If the ACA is indeed overturned (and as recently as last week, the chance of that was seen as remote), Americans will once again have to grapple with health care reform. Under the status quo, health care costs in America are rising at an unsustainable rate, more and more people are losing their coverage and outcomes are falling further and further behind other developed nations. In short, it's an emergency.
But this post isn't about health care policy, and it isn't even about politics. (I'll get to those two topics soon enough.)
No, what I'd like to talk about for just a moment is the reality of passing health care reform in America. And the reality is that it would take a Democratic president, a Democratic House and a Democratic Senate. And not only would it take a Democratic Senate, but it would take a 60-vote, filibuster-proof Democratic majority in the Senate.
(What about the Republicans' promise to "Repeal and Replace?" Senate Majority Leader Mitch McConnell said just recently that there wouldn't be any "Replace" part if the ACA is overturned. Surprised?)
Now I know what you're thinking: No big deal -- just elect 60 Democrats to the Senate.
Not so fast.
To pass the ACA, the Democrats had a 60-vote, filibuster-proof majority in the Senate (including two independents) for exactly seven months. (Al Franken was finally sworn in in July, 2009, but Scott Brown was seated in February, 2010.) That's a pretty small window of opportunity.
Again, you may be thinking: fine -- just elect 60 Democrats to the Senate and get on with it. Well, that's not as easy as it sounds. Before that seven month window from July, 2009 to February, 2010, the Democrats didn't have 60 votes in the Senate since 1976 -- 36 years ago. (I was in high school.)
So the bottom line is that if the ACA is struck down by a 5-4 majority along partisan lines (which looks increasingly likely), the U. S. may not see health care reform for another thirty years.
And that's discouraging.
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