Matthew Yglesias spells out the political case for passing health care reform:
If you've already voted for health reform, which a majority of House members and 59 Senators have, then you're already going to get hit with 100 percent of the hits that accrue to people who vote for Obamacare. Nobody is going to care about the fine nuances of "senate bill" versus "house bill" or whatever. It's Obamacare and you're going to get hit.
The question is whether you'd rather get hit for your participation in a discredited failure that's been abandoned by its own architects, or whether you'd rather get hit for participation in a controversial but successful effort to fulfill the decades-long promise of universal health care? I don't think it's even close. If the bill passes, that generates a positive narrative around the bill that can compete with the negative narrative. If it fails, then you've got all the negative narratives but you also add on a new bonus negative narrative of gridlock and failure.
I think Yglesias is basically right that Democrats who voted for a health care bill will take political hits for doing so regardless of whether or not it passes. The hits might be somewhat weaker if the bill doesn't pass, but yes, those attacks will come no matter what.
Where I'm less inclined to agree with Yglesias is on the second part of his argument. Granted, it's tough to predict how a year's political narrative will shape up months in advance, so he could be right. But he basically assumes that Democrats will be able to gin up some goodwill for the bill if they pass it. Yet given the bill's low and rapidly sinking popularity, I'm skeptical that that will happen.
Moreover, since the only way for the bill to pass at this point is to use the budget reconciliation process in the Senate, passing it would require relying on what will be portrayed as procedural trickery—a circumvention of the Senate's traditional process. Fair or not, I can't imagine that Republicans will talk about it any other way. And if we've learned anything about public opinion during this health care debate, it's that the public doesn't like either drawn out political debates or the messy details of the legislative process; passing the bill using reconciliation is only going to expose them to more of those details, and thus, I suspect, likely to make it even less popular.
So the choice for Democrats may actually be whether they want they want to be portrayed as so single-minded in their determination to push their unpopular agenda on the public that they are willing to use party-line voting and any sort of obscure procedural trickery they can come up with to get it passed, or whether they want to be able to make the argument that they responded to the public's clear concerns and backed off an incredibly unpopular piece of legislation when they had the chance.