Ron Radosh

First Thoughts on the Democrats' Health Care Victory

Here are some of my first thoughts on the evident Democratic victory—obtaining the 60 necessary votes to pass the Reid health care bill. As I sit completely snowed in a storm of blizzard proportions, which will keep me homebound for at least three to four days, I watched both Harry Reid’s morning press conference and the response later by Republican Minority Leader Mitch McConnell.

First, Reid candidly explained how what he called the political process of legislating led to the special treatment on Medicaid given to the state of Nebraska. Because many poor states will find that that the expansion of this program in the new bill will mean that they cannot meet the necessary funding that comes from their own state budgets, they will be in danger of a major shortfall or bankruptcy, thereby having to increase state taxes to cover the difference.

Now, however, the bill singles out Nebraska for very special treatment. As today’s New York Times reports, “The amendment also includes a special extension solely for Nebraska: increased federal contributions to the cost of an expansion of Medicaid, the state-federal insurance program for the poor.” The effect of this is that unlike other states, Nebraskans will not have to worry about how to fund the increased cost of Medicaid expansion in their state—forever!

Moreover, as Reihan Salam points out, “Nebraska is a relatively low-poverty state, with a poverty rate of 10.6 percent of households. Fifteen other states have lower poverty rates while thirty-five have higher poverty rates. Yet it seems that Nebraska, by virtue of its impressively stubborn Democratic senator, will receive unusually generous treatment.”

It is no mystery why Nebraska got such a favor. The Democrats needed the vote of Senator Ben Nelson, who vowed not to vote for any bill that included Federal funding for abortion. The newly rewritten bill appears to deal with that, by allowing states that do not want to accept a measure that includes abortion funding to purportedly opt out and vote to ban such coverage on any plans offered in their state.

Undoubtedly, however, ways will be found around this, probably by offering of some plans that cover abortion and others that do not. Of course, the Nebraska state legislature could vote to accept all plans offered, even if they cover abortion. But for the moment, Nelson can pretend that his conscience is clear, and point to the boondoggle he got for his state.  To put it simply, Ben Nelson was bought off plain and clear.

There also is evidently similar treatment offered Vermont, ostensibly put there to appease Rep. Bernie Sanders, who as of a few days ago had not made up his mind where he would come out in a House vote—given that as a socialist, he is committed to a single-payer plan that he says was betrayed by the Obama administration.

So the bill looks like it will pass—a bill that will change the country’s health system in profound ways, and that was done without one single Republican vote.  It is the opposite of bi-partisanship, that should be necessary when such a major change is presented. Instead, the Democrats have rammed it down the country’s throat, refusing to wait until after the holidays, when everyone- including Republican senators and congressmen-have a chance to read the entire 2000 pages and digest it thoroughly.

The Senate vote will come Monday morning at 1 a.m.—when most of the country will be sleeping, and not paying attention.   This is hardly the way one hopes the world’s greatest democracy should get its business accomplished.