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Is Obamacare a Favorite to Pass?

That’s what the punters at Intrade think right now, where the ‘Obamacare’ contract is just barely better than even-money to pass at 52 percent. It has moved up fairly significantly within the past 72 hours, as the contract was mostly trading in the 30-40 percent probability range before.

Back in January, in the immediate aftermath of Scott Brown’s victory when the contract was trading at around 33 percent, I examined the evidence in detail and concluded that, although passage was easy enough to envision, “I’d probably take the short side of those odds if forced to put money on it”. That meant I thought the bill had perhaps a 25 or 30 percent chance of passing. So how do I feel about the contract at its more expensive price now?

Let’s look at the factors which have changed since January 27th, when I wrote the original analysis. First, here are the ways in which conditions have improved for the Democrats; they are listed in declining order of importance.

Positive Factor #1: The White House has gone “all-in”. The Administration was sluggish to get involved for much of the health care debate, preferring to let Congress do its own bidding. However, the White House has pretty clearly made a decision to invest its political capital now, between putting a (fairly) specific proposal on the table, holding a bipartisan summit, taking meetings with reluctant lawmakers, making the case to the public for reconciliation, and explicitly invoking the idea that the presidency depends upon the passage of the bill.

Positive Factor #2. Smooth sailing in the Senate. Open Left’s whip count on use the reconciliation process in the Senate is now up to 46 committed votes. Moreover, just one Democrat (Blanche Lincoln, naturally) has expressly objected to the use of reconciliation whereas several others who were thought to be problems for ideological reasons (e.g. Mary Landrieu, Ben Nelson) have failed to rule it out. In addition, “process hawks” like Robert Byrd, Kent Conrad, and Russ Feingold have been relatively warm to the idea, deeming the relatively minor changes the Senate would exact to its original bill germane under reconciliation rules. It’s hard to see how Democrats aren’t bound to get at least 50 votes plus Joe Biden for a reconciliation fix, although they’ll probably want a couple of spares in the event that the procedural fight gets messy on the floor.

Positive Factor #3. Few substantive disagreements about the nature of the reconciliation bill itself. The basic parameters of what would be included in the reconciliation sidecar are more or less agreed upon: scaling down the excise tax; removing the Cornhusker kickback; re-jiggering the formulas for subsidies, and perhaps adding some additional oversight provisions and closing the Medicare donut hole. Some further provisions — like national versus state exchanges — are still being debated but are unlikely to break the back of the legislation. The more controversial issues, meanwhile, are probably out of the way. To the non-delight of some liberals, Jay Rockefeller and now the President himself have put the kibosh on the latest public option boomlet. And neither pro-Stupak nor anti-Stupak forces are of the belief that the abortion language can be addressed in the reconciliation process. In addition to all of this, the House now seems to have acknowledged that it must move first on health care reform.

Positive Factor #4. Rate increases by Anthem and other private insurers. This makes the moral case stronger and gives nervous Democrats a good talking point for the campaign trail.

Positive Factor #5. One additional ‘no’ vote planning to retire. This is Eric Massa, who is retiring either because he had a recurrence of cancer or because he sexually harassed a (male) staffer, depending on who you believe. Massa’s no vote was a bit strange before — he said he opposed the bill from the left, but he is in a moderate district and has opposed other parts of the Democratic agenda from the right — so nothing is to be taken for granted. But clearly this would seem to be an easier vote to swing now, especially if there’s some kernel of truth behind the harassment allegations and he feels guilty for having created a minor P.R. nightmare for his colleagues. There’s also a chance that Massa could decide to (or be pressured into) vacating his seat immediately, which would reduce the number of votes needed for passage from 217 to 216.

Here, on the other hand, are the factors that have worsened or at least are continuing to work against passage of the bill.

Negative Factor #1. Key ‘anti’-blocks not budging. Bart Stupak certainly hasn’t backed down from his threat to vote against the bill because of its abortion language, and continues to claim that he might take as many as 11 other Democrats with him. As before, I tend to think that with the possible exception of Stupak himself, the abortion language (which is fairly restrictive in the Senate’s bill anyway) is mostly just an excuse for Congressmen who don’t want to vote for the bill for other reasons, such as because they’re in a tough district or because they’re a Republican (Joseph Cao). Therefore, I’m not sure how many of these votes are beyond the reach of persuasion. Nevertheless, the Stupak fight greatly increases the Democrats’ degree of difficulty. In addition, although the Blue Dogs have been somewhat quiet, we’ve seen very little of the sentiment that some like Jason Altmire expressed in the pre-Scotty Brown era, which is that they might vote for the revised bill precisely because it was more moderate. Finally, Dennis Kucinich — always a party of one — still seems inclined to vote against the measure.

Negative Factor #2. Attrition. Jack Murtha has died, and Neil Abercrombie has retired. When coupled with Robert Wexler’s earlier retirement, this takes the Democrats down to 217 votes from the 220 they had in November. The slight mitigating factor is that, because of the retirements, there are now only 432 sitting Representatives so 217 votes rather than 218 are required for passage.

Negative Factor #3. Continued distress from national environment. Although the health care bill itself has not become more unpopular since the House voted on it, there has been some decline in the Democrats’ generic ballot standing, and the number of retirements among prominent members (Evan Bayh, Bill Delahunt, etc.) will do little to quell fears among Democrats who think the bottom is falling out. Nor will the Charlie Rangel and (alleged) Eric Massa scandals.

Negative Factor #4. Bipartisan summit was underwhelming. Although the decision to proceed with the Blair House Summit may later have some utility in mollifying concerns that the Democrats are “ramming the legislation through” without consulting Republicans, there was no immediate P.R. victory nor any manifest change in public opinion on the health care bill. If Democrats were holding out hope for some paradigm-shifting moment in which the health bill suddenly became more popular in the near-term, they are not likely to get one.

Negative Factor #5. The ticking clock. The best-case timetable for completion of the health care bill now appears to be the end of March, which is barely seven months away from the November elections. Some states are already starting to have their primaries, lots of filing deadlines are passing — the attention paid to electoral politics are increasing. Moreover, some Democrats might not want to vote against a bill that they voted for before, but also might not want to take another vote on an unpopular bill if they can avoid it — these Democrats might have some incentive to delay the process.


So where does the health care bill stand? The positive developments as outlined above are probably more important than the negative ones, and so I think my post-Masspocalypse sense that the bill had a just a ~25-30 percent chance of passing is clearly too pessimistic. In particular, the possibility that the bill will die for any reason other than simply not having the votes in the House now appears to be quite minimal. The Senate should fairly easily have 50 votes for reconciliation, and the White House is now invested enough that they’re unlikely to prematurely cut off debate unless things really are hopeless.

I also think, however, that a relatively ‘macro’ analysis like this one can conceal the significant hurdles that the bill faces at a ‘micro’ level in the House. The math on holding those 217 House votes was never very easy for Nancy Pelosi and its not clear that it’s gotten any easier. If everyone voted the same way today that they did in November, the bill would pass 217-215. However, two previous yes votes — Bart Stupak and the Republican Anh “Joseph” Cao — are almost certainly to be lost, whereas nobody who voted against the bill before has yet affirmed that they’ll switch to vote for it. That makes the starting point 215-217 against.

If these were Pelosi’s only problems, then it’s almost certain that she could persuade at least two of the four retiring members to switch their votes, giving the bill its majority. However, she also faces pressure from other Stupak voters and from some nervous moderates, whereas the universe of potential no-to-yes flips is very small outside of the retirees. Generally speaking, moreover, we’ve heard more negative/nervous sentiments from previous yes voters than optimistic ones from previous no’s, with the abortion fight and concerns about the use of the reconciliation process providing them with some cover in the event of a flip-flop.

The one last advantage that Pelosi has is that she can schedule the vote the very moment she gets to 217. Maybe the bill has 216 votes next Tuesday, and 216 next Thursday, but on Wednesday Dennis Kucinich gets high and decides that he’ll vote for it. OK, so that’s a joke, but there’s a difference between a bill which needs 217 at all points in time and one which needs 217 votes at some point in time.

That’s a lot of evidence to weigh. My head says yes — Pelosi will squeak this through — while my gut frankly says no. Either way, I’m not sure there’s a lot of arbitrage against that 52 percent number at Intrade, but I’d hesitate to call the bill a favorite to pass.

Nate Silver is the founder and editor in chief of FiveThirtyEight.