There is more than one way to reform health care. And as long as Sen. Joe Lieberman (I-Conn.) or Ben Nelson (D-Neb.) or any other conservative Democrat can frustrate efforts to pass a strong health reform bill through the regular order of business, Democrats should be prepared to pass as much reform as they can by any means necessary.
There’s a lot of bluster from people who are not in Congress about walking away from the deal and starting from scratch next year. Won’t happen. There are, at best, 58 Senate votes for health reform with a strong public option and/or Medicare buy-in for people from age 55 to 64. But 60 are needed to get to a final vote under the current Senate rules. And probably another half-dozen centrist Democratic senators are wobbly. If those Dems aren’t feeling the heat to pass a strong bill now, there is no reason to expect they’ll be convinced next year.
Lieberman and Nelson are only the latest members of the Democratic-led caucus who stood in the way of a cloture vote to shut down the Republican filibuster of health-care reform. Other Democrats who have been resisting the public option include Mary Landrieu (La.) and Blanche Lincoln (Ark.). Of those, only Lincoln is up for re-election next year and Dems could end up with a loss of seats in the mid-term election. (At this writing, Majority Leader Harry Reid thinks he has all 60 lined up to vote for cloture Monday.)
Lieberman has supported Medicare buy-in at least since 2000, when he supported the concept as part of the Gore/Lieberman campaign. As recently as this past Sept. 8, he told the Connecticut Post that citizens should be allowed to buy into Medicare or Medicaid. Democratic senators apparently were under the impression that Lieberman still supported the concept when they unveiled the Medicare buy-in as a public option “compromise” in December.
But Lieberman cannot be trusted. When he heard that liberals thought the Medicare buy-in was a good deal, he reversed course. He appears to be driven by a vendetta against the progressive wing of the Democratic Party. After liberals defeated him in the Democratic primary in 2006, he ran for re-election as an independent but said he would support the Democratic agenda on all but a few issues — mainly in supporting George W. Bush’s foreign policy and the war in Iraq. When Lieberman won in the general election with less than 50% of the vote, his was the 51st vote that let Harry Reid become the majority leader, so he was allowed to become chairman of the Homeland Security and Government Affairs Committee. But in 2008 he not only endorsed GOP presidential candidate John McCain, but he also spoke at the Republican convention. After the GOP electoral wipeout, with Obama’s intercession, Lieberman kept his committee chair, but loyalty apparently means little to him. So he has decided to represent the insurance companies who funded his 2006 campaign instead of his constituents who support the public option.
Democrats should take Lieberman’s and Nelson’s votes on insurance reform, hope they can keep the other 58 in line, and pass the best bill they can get through the Senate now. It should stop insurance companies from denying coverage of pre-existing conditions or arbitrarily rescinding coverage when patients file claims. It should strip the insurance industry of its exemption from antitrust laws. It should require that at least 85% of premiums go to medical costs. And it should end lifetime caps on how much insurance will cover, which is a leading cause of family bankruptcy. If it did nothing else, that would be a good bill.
Then the Dems should kick Lieberman out of the caucus and his committee chair and finish health-care reform by passing a public option or Medicare buy-in next year, through budget reconciliation, if necessary. Congress could pay for the $90 billion a year in subsidies for small businesses and the working poor and middle class with a surtax on the wealthiest earners, as the House proposed, instead of taxing health care benefits of the middle class, as the Senate Finance Committee proposed.
You’ll know the bill is worthwhile as long as Republicans remain united against it.
Budget reconciliation cannot be filibustered, so it only needs a simple majority, but it can only be used for legislation that has a direct effect on the budget. Insurance regulations, such as the ban on pre-existing conditions, would be ineligible.
Of course, there is no certainty of a Senate majority for a public option or Medicare expansion. Insurance lobbyists have their ways. But at least Dems should be put on the record. Then progressives can start hunting for primary challengers.
Ted Kennedy in 1974 walked away from then-President Richard Nixon’s proposal to require employers to provide health care for their workers. Kennedy hoped Democrats would be in a better position to push for a single-payer plan after the next election, but that didn’t work out. Kennedy spent the next 35 years regretting the lost opportunity. Hundreds of thousands of Americans have died since then because they couldn’t afford proper medical care. Uncounted homes have been lost by families that exhausted their life savings on medical bills. The Institute of Medicine says 22,000 people died in 2006 because they didn’t have health-care coverage. Harvard Medical School researchers estimate that the uninsured death toll is closer to 45,000 a year. Democrats should take as much of the loaf as they can get now, to help 30 million uninsured people get coverage as soon as possible. They can go back for the rest later.
Dismantle the Filibuster
The health-care debate shows the problems with the partisan use of the filibuster and Sen. Tom Harkin (D-Iowa), chairman of the Health, Education, Labor and Pensions Committee, said he would once again propose a bill to curtail the practice. Harkin and Joe Lieberman tried once before in 1995 but the reform failed in a 76-19 vote. Presumably Lieberman’s views toward the filibuster have softened since then.
The US Constitution does not mention the filibuster but both chambers of Congress adopt their own rules by majority vote for each two-year term. Unlimited debate was allowed from the early days of the Senate until 1917, when the Senate adopted a rule requiring a two-thirds majority vote (“cloture”) to end debate. But filibusters were sparingly used, most famously by Southern senators to block civil rights legislation in the 1950s and ’60s. In 1964 cloture was achieved for only the second time since 1927 and the Civil Rights Act was enacted after a 57-day filibuster — one of only three cloture votes during that term of Congress. In the 1960s, no Senate term had more than seven filibusters. But as Republicans increasingly resorted to the filibuster in the 1970s, the Senate in 1975 reduced the number of votes required for cloture to three-fifths, or 60 of the 100 senators. After a brief decline in usage, senators increasingly turned to filibusters in the 1980s and it effectively became a procedural vote for important legislation. A record 112 cloture votes were needed in the Congress of 2007-08, after Democrats regained a slim Senate majority. This year, the first since 1979 when either party had a (theoretically) filibuster-proof majority, 62 cloture motions have been filed and 34 cloture votes have been held as of Dec. 13.
Many Democratic senators still will be loathe to give up the filibuster. But Republicans, who are a much more disciplined lot, are likely to do away with the filibuster if they regain the majority. Then-Majority Leader Bill Frist (R-Tenn.) in 2005 threatened to end Democratic filibusters of George W. Bush’s judicial nominations by exercising what he called the “nuclear option” — under which Vice President Cheney, as presiding officer, would simply rule a filibuster “out of order” and, if the majority supported his ruling, proceed to the question. A bipartisan coalition of 14 senators preserved the filibuster that year, but Dems had to agree to let all but a few right-wing nominees be confirmed to lifetime appointments. The GOP has moved further to the right since then. JMC
From The Progressive Populist, January 1-15, 2010
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