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Betsy Markey in Loveland

“If Sarah Palin is targeting me, I must be doing something right!”

So said Betsy Markey this afternoon at a fundraiser in Loveland. The congresswoman arrived in high spirits and was happy to disabuse supporters of the notion that her vote in favor of the Patient Protection and Affordable Care Act was politically challenging, despite reports to the contrary.  ”It made sense to me,” she said.

Markey spoke for about 15 minutes and took questions for another 20 or so. She echoed her statements from Saturday, recorded in the Denver Post, that it was time to get out and tell people what’s in the health care bill.

On the topic of paying for it, Markey pointed out that the Senate bill she voted for pays for itself in part with taxes on medical devices and top-tier insurance plans, and not on the backs of small business owners, a big reason for her switch from a no vote on the House bill to her yes vote last week.

When asked about abortion concessions made to get the Stupak bloc on board, Markey acknowledged that the current bill is messy. “It’s not good,” she said. “It goes too far. If you want health insurance and you want abortion coverage, you have to write two checks.” Markey expressed optimism, however, that the concessions were fixable through future resolutions. She went on to point out that the bill funnels money to Planned Parenthood and community clinics for health services–and pro-choice Democrats love to point out that greater health services access for women reduces abortions–and it forces insurance companies to quit treating womanhood as a preexisting condition.

Markey was similarly optimistic that future resolutions will allow for an evolving public option, whether through the public insurance exchanges established in the bill or through a Medicare buy-in act along the lines of the bill introduced by Florida Democrat Alan Grayson.

The talk was not all health care, however. Looking ahead, Markey pointed to major legislation pending on financial regulation and energy, and she also mentioned her reelection campaign. Here she trumpeted the party meme that if Republicans want to run on repealing health care, let ‘em. She thinks that by November, voters will be more interested in jobs and the economy, and they’ll have had a chance to see some good from the health care bill. In the end, she believes, those factors will determine the outcome of congressional races, not health care alone.

This bill will be the single largest deficit reduction bill in 27 years.   It will most likely be the single largest deficit reduction measure I vote for as a Member of Congress.

That’s why I’m voting for this bill.  There are things that this bill does immediately that I could not, in good conscience, oppose: it ends denial of coverage for people with pre-existing conditions and prevents health insurance companies from dropping people from coverage when they get sick.

Some of the other hightlights of what this bill will do are:

• It allows people who are 26 and younger to stay on their parents health care plans.  As a mother of three children under the age of 26, that is an important issue for me.
• It closes the donut hole in Medicare Part D, which will lead to lower drug costs for seniors and guarantees that Medicare benefits will not be cut, all by saving money from withing the Medicare program by weeding out waste, fraud and abuse.
• It eliminates annual and lifetime limits on all insurance coverage and guarantees that insurers cover preventitive care for afflictions like cander and diabetes.
• Additionally, more than 30 million new people will benefit from health insurance coverage withing the next ten years.  Out of pocket costs for premiums and medical expenses will finally be made affordable for individuals and families.  There are strong private health insurance options covered by this bill, with state exchanges and more benefit plan options.

Quite simply, this is a better bill than the legislation I opposed last fall and it does more to contain costs while providing increased health insurance coverage.

Emphasis mine. Good on you, Betsy Markey, for legislating with your conscience. The people of Colorado’s 4th District are well served.

I can see the challenge facing a fractured Democratic caucus in an election year, and to be frank I’m not getting my hopes up for Betsy Markey’s vote.  DeGette is a different story, however, and contra the Post, I just don’t see this side* of the abortion issue being much of a stumbling block. Progressives and pro-choice groups will make some noise–and I suppose they should, because there’s no reason to go all progressive on health care yet force women’s rights back by several decades–but in the end, most are prepared to swallow a little bitter to achieve reform that is measurably better for millions of Americans.

Here’s the Post on DeGette’s dilemma:

As co-chair of the Pro Choice Caucus and a fierce abortion-rights advocate, DeGette is facing strong pressure from national groups not to approve a health care bill with the current language restricting insurance coverage of abortion contained in the Senate bill — but the reconciliation process allows no clear way to change it.

All of this is true, but politically it just doesn’t pack enough punch to threaten health care reform. The very next graf, in fact, gives DeGette the wiggle room she needs.

“Our bottom line is fix it,” said Nancy Keenan, president of NARAL Pro-Choice America. “We have tremendous champions in the House, Diana DeGette being one of them. And we expect, whether at this stage or another stage, that they get the job done.”

Emphasis mine. “Whether at this stage or another stage” is pretty damn generous in the course of holding politicos’ feet to the fire. My takeaway is that NARAL gets the basic premise that millions of women and children will be better off with the improvements in the pipeline if health care reform succeeds than if it fails, and the pro-choice movement won’t stand in the way of progress.

The Post also mentions the 40-odd representatives who won’t vote for a bill with language any tougher than the existing Senate language. This is an example of how skewed are our bicameral politics today. Basically, all of these reps already approved a bill with tougher language than the Senate bill contains; it’s called HR 3200, and it passed the House in November with Bart Stupak’s tough abortion language intact. Those reps were counting on the Senate to pass a less restrictive bill, which the Senate did. Those same representatives then assumed that the Senate language would prevail during markup, but no markup session ever took place. And with reconciliation looking like the only route to pass health care reform, markup isn’t going to happen. Instead, the House must scrounge the 217 votes it’ll take to pass the Senate bill as is with a pledge to fix the language later. That’s the real pickle, not this side note about progressives sabotaging health care reform.

*There’s another side of the abortion issue that is much more threatening to the health care reform agenda, and that’s the Stupak faction that insists the Senate adopt House language (Stupak language) before moving on reform. Brian Beutler has a great piece today on the problems Stupak & Co. bring to the mix.

And back home in Colorado, our elected officials are playing safe on the topic of health care reform, all except for Jared Polis, who, alongside a splinter faction of liberal Democrats, sees an opportunity to bring back the public option. Hey, at least he’s showing some spine.

Betsy Markey doesn’t answer to me, since I vote in Denver County, but she’s hunkered down with the Blue Dogs in an effort to smash apart the existing House health care bill and pass smaller, more “bipartisan” pieces. No surprise there, really, since Markey voted against the bill in the first place.

Diana DeGette, however, does answer to my vote, and I’m frankly stunned to read this in today’s Denver Post: “Rep. Diana DeGette of Denver said she’s willing to start negotiating the bill again from scratch if Republicans show a good-faith willingness to engage in the process.”

That’s a head scratcher, frankly. As the elder stateswoman of Colorado politics, DeGette ought to know better by now than to kowtow to the appearance of a bipartisanship that has left the building. Even to make statements that validate the notion of bipartisanship coming from obstructionist Republicans is to feed the false premise that Republicans want to solve any of these issues. They don’t, because it’s clearly in their better interests to let Dems wallow in the morass they’ve made for themselves out of all these elitist ideas about social change. In fact, the only thing that could make the GOP any happier right now is to do it all over again!

Ed Perlmutter is at least on track not to lose sight of what’s at stake, but as the Post points out, Big Insurance makes it impossible to just pass what we like from the bill a piece at a time:

Complicating that further, one of the most popular stand-alone elements — doing away with pre-existing-condition exclusions — is probably untenable to pass on its own. Insurance companies say they can cover pre-existing conditions only if the pool of healthy Americans buying insurance also expands significantly, as it would only do under the comprehensive bills.

Right. Well, so much for pushing through even popular legislation. Don’t worry, though. John Salazar is still working for health care reform for his constituents out there somewhere: “U.S. Rep. John Salazar of Manassa, the final Democrat in the delegation, declined to be interviewed for this story.”

As for our senators, the Post has Bennet in a pinch:

“I think it’s impossible to pick it right now,” said Sen. Michael Bennet, D-Colo., when quizzed on which of the ways forward now being discussed he preferred.

Uh, sure. Need we remind Senator Bennet that the Internet never forgets?  The freshman needs to show a little gumption and at least let us know how he plans to advance the health care reform agenda. He might as well come out fighting for it, because the president plans to campaign for Bennet and the right will hang the liberal Obama agenda around Bennet’s neck and watch him flounder.  So he might as well do something and earn progressive votes where he can.

Mark Udall has raised the clarion call on DADT repeal, asking not only for an inquiry but a roadmap to resolution–and soon–and he deserves praise for that. But Udall needs to step up as a leader on murkier issues that will matter to even more people. Colorado runs something like 18% uninsured, and in Denver it’s pushing 23%. With that many lives imperiled by the status quo, it’s not enough to answer a question with a question, even when couched in a beloved football metaphor.

Meanwhile, Democrats are getting reamed on the issue of a mandate, which they sort of deserve if they can’t come up with a viable nonprofit health insurance option to compete with big insurance. We need ideas and action, dammit, and legislators who aren’t afraid to do their jobs while they have them. And if Democratic lawmakers do play possum on real, important issues, they’re not just going to appear vulnerable to Republican challengers, they’re going to alienate progressives, the very voters who might keep them in office.

Still, if fundraising is any indicator, Markey enjoys a comfortable advantage (that and, well, being the incumbent). The GOP has Markey on a list of vulnerable Dems in 2010, and it’s hard to know how much her vote is an attempt to burnish centrist credentials as a fiscal hawk (as opposed to really being a fiscal hawk and believing in her no vote). If anything, the vote confirms that Betsy Markey is courting Independents in northern Colorado. On such a tight nose count, I thought it unlikely that the House leadership would give quaky Dems any cover. Matt Yglesias disagrees, however, and sees room for a little wiggle. And who knows? Maybe the House leadership and the White House think Dems can keep Larimer County by letting Markey vote according to her constituents rather than imposing the party line.

Sure, I’m disappointed that Betsy Markey voted against history-making reform in U.S. health care. But a part of me really likes to think that this is one piece of a highly calculated formula for success over the long term. After all, the bill passed the House without Markey’s help. That battle is won, at least for today. We’ll look to Markey’s future votes, and to her campaign and results in 2010, to see whether or not the Democratic Party hasn’t actually been quite savvy in leaving Markey to vote with the public will in northern Colorado.