You Go to Reform Health Care With the Joe Lieberman You Have

Remember last week's health care deal? The one that was going to save health care reform? Well, it increasingly looks like (as predicted) it wasn't much of one — and mostly because of Sen. Joe Lieberman. Lieberman, who'd previously taken a squishy position on the deal's Medicare buy-in plan, has said that he no longer favors the idea, and cannot support reform if it includes either an expansion of Medicare or a public option. Given that Sen. Ben Nelson is expressing similar reservations, and Sen. Olympia Snowe — the one Republican who's signaled any willingness to consider voting for reform — has also expressed opposition to the Medicare buy-in, that leaves Senate Majority Leader Harry Reid without the requisite 60 votes. 

Conservatives are already gloating, while liberals, not surprisingly, are furious. Ezra Klein writes that Lieberman "seems willing to cause the deaths of hundreds of thousands of people in order to settle an old electoral score." Matthew Yglesias says he's demonstrated a "willingness to embrace sociopathic indifference to the human cost of their actions." And TNR's Jonathan Cohn suggests that this could count as a "double cross." Yet Democrats may find it difficult to punish the Senator: As TPM's Brian Beutler tweets, "there may be penalties for Lieberman. But he can just say, 'fine by me… I'm your 60th [vote] on everything!'"

So is health care reform dead? Not quite. It's pos

sible, if highly unlikely, that the CBO score, due sometime later this week, could include news that might interest one or more of the dissenters. It's also possible that Democrats could attempt to forgo Senate moderates and pass the bill in reconciliation — although this has largely been ruled out as an option so far, and for good reason. And it's also possible that Democrats could simply strip the offending provisions of the deal and try to go forward from there, though as Sam Stein notes, this "would likely lose Reid several progressive votes — advancing the cause no further."

If there's still a deal to be made, however, I think it's this last one. Liberals are desperate to pass a bill, any bill, and might be willing, in the end, to let Lieberman have his way in order to get something they can call health care reform passed, no matter how watered down the final legislation is from their initial objectives.

Of course, even then, Leiberman could, after pushing them toward a new compromise, change his mind again and decline to support the bill entirely; having proved his point that no matter how much liberals dislike him, they have to bargain with him, he could simply walk away, leaving them with nothing. Indeed, it's not clear whether Lieberman actually wants something specific from the legislation or whether, like General Zod in Superman II, he simply wants to show Senate Democrats (and their liberal supporters) that he is strong and they are weak.