Are Democrats nearing civil war over healthcare reform?

Two major left-leaning activist groups are threatening to work against Democrats who vote against a public option or for abortion restrictions in healthcare reform legislation.

Elaine Thompson/AP/File
Protesters chant during a rally by several hundred caregivers for seniors and people with disabilities where they called for inclusion of a public option in health care, Sept. 14, in Seattle.

Three days after the House’s historic passage of comprehensive healthcare reform, Democrats are grappling with the downside of being a “big tent” party: Their coalition is diverse, and internal tensions rise to the boiling point when major legislation is on the line. Political Action, a key organizer on the left, is now taking aim at conservative House Democrats who voted against health reform. The group is spending $500,000 on ads against several such Democrats, who represent Republican-leaning districts and are seen as highly vulnerable to a GOP challenge in the 2010 midterms.

Looking ahead to a tough healthcare vote in the Senate, MoveOn has also raised more than $3.6 million to fund primary challenges against “any Democratic senator who blocks an up-or-down vote on healthcare reform with a public option,” the group said in an email to members last week. One of MoveOn’s nonnegotiables is that health reform includes a new government-run insurance plan, or public option, that would compete with private insurers.

On Tuesday, Senate majority leader Harry Reid told reporters that he expects to bring healthcare up for debate next week, and believes he can pass legislation by the end of the year.

The abortion divide

The abortion issue has also produced a schism in the Democrats’ health reform drive. At the 11th hour last Saturday, the House passed – with significant backing from anti-abortion Democrats – an amendment that would limit access to abortion services in any new insurance marketplace.

NARAL Prochoice America is now threatening to support challengers in Democratic primaries, an unusual step for the group. And more than 40 House Democrats, all supporters of abortion rights, have promised to vote against the final version of the legislation if it includes the anti-abortion language that was approved last Saturday.

Is the Democratic Party in danger of breaking out in open civil war, much the way Republican conservatives are at war with members who want their own party to be diverse? That internal GOP conflict burst into the open in New York’s 23rd congressional district, resulting in the election of a Democrat there last week.

“Civil war is pretty strong language,” says William Galston, a former policy chief in the Clinton White House. “This is stronger than the language I would use, but the fact of the matter is, the contemporary Democratic Party, unlike the contemporary Republican Party, is an ideologically diverse coalition.” Such a coalition takes some “delicate management,” he says, and “doing it in public isn’t always pretty.”

NARAL's hard line

Abortion-rights advocates say they’re not concerned about intraparty conflict when fundamental principles are on the line – even if their goal is to defeat Democrats, whose party platform supports abortion rights. For now, groups like NARAL have the luxury of a large Democratic majority in the House – 258 Democrats vs. 177 Republicans – so they can go after opponents of abortion rights without posing a major threat to the Democratic majority.

“It’s a twofold thing,” says Elizabeth Shipp, political director for NARAL. “Do I care if we lose the majority? Yes. Do I think we’re going to lose the majority? No.”

The Senate is trickier territory. The Democrats’ 60 to 40 majority gives the party just enough votes to break a filibuster, if all Democrats vote with their caucus.

MoveOn opens its war chest

But for now, the focus is on the House. The MoveOn ads will start airing Thursday against seven Democrats who voted no on healthcare: Reps. Mike Ross of Arkansas, Jason Altmire of Pennsylvania, Rick Boucher of Virginia, Larry Kissell of North Carolina, Heath Shuler of North Carolina, and Lee Terry of Nebraska.

MoveOn is also organizing more than 100 “thank you” events Thursday and Friday in districts of members who voted yes.

A spokeswoman for Political Action, Ilyse Hogue, denies that the organization is promoting a split in the Democratic Party over healthcare reform by running ads against some members.

And there’s no comparison to the GOP’s woes, she says. “We’ve got a shrinking Republican Party that is catering to the more extreme wing of its base,” Ms. Hogue says. “What we’re seeing in the Democratic Party is actually a vibrant debate about a solution to the healthcare crisis that is very popular.”

See also:

Five flash points as healthcare reform moves to the Senate

US House of Representatives votes to approve healthcare reform


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