When the story of the struggle to pass health insurance legislation in 2009 is written, much of the credit for the bill being as strong as it will turn out to be will go to the Republicans. In fact, there might not be anything more than limited reform had the Republicans not committed what may go down in political history as one of the biggest blunders ever.
Imagine if the Republicans had seriously worked with the Obama administration and/or Blue Dog Democrats to shape a version of health reform that was much less comprehensive, perhaps costing no more than $400 billion or less with fewer restrictions on private insurers. They might well have pulled it off. After all, liberal Democrats were going to have a difficult time getting 60 votes in the Senate and the Obama administration was anxious to get a bi-partisan bill.
Instead of working toward limited reform, the GOP leadership decided to oppose any reform at all. By late summer, it was clear to everyone that the Democrats weren’t going to get any Republican votes for health reform. More importantly, the No/Nothing Republicans with their high profile, tea-party opposition had placed Democrats in a bind. Democrats realized that if they did not come together and get some kind of health reform done in 2009 then they could suffer a 1994-like defeat in 2010. The Republicans had forced a showdown directly along partisan lines. They were betting that the Democrats would never get to 60 votes in the Senate. It looks very much like they have lost that bet.
If the Democrats get health reform done, which it looks like they will, the political payoff for Democrats may be huge. Most Americans don't really know what is in the Senate bill - which will be closer to the version Obama will sign than the House bill. When the bill is signed into law and Americans start finding out about all the good things the legislation will do such as end denials for pre-existing conditions, protect them from being dropped, lifting restrictions on maximum coverage, allow them to change employers or start their own business without losing health insurance and on and on, they will develop a different opinion. I predict most people will like what this legislation does for them and their families and never, ever want to go back to the way we now do health insurance. They will credit Democrats for this historic achievement and blame Republicans.
If Democrats play the politics of this huge achievement right, this could be a Social Security/Medicare-type moment for their party and a stunning defeat for Republicans that will cost them elections for a generation. It could have been so different if the No/Nothings had they just said "maybe/yes." Mistake, big mistake.