Do Democrats Have the Senate Votes to Pass Health Care? Here’s What to Look For

Do Democrats have the votes to pass health care legislation in the Senate?  Political scientists have a somewhat crude but conceptually simple way of analyzing legislative outcomes that may be useful in helping understand the likely Senate voting patterns on health care, beginning with tomorrow’s crucial cloture vote.   It begins with a simple spatial model of voting.

Let us array the 100 Senators from left to right, using the latest roll call-based data to estimate their underlying ideology.   So, on the far Left we have Democrats Durbin(D-IL),  Whitehouse (D-RI) and Harkin (D-IA).  The Far Right, meanwhile, is anchored by Republicans Coburn (R-OK), DeMint (R-SC) and Bunning (R-KY).  Occupying the ideological center is Baucus (D-MT), flanked on either side by Dorgan (D-ND) and Lieberman (D-CT). In a simple spatial voting model, in which senators vote according to their ideology along a single dimension, who wields the most power?  The median voter (or voters) occupying the middle ground, ideologically speaking.  In other words, if health care legislation is to pass the Senate, according to this spatial model it will be legislation that is shaped to attract the support of the moderate middle senators such as Lieberman, Dorgan and Baucus.

The intuition behind this is easy to see:   If health care legislation is introduced that appeals to the Far Right – say a plan based on creating Health Savings accounts and subsidies to states that reduce health care costs – there will be too many Senators on the Left who prefer a more progressive policy, and the conservative policy won’t pass.  Similarly, legislation that is supported by those on the Far Left – a single payer, government-financed system, for example – won’t have the votes to pass because it will lose the support of the more numerous Senators to the Right.

However, the situation in the Senate is a bit more complicated than that.  First, Senators don’t simply decide whether to support health care legislation based on the details of the health care plan alone.  Instead, what they do is compare the proposed legislation to the status quo – the system of fee-for-services, employer-sponsored plans on which most Americans rely.  Each Senator must decide: do I think the proposed Democratic plan is an improvement over doing nothing – that is, maintaining the status quo, or not? In other words, for many senators, given the choice of the Democratic plan or doing nothing – the latter option may be more appealing.

There is a second wrinkle that must be considered as well in forecasting the Senate vote: the existence of the filibuster.  As many of you know, under Senate rules, most legislation is drawn up using unanimous consent agreements.  As the name suggests, these are agreements that stipulate the details under which legislation will be considered: what amendments will be allowed, how long it will be debated, etc., and they require all Senators to sign on if they are to be in play. However, on some contentious issues – and health care is one of them – Senators cannot achieve consensus on the details governing debate.  The majority leadership is then forced to ask for a vote to pass a motion to proceed that, in effect, allows legislation to reach the floor for debate.

Lacking a unanimous consent agreement, that motion to proceed can be opposed through a filibuster. (Contrary to popular perceptions, filibusters rarely consist of a Senator occupying the podium by reading for hours on end from Moby Dick, or the phone book. Instead, it usually means the use of procedural tactics – quorum calls, motions to read the bill in its entirety – designed to delay the vote.) To prevent a filibuster – that is, to invoke cloture – Senate rules require 60 votes, not a simple majority of 51.

On Saturday, the Democrats will try to do just that – to invoke cloture to allow a vote on the motion to proceed to consider the Democratic-sponsored health care legislation. Note that this changes our calculations based on our simple spatial model of voting. The pivotal voter(s) now become(s) the Senator(s) who occupy(ies) roughly the 60th position away from the extreme Left of the Senate ideological spectrum (that is, the 40th position from the Right).  This is because the Senate bill under debate is trying to move health care policy to the Left from the status quo located on the Right – that is, it is trying to make health care more progressive.  (It is actually a bit more complicated – we have to worry about the 60th Senator from the Right as well, but I’ll ignore this permutation of the voting model for the moment.)

Who occupies this 40th position from the Right?   As of today, that would be Nebraskan Democrat Ben Nelson. Our model suggests that he holds the pivotal vote in this debate.  Of course, because our ideological measures are at best approximations, and because we can’t be sure where the current “status quo” health care falls on the ideological spectrum, let me list the four closest Senators on either side of this pivotal filibuster-proof point.

To Nelson’s right, we have four Republicans:

Olympia Snowe (R-Maine)

Susan Collins (R-Maine)

George Voinovich (R-Ohio)

Debra Murkowksi. (R-Arkansas)

To his Left:

Evan Bayh (D-Indiana)

Claire McCaskill (D-Missouri)

Russ Feingold (D-Wisconsin)

Blanche Lincoln (D-Arkansas)

Our spatial model, then, predicts that health care legislation will pass the Senate only if these Senators, (or at least enough of them to reach 60 votes) prefer the Democratic bill to the existing status quo.

What this means is that in fashioning the Democratic alternative to the status quo, Harry Reid had to calibrate the components of the bill in precise fashion.  If he makes the bill too far Left by, for example, including the stronger version of the public option and the more progressive funding mechanism contained in the House bill, he would lose votes, like Nelson’s, from those occupying this strategic 60th position. As it is, even the milder version of the public option contained in the Senate bill, was enough to drive the few moderate Republicans such as Snowe, from supporting this bill.   This suggests any bill farther to the Left had no chance to pass.  In short, given the position of the status quo, and the current ideological makeup of the Senate, it appears Reid got the most liberal bill out of the Senate that he could.

If this simple spatial analysis is correct, it has several important implications for the vote on the Senate bill.

1.  My guess, based on Nelson’s public comments, is that the Democrats have enough votes to invoke cloture tomorrow.  Note, however, this only means the bill will be brought to the Senate floor for debate. It is no guarantee it will pass.  In other words, if he votes to invoke cloture, the bill will proceed to the floor for debate.

2. Whatever comes out of the Senate will be a more conservative bill than what passed the House.  This is because the House votes based on a simple majority, and the median voter is located much closer to the center of the Democratic party, ideologically speaking.

3. It is possible to change the projected Senate voting patterns in one of two ways.  First, by making side payments to the pivotal voters, in effect buying their support by offering some other tangible concession.   If you are the 60th Senator, now is the time to leverage that position for all it is worth. More broadly, if Reid, (or Obama, working through Senate intermediaries) can introduce a second dimension to the voting calculus of individual Senators, then a new voting configuration might arise.  What do I mean by a second dimension?  Suppose a Senator considers the vote not just in terms of how “progressive” health care reform is, but whether it allows taxpayer dollars to cover abortions, or whether illegal immigrants are granted access to the proposed insurance exchanges.  Or, suppose the party leadership pressures moderates to support the bill in order not to damage Obama’s presidency.  In other words, by introducing a second component to the decision calculus, voting patterns can vary from what one might expect looking at a simple one-dimensional model.

4. It is possible to get around the 60-vote requirement using something called “reconciliation” (and Chris Abbot asked me about this some time ago), but for reasons I can address in another post, it is unlikely to be used with health care.

With these caveats in mind, the simple spatial model introduced here suggests that cloture will be invoked if Nelson is in favor.

In my next post, I look at the factors likely to influence the votes of these ten Senators on the final health care legislation. As an incentive to pay attention, however, I’ll give out an “It’s the Fundamentals, Stupid” t-shirt to anyone who can tell me what’s going to happen in the final health care Senate vote (not the conference bill, but the current Senate bill).  Give me the final vote totals and tell me which Democrats, if any, defect from the majority, and which Republicans, if any, cross over and vote with the Democrats.


  1. Matt –

    I hope at some time you will address the justification in our republican form of government, which already slices and dices the power of the people in many ways, for a system that has evolved to the point where the resolution of any issue on which there are important differences of opinion can be blocked by 40% plus one of the members of the U.S. Senate.

    It seems to me that this situation threatens the ability of American government to cope with the extraordinary challenges our nation faces until they have reached crisis proportions so severe that any solution is too late.

    I also suspect that this near-deadlock situation may be one of the reasons why the national government is held in such disdain by so many Americans.

    Bob Johnson

  2. This should enter into your performance review, professor: as predicted, Sen. Nelson used his position as roughly 40th from the right to seek rent, and Majority Leader Reid chose option #3 and bought him with a Medicaid cost increase exemption–a victory for political science (and Nebraskan taxpayers).

    I’d love to hear read more analysis of the new bill that’s going to be voted on tomorrow. I’m particularly interested to hear analysis of the CBO scoring. On George Stephanopoulos this morning, Sen. Kyl claimed that the CBO estimate is over-reliant on nominal legislative language, and he claimed that the CBO even expressed their own reservations about the fulfillment of those promises.

    What should we expect from the conferencing stage? Polls aren’t showing much popular support for the bill–how is this going to affect the midterms/reelection? Has Obama completely staked his presidency to this and Afghanistan already? On the show, Sen. Durbin seemed to be exhausted by the idea of even thinking about cap and trade legislation.

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