The last week, pundits have painted a picture that says passing health care reform with a robust public option is a fait accompli. After yesterday’s vote, those pundits, with their tails between their legs, are noticing that there might be a difficult, lengthy slog ahead for them:

“For many of us, we’re OK with the public option,” said Rep. Steve Driehaus, a first-year Democrat from Ohio. “There are other things we’re more concerned with.”

“I think they’re miscalculating,” Rep. Jason Altmire (D-Pa.) said about Pelosi’s Tuesday night claims that she was close to having the votes she needed to move a government option pegged to Medicare. “They might have a list of 210 people who support the public option, but they don’t have 210 votes.”

“The last count we had, there were less than 12 Blue Dogs who could back a public option tied to Medicare,” said Utah Rep. Jim Matheson, a spokesman for the coalition of conservative Democrats. That leaves 40 to oppose the plan, two more than they need to block a bill.

I hope the White House will forgive me for mentioning this but it doesn’t sound like Harry Reid and Speaker Pelosi have their caucuses pinned down. It sounds more to me like there’s plenty of discord in the ranks. I’ve often thought it might come to this.

For me, the question that I’m looking for the answer to is whether there will be enough Democrats willing to suffer defeat in 2010 to pass this bill. At this point, I don’t have the answer to that question but yesterday’s vote gives me reason for some limited optimism.

I suspect that the keys to the legislation is the CBO’s scoring once the doctor fix is included in the (semi)final bill and whether they’ll try pushing the Medicaid unfunded mandate through. I think that they’re the key to exposing the Democrats’ gimmicks to portray the bill as fiscally responsible.

Once the doctor fix is included in the bill, there goes the thin veneer of deficit neutrality. Though I’ve never thought that deficit neutrality should be the biggest benchmark, nonetheless I think it’s important because it strips away the political cover that wobbly Democrats need to justify their voting for the bill. If that political cover is gone, I suspect that alot of Democrats won’t support the bill.

I also think that exposing the cost that the Medicaid unfunded mandate will have on states strips away more of the veneer that this is a fiscally responsible bill. That limits the wiggle room of Blue Dogs. Without that political cover, they’re painted into a bit of a tight corner. They can’t say that they’re fiscally responsible if they’re voting (a) to raise taxes by hundreds of billions of dollars in taxes, (b) to dump a huge unfunded mandate on the states and (c) for a bill that raises the debt by $250,000,000,000.

This news won’t help the Democrats’ efforts:

Also, career government economists within the Department of Health and Human Services dealt a blow to the House bill Wednesday, releasing a report concluding national health care spending would increase because newly insured people would seek care.

Unlike the analyses produced by the Congressional Budget Office, which looked at the impact of legislation on the federal government alone, the HHS report examined the impact on the national economy. The report complicates President Barack Obama’s pledge to sign a bill only if it slows the rate of health care spending.

If people start noticing that their health care costs will continue to increase and that the bills won’t eliminate the uninsured, they’ll ask, like I’ve been doing, why the Democrats’ health care legislation should be called reform. Here’s a checklist of what the Democrats’ health care legislation accomplishes:

• Raises health care costs
• Uninsured is still high
• Dumps alot of expenses onto the states at a time when they’re having difficult times balancing their budgets

Only in Washington could failing on the 3 biggest priorities of the biggest issue facing the nation be considered reform. That might play well in Washington, DC but it won’t fly in Flyover Country.

Finally, I have a message for Harry and Nancy: Welcome to the battlefield of ideas. Have a nice day.

Technorati: Blue Dogs, Jason Altmire, Jim Matheson, Whip Count, Speaker Pelosi, Harry Reid, Doctor Fix, Medicare, Medicaid, Unfunded Mandates, Tax Increases, CBO, Deficits, Democrats

Cross-posted at California Conservative