I think Greg Sargent captured the significance of yesterday’s big vote better than anyone I’ve yet read:
Last night’s big health reform victory made history in many ways, but in hard political terms perhaps the key one is this: This is the first landmark piece of reform that passed over the unanimous opposition of one major party.
Both Social Security and Medicare had bipartisan support. While they were both the achievements of Democratic presidents, there isn’t a clear sense in the public mind that it was entirely the work of one party over the implacable opposition of the other one.
Now an achievement of equal magnitude—health care reform, which will dramatically reshape a vital aspect of American life—is about to pass into law as the work of one party and one party alone. The other party emerges from this battle defined entirely by its unanimous opposition to it.
This could have more dramatic repercussions than any of us know right now, perhaps helping define the differences between the two parties for years, in a way that no other major political battle has.
Republicans say—publicly—that this will play in their favor, and claim the public will reward them for showing the fortitude to stand firm against a far-reaching expansion of government into a deeply personal aspect of our lives. Democrats counter that Americans will realize that the dreaded government takeover warned against by reform foes is a caricature—and that once they do, it will reinvigorate the pact between government and the American people.
All this is to say that the real argument underlying this fight—this chapter in the larger ideological showdown over the proper role of government in our lives, an argument that has taken mutiple forms throughout our history—is only beginning. There will now be an actual law that frames and defines this debate. And the fact that each party placed all its chips on competing visions dramatically ups the stakes, with untold consequences to come—not just for the parties, but for the prospects of future far-reaching legislative initiatives.
The one wrinkle he doesn’t catch is the one Jay Cost highlights:
Harold Lasswell defined politics as who gets what, when, and how. By this metric, ObamaCare is bad politics for the foreseeable future. Like any major piece of legislation, this bill assigns winners and losers. The winners will be those who today are uninsured, but who will (eventually) acquire insurance. But there will not be a major reduction in the uninsured until 2014. So, the actual winners are going to be pretty few in number for some time.
Meanwhile, the losers begin to feel the effects immediately. Between now and the next presidential election, ObamaCare is going to pay out virtually zero dollars in benefits, but it will take billions out of Medicare. This is bad for seniors. They have an incentive to oppose portions of this bill (while supporting others, like the closing of the “Doughnut Hole,” which Republicans will never repeal). While the Democrats will claim that this reduction in benefits will have no effect on the quality of their care, CBO is much less certain . . .
After decades of developing a reputation for defending the interests of senior citizens, the Democrats have put it in serious jeopardy with this legislation. And they’ve done so right at the moment when demographic shifts are making the senior population more powerful than ever.
How will it all play out? Only time will tell.