Who Will Be the Democrats’ Mezvinsky on Health Care?

The just-released Congressional Budget Office projection that, if passed,  the Senate health care bill will reduce the deficit over a 10-year period promises to provide some political cover for “Blue Dog” Democrats who worry about the fiscal implications of another hugely expensive government program. If media reports are to be believed, Democrats – buoyed in part by the CBO projections – are now poised to pass the Senate health care legislation, although the latest whip count suggests they have almost no votes to spare.

The blue dogs’ worry about supporting the health care bill even with the CBO projection is understandable considering that public opposition to the health care bills being discussed in Congress has remained quite stable over the past few months. According to the Pew survey center, “As has been the case since last July, there is more opposition than support for these proposals. Currently, 48% say they generally oppose the health care bills in Congress while 38% say they generally favor them. That is almost identical to the balance of opinion in February and January.  Moreover, a plurality of those polled would prefer that Congress start over”:

Democrats’ uncertainty regarding the final vote will inevitably mean that some of the undecideds will leverage their position to extract concessions from the House leadership.  The latest effort to do so centers on regional disparities in Medicare payments.  But the flip side of this is the fear by many Democrats that they will be “Mevinskied”,  a reference to the Pennsylvania Representative, Marjorie Margolies Mezvinsky, who lost her seat 18 years ago as a result of casting one of the deciding votes that pushed Bill Clinton’s first budget over the bar. Clinton had been elected in part on his promise not to raise taxes on the middle class. Once in office, however, he inherited a growing budget deficit that was much larger than he anticipated.  He also  faced a Congress composed of almost an identical partisan composition as the Congress that Obama confronts today.  Reversing his campaign pledge, his first budget included a tax hike designed to cut into the burgeoning budget deficit, but many Democrats, including Mezvinsky, were leery of signing on to it.  In the end, with no Republican support at all, passage of Clinton’s budget came down to a handful of Democratic votes in both the House and Senate.  Much like the current health care debate, Clinton supporters portrayed the budget vote as a referendum on his presidency; if it failed to pass, his political capital would be severely damaged, jeopardizing his entire legislative program – including health care reform. In the end, he was able to attract just enough votes to pass the budget, in large part because Mezvinsky, the freshman Pennsylvania Representative, voted for the President’s budget. In a recent op ed piece,  Margolies defended her budget vote, and urged Democrats to emulate her by voting their conscience regarding the current health bill. Eighteen years ago, however, she was expressing a different emotion, begging the White House not to press her to support the President’s budget because she feared it would likely cost her seat in the House. A tearful President, feeling her pain, promised he would campaign for her reelection if she voted for his budget.  She did – and he did,  but to no avail.  Mezvinsky’s vote was one of two that put the President’s budget over the top by a final vote of 218-216.  Republicans chanted “bye-bye Marjorie” as her vote was recorded – and they were right. Despite Clinton’s efforts, she was was defeated for reelection in 1994, largely on the basis of that single vote.  Writing 18 years later, Margolies says she doesn’t regret the vote,and she urges Democrats to follow her lead: “I urge you simply to cast the vote you can be proud of next week, next year and for years to come. Given the opportunity, I wouldn’t change my vote.”  In the next breath, however, she admits: “Then again, what do I know? I was a lousy politician.”

Will Obama need another Mezvinsky to step forward to save health care?  And if he does, will it be “a lousy politician” who loses her seat in order to save the President?


  1. Mezvinsky should be in one of those “Profiles in Courage” books, edited by David Brooks. Stupak should be in a “Profiles in Cowardice” book, edited by Michelle Bachman.

  2. Hi Professor Dickinson,

    I have a quick question that’s not immediately relevant to your recent post. Having just completed your class in Bureaucracy, I’m wondering if there’s any interesting “bureaucratic” reason as to why the Congressional Budget Office (CBO) has confirmed that Obama’s healthcare legislation is likely to reduce the deficit. In other words, is there any particular ‘red-flag’ we should be keeping in mind here? Or should we simply interpret it as a good sign?

  3. Nick – I’m on the road, so unable to give this the full response it deserves. But the short answer is yes, there are “bureaucratic” reasons that constrain the CBO – or at least limit – its ability to “score” the health care plan. Part of the limit, of course, simply has to do with the nature of scorekeeping – they need to predict how consumers and insurance companies will react to a new policy, which is a very very difficult thing to do. The other problem is they are not allowed to “score” the bill in terms of its impact on other spending programs (Medicare, for example.) The biggest “bureaucratic” reason, however, is that that CBO must appear nonpartisan, or it will lose its reputation for objectivity. “Nonpartisanship”, as you might expect, is often driven by the need to retain autonomy, which means not rocking the boat of who ever is in charge. Having said all that, there’s no reason that I can see to believe that the CBO estimate is not as good as any other estimate that’s floating around re: the likely cost implications of the bill. In other words, it’s up to the CBO detractors to point out where its estimates are wrong, or where there are greater uncertainties than it shows. A final thought – keep in mind the difference between “cost” and “impact on the deficit” – Republicans focus on the former, Democrats on the latter.

  4. Or, perhaps she should be in the Profile of Cowardice book for failing to keep her promise to her constituents (who she represented) and instead caving to pressure from the President and party leaders?

    It all depends on one’s perspective, doesn’t it?

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