Will Health Care Reform Go Down in Massachusetts?

Who would have ever predicted that health care reform would finish with an honest-to-goodness threat from a Republican in a Massachusetts special election over a Kennedy seat? A year ago—hell, two months ago—no screenwriter, novelist, or pundit would have possibly have predicted that the GOP had a shot to win a Senate seat in Massachusetts. But as of just a few hours ago, Republican candidate Scott Brown became the near-universal favorite, with whip-smart liberal pollster Nate Silver, whose voting model correctly predicted every Senate race in 2008, positing that Brown had a 3:1 chance of winning against Democrat Martha Coakley.

A Brown win would mean that Democrats would lack the 60 votes necessary to pass a revised health care reform bill in the Senate. That's sent party leadership into full-on panic, with administration officials scrambling to ready a backup plan. Right now, that means asking the House to simply vote up or down on the Senate bill with no changes. In theory, the bill could be altered in reconciliation afterward. But getting buy-in from House members is going to be exceedingly difficult. On one hand, progressives won't like swallowing the unchanged Senate bill; reconciliation offers only limited opportunities for post-vote modification. And moderate Democrats, led by Bart Stupak, will have a tough time voting for the Senate's weaker abortion language.

The bigger hurdle for Democrats, however, will be the anxiety and political upheaval caused by the election. If Brown wins, it will be in large part because of high turnout from independents who oppose the health care reform bill. That's going to make going forward with reform, already a big gamble, even riskier. As The Business Insider's Joe Wiesenthal notes, if Pelosi manages to pull together enough votes after the Democratic chaos that's sure to ensue following a Brown win, it will be pretty remarkable.

Naturally, all of this hinges on Brown winning tomorrow, an outcome that's by no means certain. The poll results paint a pretty clear trend, but it's still fairly close, and, as Silver notes, it's possible that voter turnout—which is especially hard to predict in special elections—won't resemble pollster models. Still, it would provide some awfully good closure and narrative symmetry if this attempt at health care reform, which arguably began with the passage of RomneyCare, went down in the same state where it started.  

Update: The Hill floats another option—rush the bill through before Brown is seated:

Congressional Democrats are considering passing healthcare reform before the winner of the Massachusetts special election is seated in the upper chamber, Democratic sources say.

…"That would be an option," said a senior Democratic aide, who downplayed an alternative scenario wherein the House would pass the Senate-approved healthcare bill without changes.

If Coakley wins, Democrats will retain their 60-vote, filibuster-proof majority in the Senate.

Leaders will make a final decision when results of the election are known, but sources close to the Democratic leadership in both chambers say a speedy vote is the best option.

The plan could backfire if a single Democratic senator, such as Sen. Ben Nelson (Neb.) or Sen. Evan Bayh (Ind.), objected on grounds that it would violate the will of voters in Massachusetts.

Rushing the final bill through the Senate before Brown could take a seat would be difficult.

The president and Democratic leaders must reach an agreement, receive a cost analysis from the Congressional Budget Office (CBO) and give lawmakers and the public 72 hours to review the final language. Finally, they must pass the bill through the House and wade through the final Republican procedural objections in the Senate before clearing the bill to President Barack Obama.

On Friday, Reason Senior Editor Michael Moynihan noted the incredible incompetence of Martha Coakley's campaign. And over the weekend, he talked with pro-Scott Brown protestors outside President Obama's Coakley-support speech at Northeastern University: