This is just a reminder.
Democratic candidates for President will be releasing quite a few health policy plans now and over the next several months. Those plans will be some variant of Medicare for All or pothole fillers for the ACA or somewhere in between. Some of them will be technically good in the sense that they have a clearly defined logic model that explains where we are, where they want to go and how to get there. They won’t invoke magic. Other plans are fantasies and feel good signifiers that would fall apart at the first touch of legislative text in a universe with seventy five willing Senators and 290 willing members in the House.
All of that is important. I like candidates who don’t invoke magic to explain how they intend to achieve their policy ends.
One of the critical things to remember though is that these plans don’t matter too much. The critical combination (as always) is 218-51-1-5 in 218 votes in the House (including the Speaker willing to schedule the vote), 51 in the Senate (including the Majority Leader willing to schedule the vote) a President to sign the law and 5 votes on the Supreme Court to interpret the law against highly probable challenges.
Under one branch of highly plausible scenarios, the winning coalition of 51 votes in the Senate will have Senator Manchin (D-WV) as a key member of the winning coalition on any health insurance reform bill. Under another branch of plausible scenarios, the marginal Senate vote is either Senator Collins (R-ME) or Senator Murkowski (R-AK).
Keep that in mind as you evaluate plans.
I think that the process of planning reveals quite a bit about candidates and their ability to be an executive even if there is a significant probability that anything that they propose won’t ever pass as initially proposed.
So remember the Senate as we listen to campaign promises.
The Senate, the 2020 Democratic Primary and health plansPost + Comments (17)