House Democrats have passed the health-care reform bill. Assuming Senate Democrats pass the accompanying reconciliation bill, this is a punctuating moment in the history of the American state, and a game changer for the politics of Elections 2010.
Since the New Deal, Democrats have embarked on a state-building enterprise. Democrats have expanded the functions of the state because they believe that individuals left by themselves and markets do not give us optimal levels of economic rights, civil rights, or health-care rights. Some Republicans were on board for a while, but today most see the accumulation of governmental responsibilities as the road to serfdom.
I am not sure that health-care reform takes us one step closer to socialism, but the Republicans are correct in their public statements that health-care reform will effect a major reconfiguration of citizens' relationship with the state, and in their private sentiments that it is very difficult to roll back the state once it has been bloated. There was a time when bills calling for federal funding of roads between states were vetoed, when a federal income tax was unconstitutional, when investment banks were not regulated. None of these federal prerogatives are controversial today. Ted Kennedy and Barack Obama are correct that health-care reform is about the character of our country, though it might be fairer to say that it is about the evolving character of our country, because the developmental history of the expanding American state has paralleled America's steady transition from pluribus to unum.
There are now 32 million new constituents of the (health-care) state, even if many will end up purchasing insurance from private exchanges. They are going to be committed to the state as wards are committed to their patron, and as seniors have come to love Medicare. Americans may not like the state, but our appetite for government tends to increase once we have been touched by its largesse. Barring catastrophic implementation failure (because Medicare isn't exactly a perfect program and it remains popular), the Democratic Party has just earned itself a sizeable new constituency, not unlike what it did when FDR passsed pro-labor legislation, or when the Republican Party handed out pensions to civil war veterans. At least some of these 32 million will go to the polls in November, and Republicans who have been fighting very hard to kill health-care reform know this. But because health-care reform has passed, Democrats have at least a fighting chance of keeping their congressional majorities when this seemed all but impossible a few weeks ago. For the first time since Scott Brown's election to the Senate, the momentum is back in the Democrats' court.
Barack Obama's poll numbers are going to go up too. He lost many independents over the past year because he was seen to be too liberal, but he lost just as many because he was seen to be incompetent in delivering change. When members of congress were chanting "Yes, We Can" on the floor of he House on Sunday night, we know that some of the old magic is back. He has done something that the last popular Democratic president, Bill Clinton, did not. Because he and his party has finshed what even the Lion of the Senate, Ted Kennedy left unfinished, Barack Obama has salvaged his chance for a transformative presidency.