Health Insurance Reform Status

Nate Silvert, 538:”The beltway consesnsus seems to be that the Democrats’ prospects of passing meaningful health insurance reform this year have become much slimmer, if they haven’t already entirely evaporated. Like Ezra Klein, however, I’m not really sure what everyone was expecting. There is a lot of money — and political capital — at stake here. Were opponents of health care reform going to roll over and play dead? Has anything proceeded that differently from how we might have expected it to proceed ahead of time?

Over at Intrade, the bettors currently assign a 43 percent chance that a health care bill with a public option will be passed by the end of the year. There is no market, unfortunately, on the prospects for passage of a bill without a public option (something which could still happen under any number of scenarios). What’s interesting about this contract, though, is that it’s not particularly higher or lower than it has ever been. Sure, health care has had a bit of a rough go of things of late, but perhaps not a particularly rougher go than we should have been “pricing in” to our expectations:  To hear the defeatism and paranoia on some liberal blogs this afternoon, the “timeout” that Harry Reid and the Senate called on health care today — they won’t vote on the measure before the August recess — is just about the stupidest thing since Chris Webber, pictured at left, called a phantom timeout in the 1993 finals, costing his team a technical foul and the Michigan Wolverines the national championship.

It isn’t. It is, first of all, inevitable, and second of all, about as likely to do the Democrats some good as some harm, although that may depend on certain exogenous factors that are relatively outside of their control.

Ten days ago, I wrote a piece entitled, “Why Democrats Have No Time to Waste“, the thesis of which was basically that Obama’s approval ratings were liable to decline over the near-to-medium term and so Democrats had better get busy on health care while they could.

But a couple of things have happened since then.

Firstly, the media environment has become very treacherous. There’s been all sorts of piling on, for instance, about last night’s satisfactory press conference — this is almost certainly the most sustained stretch of bad coverage for Obama since back when Jeremiah Wright became a household name after the Ohio primary.

I don’t think the media has a liberal bias or a conservative bias so much as it has a bias toward overreacting to short-term trends and a tendency toward groupthink. The fact is that there have been some pretty decent signals on health care. Yes, it has stalled in some committees, but it has advanced in others; yes, the Mayo Clinic expressed their skepticism but also the AMA — surprisingly — endorsed it; yes, the CBO’s Doug Elmendorf got walked into a somewhat deceptive and undoubtedly damaging line of questioning about the measure’s capacities on cost control, but also, the CBO’s actual cost estimates have generally been lower than expected and also favorable to particular Democratic priorities like the public option. This all seems pretty par for the course, even if you wouldn’t know it from reading Politico or Jake Tapper, who giddily report on each new poll telling us the exact same thing as though there’s some sort of actual news value there.

The media likes to talk about “momentum“. It usually talks about the momentum in the present tense — as in, “health care has no momentum”. But almost always, those observations are formulated based on events of the past and sloppily extrapolated to imply events of the future, often to embarrassing effect: see also, New Hampshire, the 15-day infatuation with Sarah Palin, the Straight Talk express being left for dead somewhere in the summer of 2007, the overreaction to “Bittergate” and the whole lot, and the naive assumption that Obama’s high-60’s approval ratings represented a paradigm shift and not a honeymoon period that new Presidents almost always experience.

I also believe that the media can, in the short term, amplify and sometimes even create waves of momentum. But almost always only in the short term. And that is reason #1 why it’s not such a bad thing that the Democrats are getting a breather on health care. They’re at, what I believe, may be something of a ‘trough’ or ‘bottom’ as far as this media-induced momentum goes. By some point in August, the media will at least have tired of the present storyline and may in fact be looking for excuses to declare a shift in momentum and report that some relatively ordinary moment is in fact the “game changer” that the Democrats needed. This is not to say that the real, underlying momentum on health care has especially good — and the Democrats’ selling of the measure certianly hasn’t been. But it hasn’t been especially poor either . As I’ve said before, the health care process has played out just about how an intelligent observer might have expected it to beforehand.

The second reason why the delay might be OK for the Democrats is because of the economy. Nobody much seems to have noticed, but the Dow is now over 9,000 and at its highest point of the Obama presidency; the S&P is nearing 1,000 and the NASDAQ has gained almost 55 percent since its bottom and has moved upward on 12 consecutive trading days. There are ample reasons to be skeptical about the rally — it isn’t supported by strong volumes, and it’s almost entirely the result of surprisingly solid corporate earnings numbers rather than the sorts of figures that Main Street cares about. But, there are two big dates to watch out for. On July 31, an advance estimate of second quarter GDP growth will be released, and on August 7th, we’ll get the monthly report on the unemployment situation. If either of those reports reflect the optimism elicited by the corporate earnings numbers — in this context, a job loss number under ~250,000 or a 2Q GDP number somewhere close to zero — there will be a lot of quite optimistic chatter about the end of the recession which might not penetrate to Main Street, but which will at least have some reverberations on Capitol Hill.

A few hours ago, I asked our readers what they expected Barack Obama’s Gallup approval rating to be on August 31st, when the Senate’s recess will be just about over and the health care sausage-making will begin again. The average guess was 55 percent, which is exactly where it is today (a new low for Obama, we should mention). I should caution that our readers lean probably 2:1 or 3:1 liberal, and so there might be some optimism bias in this unscientific sample. But that strikes me as about the right assessment. Obama’s numbers don’t have much more room to fall before they hit the 53 percent threshold that actually elected him last November. And I don’t think they’re liable to go too much below that mark unless something actually and tangibly bad happens — a bad unemployment report (or a sharp reversal of the market rally), the actual collapse of health care, some bona fide major gaffe, etc. Any of those things, indeed, could happen. But just as likely Obama will benefit from some good economic numbers or simply some reversion to the mean as the media firing squad picks up and plays golf for a month.

The Democrats could find themselves in a better position after the August recess or they could find themselves in a worse one — how’s that for a bold prediction! But liberals’ doom-and-gloom, conservatives’ glee, and the media’s nearsighted reporting are all equally uncalled for.”


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