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Health Reform Goals May Shrink

^{William R. Boyles}

Believe it or not I was not that surprised. I have been saying for months that there will be a predictable GOP gain in the mid-terms that is much stronger than usual. It started with the governors and will probably result in 20-25 new GOP seats in the House next January, 2-3 Senators. A predictable political shift to old-timers.

But like many things in American politics, it's not the event but the reaction. If nothing else this makes it easier for the next session of Congress in 2011 -- with a different majority -- to modify whatever may come out of this Congress. Whatever happens the industry will benefit. The really experimental stuff like eliminating pre-existing conditions first, adding revenue later is toast. But don't count on them dropping the Cadillac tax or Medicare Advantage cuts just yet.

The pundits' idea this was surprise to Obama is funny. This has been in the White House playbook from day one. That's the main reason Obama was so obsessed with getting it done last year. The politics were always clear. It was always assumed that the GOP will gain seats and modify the final bill in 2011 and 2013, hence the effective dates. In fact some conservative Dems voted for the House bill assuming it will be modified by the mid-term election results. It's a fail-safe vote.

And don't be too fooled by the ridiculous media chatter and polls. The media was wrong all last year in insisting that reform would never get over the hurdles. Now they can boast they were right (they think) and start swinging the other direction with I told you so. It's the new media sheep scenario. The polls show how huge the smear campaign was by the GOP as it backs the docs and counts their funds.

I think we will find out very soon (this week) what will happen next. My guesses are either (a) the WH will keep insisting it is on track but actually delay until after the election while blaming the GOP for the delay, or (b) buy off 2 or 3 Senators with huge changes that get the 60 votes. The House liberals will not kill Obama's presidency when push comes to shove so it could still happen. 05/19/2010

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