Tag: harry reid

Health Care: Not Close to Over

The fat lady hasn’t even started to warm up yet.

The narrow 220-215 victory in the House on Saturday night was a step forward on the road to a government takeover of the health care system.  But as close and dramatic as that vote was, that was the easy part.  The Senate must still pass its version of reform—which will not be the bill that just passed the House.  Nancy Pelosi was, after all, able to lose the votes of 39 moderate Democrats.  Harry Reid cannot afford to lose even one.  A conference committee must reconcile the two vastly different versions.  And then, Pelosi must hold together her 3 vote margin of victory (if it gets that far).  Yet several House Democrats who voted for the bill on Saturday said they did so only to “advance the process.” Their vote is far from guaranteed on final passage.  And, House liberals are almost certain to be disappointed by the more moderate bill that may emerge from the conference.

Among the more contentious issues:

Individual Mandate: This should’ve been low-hanging fruit. Democrats agreed on a mandate early in the process. But it became increasingly plain that a mandate would hit those with insurance as well as the uninsured – forcing people who are happy with their plan to switch to a different, possibly more expensive plan. With this mandate now being seen as a middle-class tax hike, qualms have developed.  The House bill contains a strict mandate, with penalties of 2.5 percent of income backed up by up to five years in jail.  The Senate Finance Committee, on the other hand, watered down the mandate’s penalties and delayed the mandates implementation.

Employer Mandate: The House bill also contains an employer mandate, a requirement that all but the smallest employers provide insurance to their workers or pay a penalty tax of up to 8 percent of payroll.  The Senate,  looking at unemployment rates over 10 percent, seems unlikely to include an employer mandate.

The Public Option: The House included, if not a “robust” public option, at least a semi-robust one.  But moderate Democrats in the Senate are clearly not on board.  Joe Lieberman (I-CT) says that he will join a Republican filibuster if the public option is included.  Harry Reid is trying various permutations: a trigger, an opt-in, an opt-out.  But as of now there is not 60 votes for any variation.

The Sheer Cost: Fiscal hawks like Sen. Evan Bayh (D-IN) say they will not support a bill that adds to the deficit or spends too much.  But the house bill cost a minimum of $1.2 trillion.

Taxes: The House plan to add a surtax on incomes of $500,000 or more a year has no support in the Senate. At the same time, the Senate plan to slap a 40 percent excise tax on “Cadillac” insurance plans is unacceptable to key Democratic constituencies like labor unions.

Abortion: Conservative Democrats insisted on a strict prohibition on the use of government funds for abortion.  The bill could not have passed without the inclusion of that provision.  House liberal swallowed hard and voted for the bill, despite what they called “a poison pill” anyway with the expectation that it will be removed later.  If the final bill includes the prohibition at least a couple liberals could defect.  If it doesn’t, conservative Democrats won’t be on board.

Immigration: The Senate Finance Committee included a provision barring illegal immigrants from purchasing insurance through the government-run Exchange.  The House Hispanic Caucus says that if that provision is in the final bill, they will vote against it.

As if these disagreements among Democrats wasn’t bad enough, public opinion is now turning against the bill.

President Obama has called for a bill to be on his desk before Christmas—the latest in a series of deadline that are so far unmet.  It is hard to see how Congress can meet this one either.  The Senate has not yet received CBO scoring of its bill and is not prepared to even begin debate until next week at the earliest.  That debate will last 3-4 weeks minimum, assuming there are 60 votes for cloture.  That means, the bill cant’ go to conference committee until mid-December, even if everything breaks the way Harry Reid wants.  Privately, Democrats are now suggesting late January, before the State of the Union address, is the best they can do.

The fat lady can go back to sleep—this isn’t over yet.

Are Savvier Democrats Playing Rope-a-Dope?

Let’s simplify things and say there are essentially two parts to the health care bills moving through Congress: an individual mandate that would effectively nationalize health care, and a government-run program that would explicitly nationalize it slowly, over time.

One explanation for Majority Leader Harry Reid (D-NV) including the government-run program – supporters call it a “public option”; I prefer Fannie Med – in the Senate bill is that Fannie Med’s popularity is on the rise.  Another explanation is that Reid had to include it to remain majority leader and get left-wing Nevadans to work for his re-election.

But a third explanation, not inconsistent with the others, is that the savvier Democrats know that all they need to nationalize health care is an individual mandate.  So they’ll let Fannie Med take a beating, and then pass the more sweeping individual mandate when opponents are too exhausted and distracted by their “victory” over Fannie Med to notice.

(Cross-posted at Politico’s Health Care Arena.)

Reid’s Accomplishment

Including a Fannie Med with a “state opt-out” provision in the Senate Democrats’ health care bill accomplishes only this: it helps Majority Leader Harry Reid (D-NV) survive as majority leader by appeasing his left wing.  It doesn’t make it any more (or less) likely that Fannie Med will survive.

(Cross-posted at Politico’s Health Care Arena.)

Max Baucus’s Magic?

Max Baucus says every single Democratic senator will vote for all the taxes, all the private-sector mandates, all the inter-governmental mandates, all the Medicare spending cuts, and all the new private-insurance subsidies that he and Harry Reid are cobbling together.  What’s left to discuss?

Baucus may know something I don’t.  But here’s what I do know.

  1. To subsidize Paul, Democrats need to rob Peter.  And Peter ain’t gonna like that, whether “Peter” is union members, small businesses, insurance companies, medical-device manufacturers, sick people, or the middle class broadly.
  2. Of course, the government already does a lot of Peter-robbing and Paul-paying in health care. Democrats could subsidize Paul #2 by cutting subsidies to Paul #1.  But again, Paul #1 — whether “he” be seniors, doctors, hospitals, insurance companies, pharmaceutical manufacturers, medical-device manufacturers, home health agencies, skilled nursing facilities, etc. — ain’t gonna like that.
  3. Members of Congress, including Democratic senators, tend to listen to those Peters and Paul #1s.
  4. Democrats could try to rob future generations, but they (particularly President Obama) have painted themselves into a corner on that one by promising not to add to the deficit.  And with regard to deficit spending, the public appears to be in no mood.

Heck, I’m sure that Baucus knows a lot of things I don’t know.  But I doubt he knows any magical incantations that’ll make those challenges go away.

(Cross-posted at Politico’s Health Care Arena.)

Republicans, Democrats, and Appropriators…and Pork

I’m sympathetic to the oft-repeated saying that there are really three parties in Washington: Republicans, Democrats, and Appropriators.  This situation is likely to be demonstrated this evening when Republican members of the Senate Appropriations Committee provide enough votes for Democratic Sen. Harry Reid to close off debate and proceed to final passage of the pork-laden $410 billion fy2009 omnibus appropriations bill.

Greasing the skids for bigger government will be almost $8 billion in earmarks contained in the bill.  Fox News is pointing out that almost all of the Republican Senators expected or likely to support the Democratic measure stand to deliver quite a bit of pork to constituents and special interests.  Not coincidentally, all of the senators named, except Sen. Snowe of Maine, are appropriators.  As a matter of fact, if you look at the top 20 senators (both parties) in terms of dollars of earmarks secured for this bill, 15 are appropriators.

Bottom line: Appropriators love spending and they particularly love pork.  Sen. Snowe just likes the government spending other people’s money.

**Update: Cloture was invoked on a 62-35 vote and the legislation subsequently passed by voice vote.  Every single Democratic member of the Senate Appropriation Committee voted for cloture.  Republican appropriators Sens. Cochran, Specter, Bond, Shelby, Alexander, and Murkowski voted yes; Sens. McConnell, Gregg, Bennett, Hutchison, Brownback, Collins, and Voinovich voted no.  Thus, without the support of these Republican appropriators, the bill would have been effectively killed.  Of the top 20 recipients of earmarks in the bill, only 2 – Sens. Inhofe and McConnell – voted no.