The Aftermath

Although it may seem that the healthcare saga within the House of Representatives reached a dramatic final climax with last week’s passage of the Affordable Health Care for America Act  (NOTE: this hyperlink takes you to all 1990 pages of the House reform package … have a good read), it seems we have not come to the dénouement  (a new word I learned from my associate) that many had predicted in the ongoing drama – and, drama it is.  Rather than resolving the healthcare debate, the bill’s passage kept the House in the spotlight of center stage throughout much of the week as the repercussions of the bill began to take form. Instead of reaching a final conclusion and moving on, both sides of the aisle are feeling the political hangover effects of the vote.

While the House’s 220-215 vote came as a crowning achievement for Speaker Nancy Pelosi (D-CA), the respective right and left wing of both parties were dismayed.  On the left, Democrats were pitted against Democrats by liberal policy groups who initiated a comprehensive campaign to attack the position of the 39 House Democrats voting against the bill.  The vast majority of the Democrat members who voted in opposition to the plan face overwhelming resistance from constituents and hail largely from historically conservative districts.  Yet there was no forgiveness from the liberal wing of the party. The highly liberal MoveOn.org launched a $500,000 television campaign targeting those who voted against the bill.  In a similar action, the Progressive Chance Campaign Committee launched their companion attack – “Hit the Blue Dogs,” an online ad campaign.  Meanwhile, the liberal Health Care for American Now, a public-employee union group, initiated a series of thank-you commercials to support freshmen legislators in battleground states.  Evan Tracey of the Campaign Media Analysis Group wryly noted, “You’re going to see a healthy dose of groups going to … backslap Democrats who voted for this bill.  And, conversely, you’re going to see those who opposed try to go and shine a light on them.” Nothing could be closer to the truth.

Bearing the brunt of the Democrat backlash were Rep. Jim Matheson (D-UT) and Rep. Ike Skelton (D-MI).  Both were plagued throughout the week with protestors demonstrating in front of their Congressional offices.  Making matters even more complicated for moderate Democrats was the inclusion of a clause disallowing the coverage of abortions in the federal healthcare plan.  The approach essentially places in the health reform package the controversial Hyde Amendment which was adopted some 20 years ago as a compromise position.  Known as the Stupak Amendment, Rep. Bart Stupak (D-PA) outraged many free choice advocates with his measure although it was supported by 64 Democrats – about a quarter of the party’s caucus.  Having passed by a 240-194 vote margin, it added fuel and fodder to those within the Democrat party who feel that core party positions were compromised.  In fact, a debate began to emerge on whether or the not “the tent is too big.” 

Not to be outdone, the other side of the aisle was equally acrimonious.  Rep. Anh “Joseph” Cao (R-LA), who provided the sole Republican vote in favor of the healthcare bill, bore the brunt of considerable criticism by the conservative wing of his party. Following the vote, Cao felt the immediate media onslaught with both condemnation and support of his decision.  His office was ground zero for demonstrators at local offices and angry phone calls from all directions. Cao narrowly defeated incumbent Rep. William Jefferson (D-LA) last November after federal authorities brought Jefferson up on corruption allegations when $90,000 of cash was found stashed away in his freezer. Jefferson received a 13-year jail sentence  on Friday. Sitting in a district that many assume will switch back to Democrat control after the next election, Cao – who has “no regrets” about his vote – needed to appease his constituency who strongly favored the bill.

As I have repeatedly suggested, it is difficult to maintain a position in the center of any debate on Capitol Hill in today’s environment.  Yet, the center is where major legislative changes have occurred throughout US history.  While Representatives Cao, Matheson, and Skelton all moved towards moderate positions with their respective votes, each of them felt the backlash of those decisions in the aftermath. Though sitting in the middle may prove to be the most practical way of solving the country’s problem, last week’s healthcare vote shows how precarious the middle can be for politicians in districts with fragile coalitions who open themselves up to criticism from both liberal and conservative factions of both parties.  It’s equally clear as the House adjourned this past week for the Veteran’s Day recess that, while Congress is being bombarded by the liberal and conservative wings of their respective parties, the Members will ultimately start focusing on a more important group in the very near future – their constituency. After all, elections are in November 2010.

Kevin Fickenscher, MD

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.