President Barack Obama is pushing Senate Majority Leader Harry Reid to go further than Obama has previously disclosed to strip the final health care reform bill of the narrow deals aimed at appeasing specific senators.
The president wants to eliminate more than just Sen. Ben Nelson’s “Cornhusker Kickback” and Sen. Bill Nelson’s agreement to shield 800,000 Florida seniors from Medicare Advantage cuts, the White House told POLITICO Wednesday in response to questions about other deals in the bill.
Obama has asked Reid to strike provisions requested by senators from at least five other states, in an unusual move that accentuates the culture clash between the president’s rhetoric on changing the ways of Washington and the Senate leader’s needs to exercise the old-fashioned tools of Congress to pass laws.
“We’ve removed many of the special provisions that initially found their way into the legislation, and we’ve made it clear to the Senate that the president’s position is that the final bill shouldn’t include any earmarks or provisions that would favor a single state or district over the rest of the country,” White House spokesman Reid Cherlin said in a statement Wednesday.
Reid spokesman Jim Manley said the decision on what to keep in the bill rests with congressional leaders and that no determinations have been made.
Senators whose deals have been targeted — some of whom did not know the deals might be in danger — said they would fight to maintain them, arguing they are in no way as egregious as the Cornhusker Kickback.
“We have defended it, and we will defend it,” said Sen. Bernie Sanders (I-Vt.), whose state picked up $600 million in extra Medicaid funding for having already expanded its coverage of low-income individuals.
But ever since last-minute deal making helped sour voters on the Senate bill that passed on Christmas Eve, any provision identified by Republicans or the media as benefiting a single state or a small number of states has sat on shaky ground.
Obama tried to publicly distance himself from the deals, saying he wasn’t in the room when they were struck, even though some of his aides were. The president rankled Reid and House Speaker Nancy Pelosi by criticizing them for doing what generations of their predecessors have done: cut deals. And in the process, he may have made it entirely untenable for them to deploy one of the tried-and-true methods for muscling major reforms through Congress.
“Legislators need pork to make things happen,” Julian Zelizer, a Princeton University professor of history and public affairs, wrote in POLITICO Wednesday. “It is unrealistic to expect that legislative leaders won’t use one of the few tools at their disposal to get things done.”
Zelizer noted that then-Senate Majority Leader Lyndon B. Johnson promised the construction of a federal dam in exchange for votes for the Civil Rights Act of 1957 from a group of Western Democrats.
In a letter to congressional leaders last week, Obama targeted the Nebraska and Florida deals for elimination. (The Florida provision could also shield some seniors in California, New York, New Jersey and Pennsylvania, according Sen. Bill Nelson's office.) But in response to questions from POLITICO, the White House detailed other provisions that the president wants to see removed.
The so-called Louisiana Purchase is still safe, according to the White House, since the provision requested by Sen. Mary Landrieu (D-La.) would apply to any state in which all the counties have been declared a disaster zone. The Medicaid funding formula fix is worth $300 million to Louisiana, according to Landrieu.
But Obama has asked Reid to strike a provision that would send $1.1 billion in extra Medicaid funding to Massachusetts and Vermont — states that have already expanded Medicaid coverage but would otherwise not be reimbursed at the same level as states that would boost their Medicaid populations for the first time under the bill’s mandate.
“What I told Harry Reid is that Vermont does the right thing, and I don’t want Vermont to be penalized for doing the right thing,” Sen. Patrick Leahy (D-Vt.) said in a statement.
Through a spokeswoman, Sen. John Kerry (D-Mass.) said he, too, was working with the president “to make sure Massachusetts’s past investment to expand health coverage to low-income individuals is recognized in health reform.”
The president is also asking Reid to “look at removing” a $100 million hospital grant program requested by Sen. Chris Dodd (D-Conn.), who has acknowledged that the University of Connecticut would qualify for the money.
But the senator’s aides added that university teaching hospitals in a dozen states would also qualify and that the program is not an earmark, since the money would be awarded on a competitive basis through the Department of Health and Human Services.
Another provision the president has asked Reid to consider removing was promoted by Senate Finance Committee Chairman Max Baucus (D-Mont.) on behalf of residents of Libby, Mont.
The bill includes language that would allow people who have been exposed to asbestos from a vermiculite mine in the town to receive Medicare assistance, although a Baucus aide said the language would apply to victims of any government-declared public health emergency. The language would fulfill the government’s responsibility, first codified in a 1980 law, to provide health care to victims of public health emergencies, the aide said.
Libby was the first town to receive the emergency declaration, and implementing language is needed to finish the process, the aide said.
“The Senate bill meets the responsibility that was established in 1980, so I can’t understand why anyone would want to make it impossible to meet our statutory obligation to address disasters of this magnitude, where more than 290 people have died from asbestos-related disease,” Baucus said in a statement. “This type of tragedy could happen to any town, anywhere across the country, and all Americans deserve to have this protection.”
The aide added: “The public health emergency provision is not a special deal.”
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