Reid's at the Reins in Health-Care Battle

By Paul Kane
Washington Post Staff Writer
Saturday, October 3, 2009

With the Senate Finance Committee finally poised to complete its work, the volatile health-care debate shifts into closed-door negotiations taking place around the conference room of Senate Majority Leader Harry M. Reid (D-Nev.).

Reid, the soft-talking son of a hard-rock miner, must weave together different health-care proposals from the Finance and health committees with similar goals of insuring millions of uninsured Americans in a way that does not raise the federal deficit. But the proposals differ in critical areas that threaten the outcome, placing Reid in the eye of an ideological storm for Democrats.

Reid's own recent statements have run the gamut of the diverse positions held throughout his 60-member caucus, particularly on the "public option," the proposal for a government-funded competitor to private insurance companies.

A week ago, Reid called a compromise idea to delay the public option decision for several years a "pretty doggone good idea." By midweek, his top lieutenants adamantly pushed for the public option approved earlier by the health committee, forcing the leader to backtrack. "We are going to have a public option before this bill goes to the president's desk," Reid said in a conference call Thursday.

By late Thursday evening, his office released a statement proclaiming that the majority leader would guarantee only to "include a mechanism to keep insurers honest, create competition and keep costs down."

Such wavering has been symptomatic of all majority leaders in recent decades as they tried to push major legislation through the Senate -- now prone more than ever to minority-led filibusters requiring 60-vote hurdles. Republicans, who remain almost universally opposed to the proposal as a high-tax, government-run insurance plan, have taken some measure of glee at watching the Democratic infighting that has prevented a unified majority.

"All of the queasiness about this bill is on the Democratic side, not the Republican side. . . . They ought to be able to do anything they want to. The question is: Will they?" Senate Minority Leader Mitch McConnell (R-Ky.) said Friday morning, hours after the Finance Committee completed its two-week consideration of more than 500 amendments to its proposal.

On Tuesday, Finance Committee Chairman Max Baucus (D-Mont.) expects the panel to approve formally his legislation and send it to Reid, who will gather Baucus and other key committee chairmen to work out the differences between the competing plans. Both Reid and House Speaker Nancy Pelosi (D-Calif.) hope for votes in the full House and Senate possibly in late October, with the goal of approving a final compromise version before Christmas.

Pelosi has begun near-daily gatherings of her leadership team to debate the competing versions approved by three House committees. But the differences on the House side are more narrow, and that chamber's authoritarian rules will allow her to squeak by with a bare majority if necessary.

Looking for Consensus

Reid's path has many pitfalls. Democratic centrists have shown disdain for the health committee's legislation, and party liberals and key allies such as labor unions vehemently object to portions of the Baucus bill. The goal remains, said Jim Manley, Reid's spokesman, "to put together a bill that can get the 60 votes necessary to overcome a Republican filibuster."

Reid's first days as Democratic leader came when his party held just 45 seats in 2005, and the goal was just blocking George W. Bush's White House agenda. He unified his small caucus and scored early successes, stalling Bush's initiative to practically privatize Social Security. Reid also fired from the hip, calling Bush a "loser" and then-Fed Chairman Alan Greenspan "a hack." Those shoot-first-aim-later comments drew him wide praise among liberal activists, then clamoring for a fighter to stand up to the powerful Bush White House.

Now, with a 60-seat majority and Barack Obama in the White House, Reid seeks consensus. This has provoked a revolt among liberal activists who long for the days when Lyndon B. Johnson ruled the chamber in the 1950s with an iron fist, believing such a leader could herd Democrats into a unified bloc of 60 to pass Obama's most critical priorities.

But the days of arm-breaking majority leaders are long gone. Rules changes in the 1970s made minority filibusters easier to achieve procedurally so long as the majority cannot muster 60 votes. Every majority leader of the past 20 years has left the chamber in some level of personal or political defeat, weakening the position's institutional grip.

Reid has compared himself to the late Mike Mansfield (Mont.), who succeeded Johnson and served as Democratic leader for 16 years, the longest tenure ever for a Senate party leader. Mansfield's soft cajoling helped lead to the 1965 passage of Medicare and Medicaid, the largest "public options" ever created in the health-care system.

Beginning next week, Reid will have to channel his inner Mansfield to smooth over the different positions of key players in the legislative fight. Many hope that Obama and his advisers will weigh in to force Democrats into some form of unity.

Competing Interests

In one corner of Reid's office will be Baucus, whose legislation was deficit-neutral, in part, by lowering subsidies for lower-income workers who are to buy insurance on a new exchange. That bill has won accolades from the roughly 15 centrist Senate Democrats who represent conservative-leaning states, many of whom Reid and Sen. Charles E. Schumer (D-N.Y.) helped elect in 2006 and 2008. In another corner will be Schumer, once the campaign chief and now the No. 3 leader, along with Sens. Christopher J. Dodd (D-Conn.) and Tom Harkin (D-Iowa), who will represent the interests of the health committee.

Dodd and Harkin steered legislation through their panel with higher subsidies for workers buying insurance and a public insurance option. Their legislation also includes more stringent mandates on employers to buy worker insurance and is more closely aligned with the House drafts Pelosi is rewriting.

Reid must pull this all off while keeping one eye on Nevada. After higher-profile Republicans took a pass on challenging Reid, several GOP challengers have emerged in recent weeks with polls showing he could be the latest majority leader to suffer political humiliation.

Reid won assurance from Baucus that a tweak in Medicaid funding would not harm Nevada. It's a provision that will help his reelection campaign, but it also brought consternation from colleagues wishing for similar home-state provisions.

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