For the first time in more than a decade, Democratic lawmakers have the votesand the bullhornto make revamping healthcare a top-shelf objective of their federal domestic agenda. But budgetary realities, the next round of politicking and even the Democrats own rules could impede their progress, health policy analysts say.
While uncertainties abound, whats clear is that after being sidelined by a Republican majority that showed little room for compromise on healthcare issues, the newly minted Democratic majority is eager to find whatever narrow openings in Congress exist to pass legislation that could expand funding for poor children, uninsured adults and other initiatives popular on Capitol Hill and across the country.
The numbers are in the Dems favor. With a brief exception, Republicans have controlled the gavel for 12 years. But in November, Democrats picked up 30 seats in the House to win a 233-202 majority. In the Senate, Democrats picked up six seats to eke out a 51-49 majority, including two independents who plan to caucus with the Democrats. But Senate votes will be complicated by the illness of Tim Johnson (D-S.D.).
House Democrats have said they intend to push through legislation within the first 100 hours of being at the helm of Congress that would expand stem-cell research and give the federal government power to negotiate directly with pharmaceutical companies to drill down to the lowest prices for the Medicare prescription drug program. A timeline is uncertain, but House leaders said they would waive certain rules in order to get to a vote as early as this week.
Ambitious? Perhaps. But many analysts say its not a mission impossible. Democrats are eager to return to what they have always seen as one of their bread-and-butter issuesimproving access to affordable care. While the House has some strategic advantages, including majority-rules votes, the same initiatives are far less certain in the Senate, where Democrats hold the slimmest of majorities and the chamber operates under a more intricate committee process.
But Democrats now have the clear advantage, says Anna Greenberg, vice president of Greenberg Quinlan Rosner Research. Speaking at a healthcare conference in December 2006, Greenberg, a Democratic consultant, said that the Dems are emboldened by their midterm election victories and have headed back to Washington brimming with confidence.
Greenberg, however, said that the partys agenda may prove more modest in scope than widely expectedespecially as the political machine girds for the 2008 presidential elections. For instance, key House Democrats have tempered any expectations for a wholesale healthcare shake-up that would be on par with what was pursued in 1993 by then first lady Hillary Rodham Clintons task force.