Megan McArdle thinks so:
I now put the chances of a substantial health care bill passing at 75%, and the chances of the Democrats losing the house in 2010 at about 66%.
Replacing Ted Kennedy is major, of course, but the real game changer is that the CBO is willing to score health care savings on the grounds that the bill contains automatic spending cuts.
Conservatives are filled with rage and anguish. The spending cuts, they argue, mostly will not be done, which means that this bill is going to cost hundreds of billions more than its proponents claim. They are absolutely right: the savings cuts will not be made, and I doubt that many in the Democratic party leadership, or the liberal wonkosphere believe that they will.
... I think that for those of us who were opposed to this bill, it's game--almost--over. This isn't exactly surprising; Democrats have a commanding lead in the house and the Senate, and now they have the presidency too. If public opinion on this thing craters again, I'll reassess. But for now it looks like it's time to start preparing for an ambitious health care reform, and all the dislocations, and the budget crisis that we now have even less ability to aver.
Let's assume worst case scenario: A liberal version of Obamacare gets rammed through the Senate using reconciliation to bypass the filibuster. The purported savings don't materialize. The costs are enormous. The public option squeezes out private insurance.
Ten years from now we wake up and realize that Obamacare has been a disaster. Is there any possibility that it would be reformed, let alone repealed? The list of failed government programs that have been repealed is a pretty short one.
Since the New Deal, the role of the state has consistently grown. Shrinkage has been rare.