the spin and yammering to consider the magnitude of what has been achieved with the House vote on HCR: For starters, America will very soon be a country where no insurance company can deny health coverage to a child because of prior illness or condition. That alone is a truly monumental reform, which honest opponents of the bill will acknowledge.
Every family in America can now breathe a little freer with that knowledge, and great credit is due to the President his staff, Speaker Pelosi and House Majority Leader Hoyer, as well as the courageous House members who risked their careers to do the right thing. There’s more, much more, that can be said about the positive impact of this bill, as well as the problems associated with it. But for now, the immediate health security it will provide for millions of children is a very great accomplishment for America, and not incidentally, the Democratic party.

For many months now, we’ve been hearing the GOP threat that Democrats will pay dearly for supporting the health care reform package. Now might be a good time to ask conversely whether any House Dems who voted against the bill will lose support in November.
Most of the 34 Dems who crossed over to support the Republicans in the key vote should be safe, just because of the power of incumbency, which is strong even for members of the party in power in mid-term elections. One exception might be GA Democratic Rep. John Barrow, whose 12th congressional district, which stretches from Savannah to Augusta, includes 44 percent African American voters. Presidential nominee Obama cut an ad for Barrow in his last campaign, so Barrow’s negative HCR vote may alienate some of his district’s stronger supporters of President Obama and/or HCR. Barrow did defeat an African American primary challenger in 2008, but other Black leaders in his district must be wondering if they could unhorse Barrow in the Democratic primary.
Rep. Artur Davis (AL), the only African American congressman to oppose the HCR package, on the other hand, won’t be vulnerable to a primary challenge because he is running for Governor of Alabama. Davis won three of his terms by landslides and one with no opposition. Clearly, he sees his vote against HCR as a net asset for his gubernatorial campaign. He may be right, although even in AL, his HCR vote could hurt with state progressives in a close election.
Race would not be the only consideration, however, in assessing constituent disapproval of the votes against health care reform. A few of the 34 nay voters, including Heath Shuler (NC) and Stephen Lynch (MA) have substantial liberal enclaves/constituencies in their districts, which could make a difference as stay-at-homes in a close election.
Here is The Hill’s list of the 34 Dems who voted no on health care reform:

Rep. John Adler (N.J.)
Rep. Jason Altmire (Pa.)
Rep. Michael Arcuri (N.Y.)
Rep. John Barrow (Ga.)
Rep. Marion Berry (Ark.)
Rep. Dan Boren (Ind.)
Rep. Rick Boucher (Va.)
Rep. Bobby Bright (Ala.)
Rep. Ben Chandler (Ky.)
Rep. Travis Childers (Miss.)
Rep. Artur Davis (Ala.)
Rep. Lincoln Davis (Tenn.)
Rep. Chet Edwards (Texas)
Rep. Stephanie Herseth Sandlin (S.D.)
Rep. Tim Holden (Pa.)
Rep. Larry Kissell (N.C.)
Rep. Frank Kratovil (Md.)
Rep. Dan Lipinski (Ill.)
Rep. Stephen Lynch (Mass.)
Rep. Jim Marshall (Ga.)
Rep. Jim Matheson (Utah)
Rep. Mike McIntyre (N.C.)
Rep. Mike McMahon (N.Y.)
Rep. Charlie Melancon (La.)
Rep. Walt Minnick (Idaho)
Rep. Glenn Nye (Va.)
Rep. Collin Peterson (Minn.)
Rep. Mike Ross (Ark.)
Rep. Heath Shuler (N.C.)
Rep. Ike Skelton (Mo.)
Rep. Zack Space (Ohio)
Rep. John Tanner (Tenn.)
Rep. Gene Taylor (Miss.)
Rep. Harry Teague (N.M.)

In addition to the power of incumbency, what these Dems have going for them is that it is late for primary challengers to start new campaigns, if they haven’t already. Some of the 34 will also likely be getting lots of love in the form of dough from insurance companies and the like.
I’m sure that some of the Dem nay voters acted on principle, though all probably saw their votes as a matter of political survival. Sad, however, that they chose to be part of the fear-driven past, rather than the hopeful future. They risked hurting their party, as well as the health of their constituents. As E.J. Dionne, Jr. put it in his WaPo column:

To understand how large a victory this is, consider what defeat would have meant. In light of the president’s decision to gamble all of his standing to get this bill passed, its failure would have crippled his presidency. The Democratic Congress would have become a laughing stock, incapable of winning on an issue that has been central to its identity since the days of Harry Truman.

For Dems there’s always the thorny problem of primary challenges usually helping the Republicans. Of course, Boehner and company will praise the 34 Dems to the hilt, and then do everything they can to replace them with Republicans, where possible. All of those who are running this year are banking to some extent on most HCR supporters forgiving and forgetting by November, which could be a dicey bet. And President Obama may have a Lincolnesque capacity for political forgiveness, but Rahm Emmanuel most emphatically does not.
It may not be fair to pigeon-hole all of these Dems as DINO’s, since they vote with their party most of the time. That’s life in the big tent. Still, progressive Dems can’t be blamed for asking, if they are not with us on such a central legislative reform, one which could save many lives and one which could have decided the President’s re-election chances, then who are they?

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.