The Sausage Factory...

So the House has passed a health care reform bill, 220 to 215.  Just exactly what bill they passed is anyone's guess – at over 2,000 pages and with amendments being made right to the last minute, I doubt that anyone who voted for it had any real idea.

Pelosi used a combination of compromise (e.g., removing funding for abortions), threats (e.g., withholding desirable positions, earmarks, or election support), and bribes (e.g., special language directing health care funds to particular districts) to get enough votes.  Many commentators on the right are crowing because the vote was so close – the Democrats have a 70+ vote majority and all they could muster was a 5 vote margin?

But these commentators miss an essential part of the sausage factory of politics...those Democratic “no” votes were carefully calculated and parceled out to at-risk Democrats.  They fought each other for the right to vote “no” without incurring Pelosi's fearsome wrath (and subsequent punishment).  The Democratic leadership isn't completely stupid – they know darned well that Democrats will lose a significant number of supporters over this health care bill (only a bare majority of Democrats support health care reform at all, and less than a majority support this reform).  So those Democrats who don't have very solid support at home are placed at risk by a “yes” vote on this ground pig of a bill. 

So the main thing the close vote really tells us is that the Democratic leadership is indeed very afraid of the impact of Pelosicare on the 2010 elections.  They would rather have the bad PR of a close vote than put too many members at risk.  Insiders report that competition for Pelosi's permission to vote “no” was intense and hard-fought – and a good number who wanted that permission were denied it.  In other words, the number of House Democrats who perceived a risk in voting “yes” was substantially larger than the number who voted “no”.

Here's hoping the voters remember the ground pig bill come next November...