Surprisingly, the Las Vegas Sun has a bit of a fluff-piece on Senate Majority Leader Harry Reid’s role in passing health care reform. Amazingly, it never once mentions the ‘evil’ Rahm Emanuel. Yet, it does provide some interesting insights into the behind the scenes negotiating that Reid carried out at different points in the process. I think the take-away is that Ben Nelson exerted an effective veto over the public option and Joe Lieberman did the same for the expanded Medicare buy-in. There was a narrow window to try to push the public option through reconciliation (which is what I advocated from the beginning) but, in the end, the toxicity of the political climate left the entire process in too much doubt for Reid and the administration to risk everything on it.
After Lieberman upended the process yet again [by scuttling the Medicare buy-in], Obama asked the majority leader, “Is health care dead?
“No,” Reid said, according to those aware of the conversation. “I’ve got, in the state of Nevada, people who can’t afford health care. I’ll fix it.” …
…Reid pivoted again, setting out to convince his progressive wing there was no other choice but to pull the Medicare expansion, ending its hopes for a government-run alternative to private insurers.
Better to have something than nothing, Reid argued. This was important for the presidency, for their party. Democrats, he said, needed to stick together.
Reid brought senators on board, sealed the agreement with Nelson and called the votes.
And then in reconciliation:
Some senators were reluctant to use the reconciliation process, which is reserved for the most crucial situations, fearing a backlash from Republicans shut out of the process.
Others wanted changes to the bill. A coalition of liberal senators led by Sen. Bernie Sanders of Vermont wanted an amendment returning the public option.
Reid convinced them, Sanders said, that it might “destabilize a very sensitive situation.” The majority leader promised a vote on the public option after health care reform became law.
The “very sensitive situation” was the extremely narrow margin with which the reforms had passed the House. There simply were no more progressive votes to pick up in the House by including the public option in reconciliation, but there were conservative votes to lose.
In the end, the Republicans lost the battle over health care, but they succeeded in rallying their base and raising general anxiety about the bill to a point that there was no safety in the middle. Given Ben Nelson’s opposition to the public option and Olympia Snowe’s refusal to cross the aisle, the only way to pass a public option through the Senate was in reconciliation. For a variety of reasons, the Democrats strongly preferred to avoid using reconciliation, and by the time they realized that they had no alternative the debate had become so toxic that the will no longer remained in the House to pass a public option.
It was a close call. Had the Democrats not suffered a couple of pro-public option retirements in the interim between the two votes, they might have been able to pull it off after all. But the main thing was to assure passage of the bill. The exchanges don’t come into existence until 2014, and there is plenty of time to add a public option before then. Whether that is done or not depends a lot on how the midterms go.
