Sweetheart deals gone sour

By Marc A. Thiessen
Monday, March 15, 2010

Democrats are in a tight spot on health-care reform. The only way they got the legislation though the Senate was with a series of sweetheart deals -- including the now infamous "Louisiana Purchase," "Gator-aid," and "Cornhusker kickback." Those deals won the support of recalcitrant senators. But now they're now the biggest obstacle President Obama and House Speaker Nancy Pelosi face as they make their final health-care push.

These deals helped shift public opinion against health-care legislation. The picture of cash traded for votes has created a whiff of corruption and undermined the credibility of the entire health-care effort. President Obama admitted as much, declaring in January: "It's an ugly process, and it looks like there are a bunch of backroom deals."

In addition, the deals alienated conservative "Blue Dog" Democrats in the House. While Democrats no longer need 60 votes in the Senate (under reconciliation they only need a simple majority), they do need Blue Dog votes to pass the bill in the House. That is why President Obama pledged to eliminate the deals. But this past weekend the White House began backtracking. The reason? If the deals are cut to appease conservatives in her caucus, Pelosi may lose the votes of liberals. At least 45 House Democrats who voted for health-care legislation the first time around come from states that would reap rewards from the backroom deals. They would be in the awkward position of having to vote against provisions directly benefiting their constituents.

The Florida delegation -- including Reps. Corrine Brown, Kathy Castor, Alan Grayson, Alcee Hastings, Ron Klein, Kendrick Meek and Debbie Wasserman Schultz -- would have a hard time voting to strip the deal shielding 800,000 Florida seniors from Medicare Advantage cuts.

The Connecticut delegation -- including Reps. Joe Courtney, Rosa DeLauro, Jim Himes, John Larson and Chris Murphy -- would be reluctant to strip a provision providing $100 million for construction of a health-care facility in its state.

Rep. Earl Pomeroy of North Dakota probably wouldn't want to let go a provision that increases Medicare payments to "frontier states" such as his by $2 billion. And Rep. Mazie Hirono of Hawaii presumably wouldn't want to give up the increase in the Medicaid Disproportionate Share Hospital payments for her state.

In Vermont and Massachusetts, Reps. Peter Welch, Mike Capuano, Bill Delahunt, Barney Frank, Stephen Lynch, Ed Markey, Jim McGovern, Richard Neal, John Olver, John Tierney and Niki Tsongas would find it difficult vote to strip $1.1 billion in extra Medicare funding for their states.

The Michigan delegation -- including Reps. John Conyers, John Dingell, Dale Kildee, Carolyn Kilpatrick, Sandy Levin, Gary Peters and Mark Schauer -- would be hard-pressed to strip the deal shielding Michigan from the new tax on insurance companies.

Meanwhile, Reps. Alan Mollohan and Nick Rahall of West Virginia, and Reps. Robert Brady, Chris Carney, Kathy Dahlkemper, Mike Doyle, Chaka Fattah, Paul Kanjorski, Patrick Murphy, Allyson Schwartz and Joe Sestak of Pennsylvania would be asked to strip the "Black Lung Buy-Off" expanding the number of families eligible to receive black lung benefits.

Perhaps some members of Congress would vote against the interests of their constituents. But at least some could be expected to balk. And given the razor-thin vote margin on health care in the House, all it would take to kill health-care reform would be for just a few of these "yeas" to become "nays."

Pelosi is caught in a kickback Catch-22: If she does not remove the deals, she will fail to win over Blue Dogs and hand the GOP a powerful campaign issue that it can use to throw her and the Democrats out of power. But if she does eliminate the deals, she may lose the votes of members who previously voted in favor.

Democrats recognize their conundrum -- so they are desperately trying to redefine what a special deal is. Over the weekend, Obama adviser David Axelrod declared that if a deal is open to any state, it's no longer a special deal -- even if the language is written so that, in practice, just one or two states could qualify. Let Pelosi try explaining that to voters in November.

Pelosi's predicament is the result of the highly partisan strategy Democrats have followed to pass their bill. If they had tried to enact broadly bipartisan legislation, they would not have needed to make such deals in the first place. Now the deals they cut threaten to discredit or tank their health-care legislation -- and quite possibly both.

Marc Thiessen is a weekly columnist for The Post and author of Courting Disaster.

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