Why Pelosi Doesn't (Yet) Have The Votes For The Senate Health-Care Bill

Speaker of the House Nancy Pelosi fueled speculation of health care’s demise when earlier this morning she told reporters, "I don't think it's possible to pass the Senate bill in the House. I don't see the votes for it at this time." Which, for me, raises an interesting question: how is it that Pelosi, with 256 Democrats in her caucus, 219 of whom voted for the bill the first time around, doesn’t have the 218 votes she needs to approve the Senate bill?

From what I can tell, the answer is this: among those 256 Democrats, she has a lot of colleagues unhappy with, and unwilling to vote for, the many compromises that their Senate counterparts made.

The Senate bill required a lot of dealmaking to get the whole Democratic caucus on board. In that process, a number of House provisions got watered down or altogether dropped. The Senate nixed the public option and then the Medicaid buy-in when that was causing issues. Their Medicaid expansion and federal subsidies are much smaller. The Senate bill would create less ambitious state-level exchanges rather than the national exchange in the House bill. Senators toned down abortion language, from the very strong Stupak restrictions to a more moderate version crafted by Ben Nelson from Nebraska and Harry Reid. Take a look at the two bills side by side and you'll see the Senate bill is consistently a compromise.


This kind of compromise works well when you’re trying to woo a moderate senator like Ben Nelson. But not so much when you want to win over a more liberal House who seem, from most estimates, unwilling to part with their more ambitious demands. It’s mostly noted liberals Anthony Weiner of New York, Lynn Woolsey of California and Barney Frank of Massachusetts making the television circuits declaring the Senate bill untenable (Frank, to be fair, walked back on his comments a bit earlier today). None have commented specifically on what exactly they find so objectionable about the Senate bill, but the general sense is that it’s just too weak.

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