After the halls

WASHINGTON-On the last night of July-as restless lawmakers counted the minutes until the start of the their August recess-a key House committee passed a mammoth healthcare overhaul measure. The next morning Democrats flooded the D.C. airports and headed home with a single homework assignment: Sell this bill to constituents.

But their neighbors had different plans.

The summer of 2009 will be known as the summer of the town hall meeting. Politician after politician got knocked back on his or her heels by constituents who clearly took many Democrats by surprise. The healthcare debate in August became more about the protests than the actual plans.

But that is about to change, as lawmakers head back to Washington and the focus returns to the legislative process. The question now is whether the August protests are enough to derail a healthcare overhaul that has gone through more momentum swings than a Brett Favre retirement decision.

Right now, the momentum is with the opponents of Obamacare. Throughout August, packed halls from Pennsylvania to California featured a passionate public confronting lawmakers. With clips from the meetings becoming nightly must-see viewing on cable news channels, conservatives are saying that people now understand why Democrats pushed so hard to get a bill passed before recess.

In response to the protests, Democratic leaders clung to a curious tactic: They went after critics rather than confronting their criticisms. Senate Majority Leader Harry Reid, D-Nev., dubbed the protesters "evil mongers."

Soon Democrats moved to questioning the authenticity of the protests, calling the town hall takeovers fake grassroots, or Astroturf, whipped up by the Republican Party, conservative groups, talk show hosts, and industries opposed to healthcare reform. "I just want to show you what Astroturf really is," Reid told reporters while raising a handful of fake grass.

One can follow the money to see that both sides of the healthcare debate have employed professional tactics: More than $52 million has been spent this year on commercials related to the healthcare debate, says the Campaign Media Analysis Group, with spending by those favoring Democratic plans more than doubling the spending by their opponents.

But John Goodman, president of the National Center for Policy Analysis, believes the town hall protestors formed a diverse cross-section of well-informed Americans, including 60,000 Obama supporters who have expressed buyer's remorse, joining more than a million others in an online petition against nationalized healthcare. "This is a very spontaneous, genuine nationwide phenomenon," Goodman explained. "Are there organizations? Sure, but the people showing up at the town halls are real people who are really upset."

While boos, interruptions, taunts, and jeers were broadcast nationwide, most agree that the typical meeting contained calm but critical questions from citizens worried about the consequences of proposed changes to an industry that controls one-sixth of the nation's economy.

Gail Wilensky, a health researcher with Project HOPE, says recess reminded Democrats that 85 percent of Americans already have medical insurance. Anger over the healthcare efforts, Wilensky added, reflects larger fears "in middle America about how much government is involved in their lives. Politicians ignore that at their own peril."

The first post-town hall test will be in the House, where leaders have set a post-Labor Day vote on their 1,000-page bill. Moderate Democrats opposed to the measure "will have their backbone strengthened" by the recess, predicts Michael Tanner with the Cato Institute.

Some observers believe the epicenter of the debate will be the Senate Finance Committee, which has given itself a Sept. 15 deadline for producing a bill. Debate is expected to revolve around two unresolved issues: how to pay the $1 trillion price tag for change and the creation of a government-run plan.

Wilensky predicts that the biggest repercussion from the August protests may be a greater emphasis on controlling costs, with a final bill closer to $700 billion. But so far the Finance Committee has been able to shave only about $100 billion from the plan. The group is seeking additional reductions by making a smaller pool of individuals eligible for insurance subsidies from the government.

Selling the cost of an overhaul just became harder with a government forecast last week that the U.S. national debt will nearly double over the next decade to close to $20 trillion. The House healthcare plan would add $240 billion to projected deficits by 2019, according to the Congressional Budget Office.

Meanwhile, the public insurance option that would compete with private insurers has become the glass jaw of Democrats' reform efforts. The focus of much ire in the town halls, the plan has been put on the chopping block by even top Obama officials such as Health and Human Services Secretary Kathleen Sebelius, who called it "not the essential element" of reform. Such comments create an intraparty confrontation with Congress where House Speaker Nancy Pelosi has said, "There is no way I can pass a bill . . . without a public option."

Cato's Tanner explains that jettisoning the government-run option may well alienate the liberal wing of the party, which believes there can be no healthcare reform unless the government takes on a larger role. But by sticking to a government-run option Pelosi will lose votes from moderate-to-conservative House Democrats, or Blue Dogs. "At the moment the president doesn't even have a majority of his own party backing reform," Tanner says.

That leads to a final question: Will Democrats abandon bipartisanship in crafting a bill? A Senate bipartisan group dubbed the "Gang of Six," which includes Republicans Charles Grassley of Iowa, Mike Enzi of Wyoming, and Olympia Snowe of Maine, worked through recess for a compromise. But some congressional Democrats are losing faith in the chances of winning any Republican votes. They favor invoking a procedure called reconciliation that would allow the Senate to pass a healthcare overhaul with 51 votes instead of 60.

But White House officials continue to stress the need for some Republican support. This is likely for political cover: A new Washington Post-ABC News poll found that just 49 percent of Americans have confidence that President Obama will make the right decisions for the country, down from 60 percent in the spring.

That has not deterred Obama from guaranteeing that healthcare legislation will become law. He might have found comfort in the fact that the poll showed only 21 percent think congressional Republicans will make the right decisions. Conservatives succeeded by going on the offensive in August but now must do a better job of defending their own alternative healthcare plans.

Clearly, what happens during the next few weeks will be the crucial event for both parties heading into the 2010 mid-term elections. "Ain't democracy grand?" said U.S. Rep. Mark Kirk, R-Ill., as he entered the gantlet of his own recent town hall meeting.