Tuesday, November 9, 2010

Health Care And The Hillary Counterfactual

A lot of people are wondering how health care reform would've gone differently if Hillary Clinton had been president. It's a question that interests people because Democratic primary voters had a choice between her and Obama, and we want to know if we did the right thing.

But there's a slightly different question that's actually more relevant to our choice. How would health care reform have gone if we had nominated Hillary Clinton? And here I think the answer is: significantly worse.

The big question I have about a world where we nominate Hillary is: Does Al Franken still win the Minnesota Senate race? After a long recount, dragged out by Republican legal challenges aimed at keeping Democrats down a Senate seat, Franken prevailed by 312 votes out of nearly 3 million cast. With a margin so thin, the question of who's at the top of the ticket could very well have made the difference.

There's some reason to think that Obama was more appealing to Minnesota voters than Hillary was. (I think Nick made this argument at some point but I can't find it.) Looking back at the primary, Hillary's strength was concentrated in the Appalachians. Obama did better in areas with either a high black population or a large number of college-educated voters, and Minnesota falls squarely into the latter category. If who does better in the primary is a good proxy for who's going to get a bit of extra base turnout, and thus who gives Franken better coattails, it looks like Obama might've put Franken over the top. And then when it came time to get 60 in the Senate, Franken put health care reform over the top.

I don't think there's any similarly close Senate race we lost where Hillary would've tipped the balance in the other direction. In general, coattail effects probably aren't very large. It's just that this race was incredibly tight, so a bunch of small things made the difference. And that's what eventually allowed us to break the filibuster and pass health care reform.


Charlene said...

Hillary would have been a good VP, but she didn't want that, so that's her choice. Even now, she would make a great VP in the second term.

I agree with you on the Frankin win.

Nick Beaudrot said...

I have a version of this post kicking around.

My guess is that had Clinton been the nominee, Franken would have lost but we might have beaten McConnell in Kentucky. I also think Nick Begich would have lost in Alaska. Jeff Merkley only won by 3%, so Oregon might have been dicey as well. It's possible that the Colorado Udall would have lost as well, though less likely.

I doubt Clinton would have made GA or MS competitive enough to put those races any further into play.

So let's be charitable and say Dems now have 58 seats in the Senate, but Mitch McConnell is not the minority leader. Kyl is next in line as the whip; if he's the leader, that's just as bad, though maybe he can't keep Snowe/Specter/Collins/Grassley in line. Richard Burr I assume is the same. But if it's Lisa Murkowski or Lamar Alexander (the next 2 in line), maybe we get somewhat more bipartisan governance.

All in all, it looks like HCR would either not pass or be further watered down.

As far as Obama's impact on House races, that's tougher to tease out.

Neil Sinhababu said...

McConnell won by 5.8%, so I doubt Hillary could've overcome that. But I guess you're running the scenario where coattail effects are massive, and getting similarly unhappy results for number of senators.

If we do beat McConnell, I really don't know what happens, because I don't know if Kyl botches the job or what. People who know Kyl better could probably have a better guess.

wsn said...

My thinking on this is that she might have better understood Republican opposition and Democrats would have understood it too.

That is, everyone would be aware there was an all-or-nothing fight coming up. The magical unity pony approach would not even have been considered because no one would have even considered that Republicans might compromise with Clinton.

The magical unity pony seemed to be really going on post-election/pre-inauguration. Instead of thinking R's would go along, D's would be thinking of ways to get around it.

Knowing this, Clinton and Senate Dems would have tweaked the filibuster rules or designed a bill around reconciliation knowing Lieberman, Nelson, Landrieu, & Lincoln wouldn't vote with the "divisive" (or whatever) Clinton. Much less the Maine twins or Grassley or anyone else.

Basically, it wouldn't have been drawn out as long because everyone would be expecting and preparing for a fight, as opposed to dithering waiting for the magical unity pony to arrive.

I don't know if this is right, or it would have produced a better outcome than what we got - either in terms of HCR legislation or anything else.

Ron E. said...

You're assuming that whatever decline Hillary would have experienced among groups that went heavily for Obama wouldn't have been more than made up for by an increase in voting for her to be the first woman president in the general election. Maybe that's true, maybe not.

In any case, looking back at how she ran her campaign and who she picked to run it, I have a hard time believing she would have been able to actual govern any better than Obama has.

At the end of the day, it was the Senate and its insane rules and ridiculous/corrupt members who largely determined the process and content of health care reform. It's doubtful that President Hillary would have gotten Max Baucus to stop wasting time negotiating with Grassley or convinced Lieberman, Lincoln, and Nelson to support the public option or Medicare buy-in.

Blue said...

I agree with Neil and Niq's points, but would add my proposal that: maybe have 57 Senate seats is better than 60. We might have seen the filibuster overturned, especially if the GOP was turning on the crazy in Dec 2008 because of Clintonphobia, and Democrats saw there was only one way any bills were getting passed.

Blue said...

Of course, if Hillary was the nominee maybe McCain wouldn't have nominated Sarah Palin, but would have nominated Michael Steele instead and Palin became the RNC Chair.