"Something called health-reform legislation will pass," a prominent Democrat told me. "The political consequences of not passing anything would be too great." A bare-bones bill that reforms the health-insurance industry — insurers would have to accept all comers, including those with pre-existing conditions, at the same rates — is a distinct possibility. Expanded coverage, perhaps including the parents of children eligible for the State Children’s Health Insurance Program (SCHIP), is also probable. Most important for long-term reform, a system of health-care superstores — the wonks call them "exchanges" or "co-ops" — where individuals and small businesses can go to buy a plan, could be included.
I feel like I’ve heard this one a few times before, so it seems a likely scenario. And while I can think of worse possibilities, the fact is that I can think of better ones, too: for if the Democrats get the chance to claim success without doing something more substantial, then one possible outcome is that the current momentum behind the “reform” cause dies out before achieving the sorts of changes that are necessary, and so resulting in a reform that truly deserves the title. But as things stand the Republicans have no incentive whatsoever to compromise, as any bill that passes will forever be credited to the majority party; hence the most politically attractive strategy for the minority is simply to resist such passage at every juncture possible. How likely is it, though, that in the unlikely event that such a strategy pays off the GOP of the future will get its legislative act together, and put the work into developing and promoting reform proposals of their own? Signs point to “Not Very”.