Good health care law won't expire like milk

In the congressional battle over health care, a coalition of centrist Democrats may be saving their party from itself.

Liberal Democrats have been pushing to ramrod a massive overhaul of American health insurance through Congress at warp speed. They fear it will get snarled in election year politics, as happened to Bill Clinton’s proposal in 1994.

They’ve run into resistance from three different camps.

Some Republicans appear to view the whole issue merely as an opportunity to inflict a crippling defeat on President Obama. Other Republicans – Sen. Charles Grassley of Iowa, for example – genuinely want reform, but in a less government-intensive form than Obama and his liberal congressional allies.

In the catbird seat is the Democratic centrist minority, including lawmakers known as Blue Dogs. Fiscally conservative for the most part, they are strategically positioned to block legislation. They’re finding a lot of common ground with the constructive Republicans.

Between them, they’ve prevented Obama and congressional leaders from getting health care legislation through both House and Senate August recess.

On Wednesday, U.S. Rep. Adam Smith of Tacoma laid out the case for delay to this newspaper’s editorial board:

“They’re saying, if you can get the votes for something, do it. I’m saying, from my experience, it has to be a durable agreement that, when people see it, they say, ‘OK, I can support that.’”

If a health reform package can’t survive public scrutiny and criticism through the month of August, he said, it’s not going to survive as a national policy even if it is somehow rushed into law.

Smith noted that the state Legislature passed its own sweeping health reform bill in 1993. As the public and state businesses discovered more about its various mandates – which would have raised payroll costs and squeezed many patients into managed care – a backlash ensued.

Voters replaced the Democratic majorities with Republican majorities, and the reforms got repealed.

There’s no reason the same thing can’t happen nationally. In fact, it has – in 1988, when angry retirees forced Congress to repeal what had seemed a beneficial provision to expand Medicare coverage for catastrophic medical expenses.

Public support for national health care reform this year is already eroding quickly. Much of the reason is that Americans simply don’t understand the complexity of the proposals. They fear the unknown.

Congress won’t win more support by greasing a package through before people figure out what’s in it. The potential for backlash is enormous: Americans are rightly concerned about any changes that affect their personal care. The public must be brought along – even if passage must be deferred until the early months of an election year.

It’s imperative to cut the cost and expand the reach of health care. But if it’s not done right, it won’t stick.