Basically, as Jonathan suggests, the least-bad option for the Dems is going to be getting the House to swallow the Senate version of the bill whole. That can come with promises of fixing things later, perhaps through reconciliation, or perhaps by packaging it with some other popular bill. But I agree with the political logic that marginal Dems are generally better off if the bill is a law than if it isn't.
Just one caveat to that, however. Cohn writes:
Democrats from both ideological sides ought to consider whether voting against it now really spares them political blow-back. All of them have already voted for a health care bill. And that means they can expect one of the following two advertisements this fall:The problem is that this logic only holds for Dems who did, in fact, vote for health care. And the bill passed the House narrowly. So if only a handful of those who already voted for the bill bail -- because of electoral panic, or because they can't swallow various specific provisions that are different than the House version (for liberals, no public option; for Dem right-to-lifers, no Stupak, and that's just the big ones)...well, even though the bill should look better for all the moderates who opposed it on the House floor earlier, it's an open question whether they'll be willing to flip from no to yes at this point. There is another way of thinking about it, which is that each Democrat is better off if the party as a whole (and the president) looks good, and that the way to do that is to pass the bill. I think that's a strong logic, but whether it's enough to prevail...well, Pelosi might know whether she has the votes, but then again she might not know.
Candidate X is an out-of-touch liberal who voted for the horrible health care reform bill that passed.
Candidate X is an out-of-touch liberal who voted for the horrible health care reform bill that almost passed.
It seems to me the two ads would be equally effective, unless Democrats can counter it by touting the benefits of reform--by reminding voters that, in the future, they won’t have to worry that insurance will run out when they get sick, that they’ll be able to have a binding appeal when insurers deny coverage, that they’ll be guaranteed emergency room coverage without prior approval, that they’ll be able to change jobs worrying about losing insurance, and so on.
But the only way to make that argument is to pass health care reform. No matter what happens on Tuesday.
By the way, if this thing does fall apart then the failure of the Dems to move quickly to strike a deal -- by, say, January 1, holidays be damned, with final votes taken in the House and Senate by January 15 -- may go down as one of the great blunders in the history of legislating.