The Physical Improbability of Health Care Reform In the Mind of Nancy Pelosi


Vote count performance art?

Last week, House Speaker Nancy Pelosi insisted that, at least at that particular time, she had the votes to pass health care reform. Problem was, her whip hadn't started an official count yet.

Now he says he has. And he also says that as of yesterday morning, the votes aren't in place.

Still, Pelosi and the Obama administration are insisting that, when the time comes, the votes will be there. But given that House leadership expects a vote by this coming weekend, it's not at all clear that this is true.

Here's The Daily Caller's Jon Ward on the current outlook:

It will take a vote whip for the ages, according to The Daily Caller's own reporting and an analysis of vote tallies by other news organizations (FireDogLake, The Hill, The Examiner, CNN).

The latest vote count from David Dayen at the liberal FireDogLake on Sunday put the tally at only 191 definite yes votes and 203 definite no votes. That leaves 37 House Democrats as the group that will make the difference.

House Speaker Nancy Pelosi needs 216 yes votes to pass a bill, so she will have to nab 20 of the 37.

Pelosi faces two challenges. First, she must keep Democrats who voted for the bill in November from bolting (20 lawmakers are in this category, by Dayen's count). That alone is big task, because so many moderates are looking at the polls and the political winds and calculating that a vote for this bill will likely cost them their job.

Pelosi's second challenge is even more difficult. She must convince a number of Democrats–at least five–who voted against the bill the first time to switch and vote for it this time.

Tag team!

Ward says there are six former no votes who might change their votes, but on Good Morning America, ABC's Jon Karl reports that all 37 of the original no votes have told him that, as things stand, they will not flip. If that remains true, then the reform bill probably won't pass.

But of course, it's tough to tell how accurate any of the current vote counts going around really are. How many of the legislators stating their likely positions are just looking for home-state handouts or other goodies? We all remember how Sen. Ben Nelson played the Senate vote to his advantage. My guess is that, as in the days before cap-and-trade passed in the House, the true count is still fluid enough that Pelosi potentially could pass the bill, but doesn't actually know yet that she will.

The other thing we don't know is what leverage Pelosi has over her members. If she and the White House are pushing forward with this much confidence, she presumably has something to offer undecided members. But what? With Democrats likely to lose the House in November, she won't be in power much longer. And passing health care on a party line vote is likely to make Congressional Republicans even more intransigent (if that's possible).

So passing additional legislation after this isn't going to be easy. And consequently, there won't be many new opportunities to hand out favors between now and November. Which may be why the White House is now signaling that it's open to certain kinds of state-by-state deals that it had previously opposed; without those deals, Pelosi may not have enough leverage to pass the bill.

If it passes, it'll likely be on a tiny margin that comes through at the last minute. Until then, it's a waiting game. For the last year, health care reform has looked simultaneously inevitable and impossible; by the end of the week, we should know which it actually is.