Nancy Pelosi's Search For 216 Votes For Health Care

President Obama was in Strongsville, Ohio yesterday, at yet another event to rally support for his health care legislation. One impetus for the trip: he received a letter from Natoma Canfield, a cleaning woman from Medina, Ohio, who had to cancel her health insurance policy because of costs and then was diagnosed with leukemia.

But the real audience was the House of Representatives. The fact remains that the Democrats, with 253 members in the House, may still not have the 216 votes needed to pass the bill. And Ohio was as good a locale as any for the president to visit, with Cleveland Rep. Dennis Kucinich — whose district includes Strongville and who hopped a ride to the Buckeye State on board Air Force One — saying he could vote against the bill, as he did last November, because it is too weak. Another Ohio Democrat who also voted no in November, freshman John Boccieri from Canton, represents a Republican district. And freshman Steve Driehaus, a freshman from Cincinnati, is facing a daunting re-election challenge. He voted yes last time, but is thought to be on the fence now.

In November, the House vote to pass the measure was 220-215. Back then, Democrats had 258 members; now, they're down to 253, as John Murtha (PA) died, Parker Griffith (AL) switched to the GOP, and Robert Wexler (FL), Neil Abercrombie (HI) & Eric Massa (NY) resigned. Griffith and Massa, however, had voted no in November, so it's only a net loss of one for the pro-health care side. (And the one Republican who voted for the bill in November, Joseph Cao of Louisiana, has said he will vote no this time.) Here's a complete list of the 39 Democratic "no" votes:

John Adler (NJ) — freshman
Jason Altmire (PA)
Brian Baird (WA) — retiring
John Barrow (GA)
John Boccieri (OH) — freshman
Dan Boren (OK)
Rick Boucher (VA)
Allen Boyd (FL)
Bobby Bright (AL) — freshman
Ben Chandler (KY)
Travis Childers (MS) — first elected May 2008
Artur Davis (AL) — running for governor
Lincoln Davis (TN)
Chet Edwards (TX)
Bart Gordon (TN) — retiring
Parker Griffith (AL) — freshman; switched to GOP in December
Stephanie Herseth Sandlin (SD)
Tim Holden (PA)
Larry Kissell (NC) — freshman
Suzanne Kosmas (FL) — freshman
Frank Kratovil (MD) — freshman
Dennis Kucinich (OH)
Betsy Markey (CO) — freshman
Jim Marshall (GA)
Eric Massa (NY) — freshman; resigned last week
Jim Matheson (UT)
Mike McIntyre (NC)
Michael McMahon (NY) — freshman
Charlie Melancon (LA) — running for the Senate
Walt Minnick (ID) — freshman
Scott Murphy (NY) — first elected in 2009
Glenn Nye (VA) — freshman
Collin Peterson (MN)
Mike Ross (AR)
Heath Shuler (NC)
Ike Skelton (MO)
John Tanner (TN) — retiring
Gene Taylor (MS)
Harry Teague (NM) — freshman

In the 2008 presidential race, John McCain won 32 of the 39 districts, losing in the ones represented by Adler, Baird, Barrow, Artur Davis, Kucinich, Murphy and Nye.

Another concern for the bill's chances of passage is what will happen to the dozen or so Democrats who are aligned with Bart Stupak, the Michigan lawmaker whose anti-abortion amendment passed the House in November. The Stupak amendment attracted 64 Democratic votes back then (click here for list), but the list of those who are threatening to vote no this week (because the Senate bill, which the House will be voting on, has stripped the Stupak language) is thought to be much, much smaller; in recent days, pro-life Democrats James Oberstar (MN) and Dale Kildee (MI), among others, have said they will vote yes.

Primary Colors? Some progressives and labor groups are saying that Democratic lawmakers who vote no should be hit with an opponent in the primary. Donna Brazile, a DNC vice chair, Tweeted this yesterday: "If a handful of Democrats decide to defeat this bill, they deserve to get a primary challenge to defend the status quo & insurance industry." A pretty gutsy move, considering that Brazile is in the party leadership. Sam Stein at the Huffington Post quotes Brazile as saying she had "decided to stop pretending that I will go back to support anyone not backing health reform." Of course, DNC bylaws prohibit it from getting involved in primary challenges to incumbents. Still, the fact that the future of health care is teetering has made many anxious, as Stein points out:

It is a telling illustration of just how high emotions are running in this crucial late-stage portion of the health care reform debate. Until now, the main voices calling for primaries for Democrats who withhold their support for reform have been progressive organization and union groups.

Brazile doesn't carry the same type of threat as these institutions, both of which can rally supporters or funnel donations behind candidates. But to the extent that her remarks illustrate reluctance among those with close ties to the party to support candidates who oppose reform, they are foreboding.

A similar story in Monday's New York Times by Steven Greenhouse quotes Andy Stern, the president of the Service Employees International Union, as saying he would "back some independent candidates this fall against House Democrats" who vote against the bill. Stern said the SEIU would "likely" back an independent challenge to freshman Rep. Michael McMahon of Staten Island, who won in 2008 "with considerable help from the union":

If health care goes down and there are people who promised our members that they were going to vote for health care reform — which for our members is a huge issue — if they aren't going to stand up for what they said they were gong to do, they shouldn't be going back to Washington.

You Know Demon Sheep; How About Deem And Pass? The Washington Post's Montgomery & Kane report today that Speaker Nancy Pelosi "might attempt to pass the measure without having members vote on it." It's a "procedural sleight of hand" called "deem and pass," by which the House would vote on a "more popular package of fixes" to the Senate bill without having to vote on the Senate bill at all. The tactic has been "commonly used, although never to pass legislation as momentous as the $875 billion health-care bill." Pelosi said she likes that idea "because it would politically protect lawmakers who are reluctant to publicly support the measure."

Predictably, the idea provoked an uproar from Republicans, some of who suggest it would be unconstitutional. Rep. David Dreier (R-CA), the ranking Republican on the House Rules Committee, said, "It's very painful and troubling to see the gymnastics through which they are going to avoid accountability."

Either way, writes Mark Ambinder in The Atlantic, "it's still an up or down vote on health care — one that Republicans can use to bash Democrats with if they want to, but one that Democrats hope will provide them with some political cover — yes, they voted for the Senate bill, but they did so with its amendments attached":

Republicans really don't have much of a constitutional argument because the Constitution gives the House and the Senate the power to define its own rules. If "deeming" a Senate bill as passed is ruled to be the same thing as passing it, then the bill is "passed," constitutionally. (As Rep. Sam Rayburn, in 1948, put it, "There is to be one vote only; and if the resolution is agreed to, it means that the House concurs in the Senate amendments.")

And while it's true that the rule has never been used for something this large, it's unusual for Republicans to be bothered by the idea that controversial legislation ought to be subject to an up and down vote on its merits. GOPers, endorsed by their own rules guru, Rep. David Dreier of California, have used the maneuver to pass legislation large and small — including a $40 billion dollar deficit reduction bill. Dreier in 2005 used the tactic to allow Republicans to avoid having to take a recorded vote on an immigration measure. It's also a bit rich for Republicans to complain about a parliamentary tactic being employed in a way that's not in keeping with the spirit of the traditions of Congress.

Truth be told, it's difficult to see the "deeming" move providing any plausible deniability for Democrats. It's just an easier — and not controversial, or rare — way for them to pass a difficult bill. In November, they'll still be on the hook.

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