Now what? Minnesota’s delegation has many views

WASHINGTON, D.C. — Now what?

That was the question ringing through the halls of the Capitol today after what some in the press have dubbed the “Scott Heard ‘Round the World” — Republican Scott Brown winning the Massachusetts Senate seat once held by the late Ted Kennedy. Brown has pledged to be the 41st vote against Democrat-backed health care legislation, leaving one bill that has already passed the House and another that cleared the Senate in limbo.

“There will be discussions among my colleagues about what happens next,” Sen. Al Franken said. “I’m not sure right now what the best process is.”

“It obviously has changed the debate, because the presumption before tonight was that the House and Senate leadership would come up with something that could pass both bodies,” Republican Rep. John Kline said, adding that without the Democrats’ 60th vote, it would be a nearly impossible task to pass anything resembling current legislation through the Senate.

Several options remain on the table, among them asking the House to approve the Senate bill or trying to push a merged bill through the Senate using budget reconciliation, a complex procedure that would only require 51 Senate votes but might not allow for all parts of the current legislation to go through. Alternately, leaders could force Senate Republicans to actually stand on the floor of the Senate and filibuster the health care bill or give up on current legislation and start anew with a smaller package.

Rep. Keith Ellison
REUTERS/Larry Downing
Rep. Keith Ellison

“We’ve got to look at every option, including reconciliation,” Rep. Keith Ellison said. “The bottom line is we’ve got to buck up and do it.”

Part of the current uncertainty is because Brown’s victory snuck up on many in Washington.

At the end of last week, House Democrats held their annual caucus retreat. Not mentioned during that time was a contingency plan on what to do if Brown won. Polls at that point showed the race tightening, and as the week drew on, Brown pulled into the lead. According to Pollster.com, which tracks this sort of thing, no major independent survey showed the Democrat Coakley ahead after Jan. 11.

Yet at 7 p.m. Tuesday, just one hour before polls closed in Massachusetts, House Democrats held a caucus meeting where leaders briefed their members on the current negotiations between the House and the Senate. Democratic insiders said some parts of the compromise that have already been hammered out — public health, Indian health and parts of the Medicare and Medicaid costs — have already been sent to the Congressional Budget Office so the agency could get a jump start on scoring them. Not mentioned, according to insiders, was a detailed contingency plan should Brown win the election.

Rep. Betty McCollum said House Speaker Nancy Pelosi told the caucus that the plan was to continue moving forward with negotiations regardless of what happened in the special election.

Less than three hours later, Coakley conceded and Brown was declared the winner in Massachusetts, signaling an end to the Democrats’ filibuster-proof majority in the Senate.

Democrats: Press on
So now what?
One plan that had been seriously considered was to have the House vote on the Senate’s already-passed bill, then use the ensuing technical amendments process to “fix” what House members don’t like. However, as the day wore on that scheme seemed to be losing favor amidst concerns that the Senate bill might not have enough House votes to pass. Rep. Bart Stupak — the Michigan Democrat who authored the abortion-restricting Stupak Amendment — estimated that only 100 Democrats would actually support the Senate’s bill if it came up for a vote, a guess that Rep. Collin Peterson said “probably isn’t that far off.”

Rep. Collin Peterson
REUTERS/Mike Theiler
Rep. Collin Peterson

“No, I would not vote yes, and I don’t think they could pass it in the House,” said Peterson, the only Minnesota Democrat to vote against the House’s health care reform bill.

“I don’t think I’m going to be voting for Ben Nelson’s Nebraska provision,” McCollum, referencing a deal cut with Nelson whereby 49 states would chip in to pay for Medicaid expansion in Nebraska alone now known colloquially as the “Cornhusker Kickback”.

In fact, a MinnPost survey of Minnesota House Democrats turned up just one — Rep. Tim Walz — who said that he’d likely back the Senate’s bill if it came to the House floor.

“I think I can be comfortable with that,” Walz said in an interview Monday. “I never saw this as one bill and done, there’s going to be more. It’s about changing the system that’s broken.”

It’s unclear how the other two Minnesota House Democrats, Keith Ellison and Jim Oberstar, would vote.

“I really do hate the Senate bill,” Ellison said, ticking off reasons like the lack of a public option and excise tax funding mechanisms. “The question is whether it’s better than nothing.”

Oberstar spokesman John Schadl, asked if his boss would back the Senate’s bill, said: “He’s not going to talk about hypotheticals right now. When legislation comes to the floor, he’ll look at it and make a decision.”

Kline and Minnesota’s two other House Republicans, Michele Bachmann and Erik Paulsen, voted against the House health care bill and would oppose the Senate’s version as well, staffers for both.

Just one Republican, Louisiana’s Anh “Joseph” Cao, voted for the House health care bill, but a Cao spokeswoman told the Washington Times he doesn’t support the Senate bill as written.

Scale it down
Republican leaders stood united Wednesday behind the notion of scrapping the current bills and starting over, with most joining Bachmann in her assessment that the Massachusetts election was a “profound indication” that voters have rejected the Democrats’ health care plans.

“We ought to stop, start over and go step-by-step to concentrate on the real problem, which is rising costs,” Senate Minority Leader Mitch McConnell said.

“The American people could not have been clearer that they do not want this government takeover of health care,” agreed Michael Steel, spokesman for House Minority Leader John Boehner. “If out-of-touch Washington Democrats try to jam it through anyways, they’ll have a firestorm on their hands.”

Rep. John Kline
Rep. John Kline

Kline suggested Democrats cut their losses and embrace a much smaller compromise measure consisting of items that could garner support from Republicans. Among his suggestions: Allowing young adults to stay on their parents’ health insurance, letting small businesses pool together to purchase coverage, eliminating restrictions on buying coverage across state lines and restricting medical malpractice lawsuits.

There’s certainly a part of the Democratic caucus that wants to do just that.

Peterson is among a group of Blue Dog Democrats pushing for a scaled-down bill to “do the stuff that can get bipartisan support.”

Included in Peterson’s proposal is adding a quality of care index to the Medicare reimbursement rate formula, a provision that would likely benefit Minnesota medical providers. The Mayo Clinic in Rochester, for example, is sometimes paid just half of what other hospitals get in parts of Florida and Texas for doing the same procedures — despite the fact that Mayo’s outcomes are often better. Including quality of care in the final bill was described by both McCollum and Sen. Amy Klobuchar as their top priority for negotiations.

Peterson and Kline may have an unlikely ally on that front — the president himself. The Associated Press reported late Wednesday that the White House may now be seeking a pared-down bill in the wake of Brown’s victory. Issues important to White House in that compromise include the quality care and young adult provisions, as well as insurance premium assistance for small businesses and those with low-incomes.

Should a compromise plan not be possible, Peterson’s not opposed to punting. “I do think there are problems with the health care system that need to be fixed, but I’m not in the camp that says we have to do something no matter what,” he said.

Get something done
Most Minnesota Democrats, however, began today the same way they began Tuesday — determined to get something done.

“In every football game, the winning team often throws a pick or has a three-and-out [possession],” Ellison said. “This is the time that the people committed to social justice have to ask themselves how committed they are.”

“I know the Republicans want this to be dead,” McCollum said, “but we’re committed to moving forward on health care reform.”

McCollum said there may yet be a way to move health care reform through the House and Senate. Congressional history is chock full of procedural precedent for moving tricky legislation through both houses on tight majorities, she said, adding that something is bound to work.

After all, Democrats still control 59 votes in the Senate. And despite what some pundits are saying, 41 is not all of a sudden equal to or greater than 59. Democrats also command a 78-vote margin in the House that has been large enough to hold on every major piece of legislation that Democratic leaders have pushed so far — health care reform included.

“This is a good bill that I believe in,” Franken said. “Negotiations have been ongoing, they’ll keep going, and I’m hopeful we can still get it done.”

Derek Wallbank is MinnPost’s Washington, D.C., correspondent and can be reached at wallbank[at]minnpost[dot]com.

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Comments (9)

  1. Submitted by Karen Sandness on 01/21/2010 - 11:11 am.

    Compulsory private insurance without a public option is pure corporate welfare and will do nothing to rein in costs. Massachusetts, which has such a system, now has the most expensive health care in the world and falling levels of satisfaction.

    I suggest passing the GOOD parts of the bill separately: a ban on rescissions, a ban on denials of coverage for pre-existing conditions, removal of anti-trust exemptions from the health insurance industry, and Bernie Sanders’ expansion of public health clinics.

    In fact, for all the money that the Senate bill would have spent on subsidizing people who can’t pay for their compulsory private insurance, we could probably make public clinics available to every uninsured and under-insured person in the country.

  2. Submitted by Paul Scott on 01/21/2010 - 01:51 pm.

    I fail to see how the Scott Brown victory tells us anything about popular support for health care reform. Does anyone here believe that Ted Kennedy was in risk of losing his seat? I didn’t think so. Yet by the conventional wisdom, he was on the verge of being shown the door. After all, health care reform was his signature issue. I think the voters selected a person with good social skills over a person who they did not identify with. It’s why we got Bush over Gore and why, in part, we got Obama over McCain.

  3. Submitted by Bernice Vetsch on 01/21/2010 - 02:33 pm.

    Karen Sanders: You are SO right. Community clinics do a marvelous job of helping those who can’t afford the expense of insuring themselves OR the high fees normally charged.

    Community clinic fees are tied to income and can be as low as a couple of bucks if necessary. Increasing their number and their funding could solve the whole health-care problem if we let it develop into true universal care. Or at least could ease the suffering of the uninsured until Congress can pass a bill that really does reform the current system (HR676 or S703).

    Senator Sanders is a treasure and should be given the kind of authority that was instead given to Blue Dog Baucus and the industry-lobbyist friends who helped write the Senate bill.

  4. Submitted by Rebecca Hoover on 01/21/2010 - 06:17 pm.

    Wow, it is hard to believe Franken thinks the Senate bill is a good bill. LOL. I voted for Franken but his assessment of the Senate bill makes me believe I made a mistake.

    The Senate bill with it’s varied plans is a laugh. The Senate bill is the way to shuffle the poor into lousy plans with lousy care. And, of course, women are the ones who are usually poor so the Senate plan is terrible for women.

    Howard Dean said we should do something simple like expanding Medicare and Medicaid. I agree. That is much more humane and does not involve shafting the poor and women while giving a windfall to the insurance companies.

    Franken is goofy. LOL I can’t believe the guy is coming up with his support for the Senate bill of all things.

  5. Submitted by Dave Callaway on 01/22/2010 - 02:17 am.

    Martha Coakley lost because of her limp noodle campaign, and the fact that a wide spectrum of folks didn’t care for another round of “socialism”, for corporate America!

    Check out this video, this is at a CATO Inst. meeting: http://www.commondreams.org/view/2010/01/15-10 .

    Yes, Martha was the 60th vote, for a deeply flawed bill….

  6. Submitted by Steve Titterud on 01/22/2010 - 06:23 am.

    The Senate bill is a stinker, no doubt.

    The House & Senate leadership could get together along the lines of Ms. Sandness’ comments above, if the Democrats wake up & realize they must compromise. Why not make the Republicans an offer they can’t refuse?

    Why not dangle some tort reform under the noses of the Republicans in the House and Senate as part of the package? They have been screaming about it for decades, and they would have a terrible time explaining to their supporters why they voted against it. It could be done in a manner that makes sense to everyone except the trial lawyers.

    Mitigating the full cost implications associated with our pernicious medical malpractice system would be beneficial in terms of bending the cost curve. Capping awards will reduce the costs of those suits ($30 billion in 2007), reduce medical malpractice premiums, and reduce the worst effect of all: doctors ordering tests not for patient benefit, but in the interest of self-defense.

    There won’t be too many tears shed if a small handful of greedy malpractice lawyers have to be thrown under the bus for the benefit of society as a whole.

  7. Submitted by Richard Schulze on 01/22/2010 - 06:43 am.

    The reality is that most people have a very superficial understanding of our monetary system. Allowing so many banks to fail would be like letting the power utility fail: no banks, no money. So, we should regulate banks like we do the utilities and stop pretending that another reality exists. Complaining about a course of action that was necessary is nothing short of irresponsible.

    Currently, there is much derision of universal health care and other social safety nets. Social safety nets are an integral part of the advanced economic system: economic churn would be dreadfully painful if not for social safety nets. Life was much harder, more difficult and less productive before social safety nets were introduced. Now the problem has to do with that fact that the angry people have never been without SSNs and so have forgotten the value they provide to our economy.

    So, let me get this straight: the state with universal health care has spoken for the rest of us and said that we don’t want the universal health care they already have? Its like I tell my grand-kids while I am eating ice cream, “This ice cream is awful.”

  8. Submitted by Bernice Vetsch on 01/23/2010 - 08:52 am.

    Mr. Schulze. Massachusetts has only sort-of universal health care. It runs hundreds of millions of dollars per year over budget and, to save money, has told 30,000 LEGAL immigrants they are no longer free to purchase insurance through the exchange. It is being sued by a major Boston hospital because it underpays the hospital by so much that it will probably have to stop serving the indigent.

    I don’t think this is the kind of “universal” coverage we want to multiply by 50 states, when we could have a single-payer plan that does cover 100 percent of us while saving $400 billion per year.

    See the web site of Physicians for a National Health Plan (www.pnhp.org) for analyses of the MassPlan by Harvard researchers and HR-676 for a description of real reform (www.thomas.loc).

  9. Submitted by Jan Hively on 01/23/2010 - 05:32 pm.

    What drives me crazy is the poor communication from our elected officials and the administration about what’s in the health care reform bill and what it means to the American people. All I hear is moaning about losing “Health Care Reform.” No one is explaining the consequences based on real knowledge of the House and Senate bills.

    Yesterday on public radio, for example, Al Franken said that he plans to add an amendment that will delete the tax to be paid by Minnesota’s health care providers because they are non-profit, charitable organizations in comparison to the for-profit organizations in other states. Aside from offering that questionable judgment, he never said why the loss of the health reform bill is a big thing to the American people. Why should he, after all, when Obama has never given a bottom line description that is brief and makes sense so that voters can talk it over.

    This is what I told my relatives in Massachusetts about why health reform is important: The House bill will save $109 billion in Medicaid payments and the Senate bill $132 billion. Both will expand coverage while still offering people all their current vendors. We cannot afford the system as it stands because Medicare/Medicaid cost overruns are huge contributors to the deficit. I’ll probably never know if those are President Obama’s “bottom line” priorities. Or maybe I missed that speech.

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