Article by Yamileth Medina

The victory of Republican Scott Brown in the Massachusetts special election on Tuesday is a game changer for the future of healthcare reform. The carefully crafted compromise among House and Senate Democrats is effectively moot; Brown’s presence in the late Ted Kennedy’s Senate seat destroys the fragile 60-seat super-majority they needed to avoid a filibuster. Senate Majority Leader Harry Reid, along with other prominent Democratic politicians, have dismissed the idea of attempting to either delay Brown’s swearing-in or rush a bill through before he is seated. Reform of the health insurance industry has been one of the party’s main priorities, but its prospects are in doubt. What will the Democrats do now?

One option available to the Democratic party is for the House of Representatives to accept the last health insurance bill passed in the Senate, without modifications. That way, interim Democratic Senator James T. Kirk’s vote in favor of the proposal would legally stand. The bill would then be sent to President Obama’s desk for his signature. However, it appears unlikely that the party will go that route. For one thing, Democrats across the political spectrum are unhappy with the current Senate bill and were hoping to change it in committee. Liberal members of the House, who managed to include a government-run public option for health insurance in their version of reform legislation, were seeking further regulation of health insurance companies and more protections for consumers. Some conservative Democrats, on the other hand, wanted stricter limitations on using federal subsidy money to buy health insurance plans that include abortion coverage.

Such political wrangling may also lead to yet another blow to Democratic prospects in the fall mid-term elections, and certain Democrats are realizing that the appearance of ignoring the public’s wishes on this issue is detrimental. Even if House Democrats were willing to forgo their wishes for healthcare reform in order to avoid facing an even more unfavorable bill–or worse yet, the possibility or reform slipping away altogether–party leaders are steering them against it. Senator Barney Frank, a staunch supporter of healthcare reform, is only one of several Democrats who has suggested that it would be best to pause debate on the health insurance issue until Scott Brown is seated. Moderates in the Senate, such as Jim Webb, agree. Even President Obama is showing signs of preferring that the effects of the electoral process take their course, indicating that he may not sign a bill that passes through such means.

For his part, Brown has proposed scrapping the existing healthcare reform bill altogether and starting fresh. Whether that statement was made in good faith, or if he will bend to the population of “tea party” supporters against any type of healthcare reform, is unknown. Democrats may not want to believe his pledge, but it is obvious that their political strategy needs to change. They will have to reach across the aisle and convince a handful of Republicans to join their side. The current bill may be too damaged in the public eye for that to happen, however.

Any new bill must be scaled back, limited to the most noncontroversial elements. Provisions that could avoid further accusations of overreaching include a ban on individual health insurance providers denying medical coverage to people with pre-existing conditions, along with the closing of the infamous prescription drug “donut hole” associated with Medicare coverage. These proposals are likely to decrease the population of uninsured Americans. Costs are predicted to eventually decrease as a result of people receiving more, cheaper preventative medical care. However, health insurance companies have hired lobbying groups to prevent the potential decrease in profits. The Obama administration has been forced to cooperate with them to gain fragile support. With at least some level of bipartisan approval, that Faustian bargain may no longer be necessary.

There will also be some Republican-led amendments that will probably need to be included to receive some of their support. Maine Senator Olympia Snowe initially supported healthcare reform without a public option, but months of partisan rancor led to her support disappearing–despite a Senate bill that no longer created new government health insurance. Crafting a new bill may reduce those hard feelings, winning back support from Snowe and fellow Maine Senator Susan Collins (who has expressed a willingness to negotiate). Further cost controls are a must, which may be unpalatable to progressives: however, reform failing entirely would be humiliating for the party. Another provision the minority party is likely to push for is medical malpractice reform; many doctors complain that the threat of potentially frivolous lawsuits force them to take out expensive insurance policies and order unnecessary medical tests to avoid liability, which increases the cost of health care. Trial lawyers are a strong Democratic constituency, but they have been relatively silent during this fight. The so-called “Cadillac tax” on high-cost health insurance plans showed that Democrats are willing to anger another part of their base, labor unions, in order to get a bill passed. If both parties are serious about working together for healthcare reform, the result may be more readily accepted by the American public.