13 Attorney Generals Threaten Lawsuit Over Nelson's Medicaid Bribe...Repeal

13 Attorneys General Threaten Lawsuit Over Health Care Reform



Republican attorneys general in 13 states say Congressional leaders must remove Nebraska's political deal from the federal health care reform bill or face legal action, according to a letter provided to The Associated Press Wednesday.

"We believe this provision is constitutionally flawed," South Carolina Attorney General Henry McMaster and the 12 other attorneys general wrote in the letter to be sent Wednesday night to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.

"As chief legal officers of our states we are contemplating a legal challenge to this provision and we ask you to take action to render this challenge unnecessary by striking that provision," they wrote.

In a rare Christmas Eve vote, Senate Democrats pushed sweeping health care legislation to the brink of Senate passage, crushing a year-end Republican filibuster against President Barack Obama's call to remake the nation's health care system. The 60-39 vote marked the third time in as many days Democrats posted a supermajority needed to advance the legislation.

The letter was signed by top prosecutors in Alabama, Colorado, Florida, Idaho, Michigan, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Virginia and Washington state. All are Republicans, and McMaster and the attorneys general of Florida, Michigan and Pennsylvania are running for governor in their respective states.

Last week, McMaster said he was leading several other attorneys general in an inquiry into the constitutionality of the estimated $100 million deal he has dubbed the "Cornhusker Kickback."

Republican U.S. Sens. Lindsey Graham and Jim DeMint of South Carolina raised questions about the legislation, which they said was amended to win Nebraska Sen. Ben Nelson's support.

"Because this provision has serious implications for the country and the future of our nation's legislative process, we urge you to take appropriate steps to protect the Constitution and the rights of the citizens of our nation," the attorneys general wrote.

A conference committee begins meeting next year to work out a compromise between House and Senate versions of the bill. Experts expect those talks will likely last into February, and a spokeswoman for U.S. House Majority Whip Jim Clyburn, D-S.C., did not immediately comment on the letter.

McMaster says if the bill goes through to final approval with the benefit to Nebraska, taxpayers in the other 49 states will have to pay for it.

Meanwhile, Nelson is taking his message on health care reform directly to his constituents. In a television ad beginning during Wednesday night's Nebraska-Arizona Holiday Bowl football game, the Democrat says he stuck by his principles throughout the debate and doesn't want Nebraskans to be confused on his position.

While it's not uncommon for states to challenge federal laws in court, one legal expert said political bluster was likely behind the letter.

"I do think that it is some combination of the losers just complaining about the officiating, or complaining about how the game was played, in combination with trying to make the bill look as seedy and inappropriate as possible, for political purposes," says Andy Siegel, a former University of South Carolina School of Law professor now teaching at Seattle University School of Law.

"It is smart politics to try to tarnish it and make it look less like an achievement and more like some sort of corrupted bargain," he said.



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Sources: AP, Huffington Post, MSNBC, TPM, Youtube, Google Maps

Dems' Senate Health Care Bill Deals Teaching Youth "Dirty Politics"

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A Senate Health-Care Victory That Stinks


The health-care reform bill coming out of the Senate presents a real dilemma for spectators: How do you applaud while holding your nose?

There is so much that is wrong with it -- and the way it was made -- and, at the same time, so much that is right that you just have to shake your head in despair and in wonder.

As one who covered the Clintons' struggle 15 years ago to pass health-care reform and who wrote an overly long book about their failure to even bring it to a vote in a Democratic Congress, I am in awe at the prospect of such a bill making it all the way to the White House.

When implemented years from now, it promises to make as many as 30 million men and women who now live with the fear of illness or hospitalization leading straight to financial ruin eligible for the same care as their more fortunate, insured neighbors.

Six decades after FDR's death, one of his Four Freedoms will, at long last, be guaranteed to almost all Americans. And the shame of this affluent society tolerating the denial of health care to its citizens will be largely lifted.

But Lord, what a load of embarrassment accompanies this sense of satisfaction! What should have been a moment of proud accomplishment for the Senate, right up there with the passage of Social Security and the first civil rights bills, was instead a travesty of low-grade political theater -- angry rhetoric and backroom deals.

There's blame enough to go around. Start with the 40 Republicans, not one of whom was willing to break out of the mold of negative conformity and offer a sustained working partnership in serious legislative effort.

But even those Republicans who were initially inclined to do that -- and there were at least a handful of them -- were turned away by the White House and the Senate Democratic leaders, who never lifted their sights much beyond the Democratic ranks.

Forced to bargain for every vote among the 60 in his caucus, Senate Majority Leader Harry Reid did what he usually does: He reduced the negotiations to his own level of transactional morality. Incapable of summoning his colleagues to statesmanship, he made the deals look as crass and parochial as many of them were -- encasing a historic achievement in a wrapping of payoff and patronage.

The taint has rubbed off on the bill.

This week's Quinnipiac University poll found a majority of Americans disapproving of the legislation by 53 to 36 percent and an overwhelming number -- 73 to 18 percent -- saying they do not believe it will, as promised, reduce future budget deficits.

It now becomes President Obama's responsibility to strengthen the bill's cost-saving features and present them in a better way. Two of them are vulnerable to attack when the bill goes back to conference with the House in January.

Liberal Democrats do not like the Independent Commission in the Senate bill having power to enforce savings in Medicare and the Private Health System. And Labor does not accept the Senate plan to Tax high-end insurance plans.

Obama has not intervened with a heavy hand as the bill has moved through the House and Senate, but now it is time for him to act.

It would help a lot if he reached out personally to those few Republicans who might still want to improve the bill rather than sink it. And it would help even more if he shamed the Democrats into rescinding some of the crasser bargains they made to buy votes along the way.

The country would welcome even a few signs that this legislation has Bi-partisan support.

Then we could applaud its final passage and take our thumbs from our noses.




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Sources: Washington Post, MSNBC, Freaking News, Youtube, Google Maps

Ben Nelson Slammed By Nebraska's Governor For "Medicaid Compromise" Deal

Nebraska Guv Blasts Nelson


POLITICO's Manu Raju gets in touch with Nebraska's Republican Gov. David Heineman, who pulls a Sanford, telling Manu he doesn't want hundreds of millions in free Medicaid money.

Plus he suggests that 'Husker voters will punish Democratic Sen. Ben Nelson, a former governor, for securing the cash at the cost of implementing the overall reform package.

“The last few days have made Nebraskans so angry that now it’s a matter of principle,”

Gov. David Heineman told POLITICO: “The federal government can keep that money.”

When told about the governor’s comments, Nelson said:

“If he wants to subject Nebraska to future liability — it’s his call.” And he called it “foolish” since the money wouldn’t be available until several years down the road, when other states would almost certainly lobby to get increased federal aid.

Nelson is engaged in a tense war of words with his home-state governor over his health care vote and the Medicaid deal he helped secure for their state, a signal that Nelson’s political opponents plan to bloody him up for his health care stand — and that could impact his standing ahead of his 2012 re-election.

“The reason he’s in hot water right now is that he’s not listening to Nebraskans – it’s very unusual for him,” Heineman said. “I am shocked.”

Asked about the governor’s direct aim at him, Nelson said it’s just “partisan politics.”



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Sources: Politico, Google Maps

Obama, Reid Make History With Senate Health Care Bill Passage 60-39...Merry Christmas!

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Senate Passes Historic Health Bill


After months of blown deadlines and political near-death experiences, a sweeping health care reform bill cleared the Senate Thursday on a party-line vote, putting President Barack Obama within reach of a domestic policy achievement that has eluded Democrats for decades.

With Vice President Joe Biden presiding over the session, Democrats gathered in the chamber before sunrise on the day before Christmas to cast a vote long in coming but in the end, hardly a surprise, a 60-39 tally that was the fourth time in as many days that Democrats proved they could muster the winning margin.

But this was the one that counted, the bookend to a House vote last month that puts Congress on record saying that Americans have the right to affordable health insurance, with plans that will cover 30 million Americans currently without it.

Senate Majority Leader Harry Reid (D-Nev.) said before the vote that Americans could wait no longer. “We certainly don’t have. . .the luxury of waiting. We may not completely cure this crisis today or tomorrow, but we must strive toward that progress.”

When Sen. Robert Byrd’s name was called, the ailing West Virginian said, “Mr. President, this is for my friend, Ted Kennedy – aye," a reference to the late Massachusetts senator who long fought for universal health care.

But Senate Republican leader Mitch McConnell (R-Ky.) vowed: “This fight isn’t over. My colleagues and I will work to stop this bill from becoming law. That’s the clear will of the American people — and we’re going to continue to fight on their behalf.”

The vote sets the stage for difficult House-Senate negotiations during which Democrats will be forced to settle differences that have lingered for months, and there is no guarantee a bill will pass in the end.

Sen. Joe Lieberman (I-Conn.), one of the last Democratic holdouts, once again made clear that his vote isn’t assured when the bill returns to the Senate. In the hallway outside the vote, he told his fellow moderate, Sen. Ben Nelson (D-Neb.), “Our work is not over.”

"Splitting the difference here could well break the 60 vote consensus," Lieberman said to reporters.

With momentum at their back, Democrats believe they can craft a compromise that, in broad strokes, would expand coverage through subsidies to help Americans buy insurance and allowing more people into the Medicaid program. The Senate plan includes a new national health insurance program overseen by the government but offered through private insurers.

It would prevent insurance companies from dropping patients who get sick and create a new legal requirement that all Americans must own health insurance – a provision already under growing attack from conservatives.

For one day at least, however, Democrats basked in the historic moment. Kennedy’s wife, Victoria Kennedy, attended this vote, as she did early Monday morning. Tears her eyes, she was emotional after the vote. "This is enormous step for our country," she told reporters off the Senate floor. "We have some steps to go. But we have come too far. We're not going to let this opportunity slip away"

There were moments of humor. Clearly exhausted, Reid mistakenly voted no before changing his vote to yes, which got a laugh in the chamber, especially from Mitch McConnell. Reid shook his head, changed his vote to "aye" - and rested his head on his desk briefly.

Afterward, Reid joked: "I spent a very restless night last night trying to figure out how I could show some bipartisanship and I think I was able to accomplish that for a few minutes."

Sen. Bernie Sanders (I-Vt.) was the last vote, entering the chamber to a round of applause, and he yelled out "yes."

The visitor's gallary filled with staff, as well as the longest-serving house member in history, John Dingell. Following the vote, Reid broke into a smile, and accepted a parade of handshakes from Democrats. He embraced Sen, Mary Landrieu (D-La.), who he worked hard to win over last month for the first key test vote.

Senate Republican Jim Bunning of Kentucky was absent for the vote.

Obama is expected to speak Thursday morning before leaving for Hawaii. He has said he would be deeply involved in the negotiations – a contrast to his personal approach up to this point, involving himself only at key moments and frustrating Democrats who wanted more hands-on help from their leader as they took politically dicey votes.

“We hope to have a whole bunch of folks over here in the West Wing, and I’ll be rolling up my sleeves and spending some time before the full Congress even gets into session, because the American people need it now,” Obama told PBS Wednesday in an interview.

Reid accomplished what was long viewed as impossible: He drafted a comprehensive reform bill palatable to the both extremes of his Democratic caucus, moderates and liberals, plus everybody in between.

The plan falls far short of Democrats' initial vision for reform in one key regard — it lacks a government-run insurance option after several moderate Democrats said they’d block the bill if it remained. That decision has divided the Democratic base, with many liberals saying the plan isn’t true reform and would merely enrich private insurers.

But the past four days have still been heady for Democrats, who are well aware of their role in pushing health care reform farther than their predecessors. Reid, in particular, has been singled out repeatedly for praise.

“He is on the verge of achieving what majority leaders going back over a half-a-century have failed to accomplish,” Sen. Tom Harkin (D-Iowa), chairman of the Senate health committee, said. “Make no mistake, Majority Leader Reid has earned his place in the Senate's history.”

Senate Republicans gambled on Democrats becoming so utterly divided that they would be forced to scrap the bill.

Democrats did struggle to find consensus at every step of the process – during the painstaking committee-level negotiations in both chambers, and as Pelosi and Reid attempted to push the bills towards final passage.

But congressional Democrats always remained remarkably united on the need to finish the job. In the last month, as Senate Republicans threw up procedural hurdles and portrayed the bill as a dangerous experiment, Democrats emerged as a more cohesive unit than when the process began.

“Ultimately, every Democrat from the most liberal to the most conservative realized we had to get a bill, whether they wanted to do health care at the beginning or not,” Sen. Chuck Schumer (D-N.Y) said after Sen. Ben Nelson (D-Neb.), the last holdout, committed his vote last weekend. “Everybody realized there was just no option and nobody wanted to be the last person to bring it down.”

Republicans kept up their fight to the end. Sen. Chuck Grassley (R-Iowa), who was once viewed as a potential Republican supporter and spent months negotiating with Finance Committee Chairman Max Baucus (D-Mont.), said passing the bill would be worse than doing nothing.

“When the debate began last year, interested legislators of both parties set forth benchmarks that were no-brainers: Health care reform should lower the cost of premiums. It should reduce the deficit. It should bend the growth curve in health care the right way,” Grassley said. “The Reid bill doesn't do any of those things.”

Sen. Tom Coburn (R-Okla.) repeated charges he first made last weekend that the process was corrupt, citing state-specific deals Reid struck with members to secure their votes.

“This vote is indeed historic,” Coburn said in a statement Thursday. “This Congress will be remembered for its arrogance, corruption and stupidity. … If this bill becomes law, future generations will rue this day and I will do everything in my power to work toward its repeal.”

Some of the toughest work remains ahead.

Senate Democrats concede that significant differences with the House – coupled with the fatigue caused by 25 consecutive days in session this month – will prevent delivering a final bill to Obama’s desk by the State of the Union speech.

“Let's be very honest about this, we need a break,” Majority Whip Dick Durbin (D-Ill.) said. “We need a break to get home to our families, to repair some relationships with our spouses, and to relax and recharge and come back. And I think we'll have a much more positive outcome after that break. But it does take time away in January. It may mean that this will take a little longer.”

And after a year of deadlines for action that came and went – the August recess, Columbus Day, Thanksgiving, the end of year – Durbin swore them off. “No. Nope. No deadlines. Boy, I have I learned that. I've announced three or four solemn deadlines during the course of this and had to eat my words every time so I'm finished with deadlines,” he said.

The two bills share the major goal of expanding coverage to millions of Americans and slowing the rapid growth in health care costs. But they differ in many ways, both large and small. Beyond the public option and abortion, the House and Senate bills are at odds over the taxes levied to pay for the overhaul, the mandate on employers to provide coverage, and the amount of subsidies for low- and moderate-income people to purchase coverage.

The Senate bill would expand Medicaid, create new insurance subsidies and set up a national insurance marketplace and offering private plans nationwide administered by the same federal agency that oversees federal employee benefits. No longer could firms deny insurance over pre-existing conditions or set a lifetime limit on benefits.

Democrats at both ends of Pennsylvania Avenue have been trying to ease the way for a smooth, politically painless negotiation between the House and Senate on a final bill. Few expect the public option to survive when the two bills are merged, but that didn't stop prominent liberals in the House from waging a last-ditch campaign to save it on the eve of Thursday's big vote.

"By eliminating the public option, the government program that could spark competition within the health insurance industry, the Senate has ended up with a bill that isn't worthy of its support," the always-candid Rules Committee Chairwoman Louise Slaughter wrote on CNN.com Wednesday.

On a conference call with her rank-and-file Wednesday, Speaker Nancy Pelosi (D-Calif.) reminded House Democrats, "We need to let the Senate work its will," according to someone on the call.

But she also appeared to remind them that she doesn’t plan to concede much ground during the conference negotiations.

"They have a good bill. We have a great bill," the speaker told her colleagues.

Pelosi walked House Democrats through the schedule for the negotiations, telling her members that the best-case scenario would have a bill on the president's desk at the end of January or the beginning of February. Hoping to pass the bill before Obama comes to the House for his first official State of the Union, the speaker said the White House has shown some flexibility to schedule the speech a little later than usual. Pelosi also warned her caucus that the Congressional Budget Office would need at least 12 days to deliver its final cost projection on whatever negotiators agree to.

House Democrats want to ensure the final package makes mandatory insurance more affordable. The House bill provides more extensive subsidies than the Senate legislation at the lower end of the income scale. Liberal Democrats would also like to see the final bill impose a greater burden on businesses to cover their employees.

On the call, a number of Democrats also asked the speaker to push for a mix of new taxes in the final bill. Some Democrats in the House want to see a combination of their surtax on the wealthiest Americans and the Senate's tax on high-end health care plans.



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Senate Dems Pass Final Procedural, "Earmarked" Health Care Vote 60-39

Health Care Overhaul On Track For Final Passage



Senate Democrats pushed the health care bill past its final major procedural test Wednesday, voting 60-39 to end debate and putting the $871 billion overhaul on track for final passage Thursday morning.

Majority Leader Harry Reid (D-Nev.) kept his caucus together for the third time in three days, delivering the 60 votes necessary to break a Republican filibuster on the bill.

Reid also announced he’s moving up the time of the Christmas Eve vote by one hour, to 7 a.m. Thursday.

After the vote, congressional Democrats will turn to reconciling the House and Senate bills, which include different approaches to restrictions on abortion coverage, the role of government in health care and the mandates placed on employers to provide insurance.

Sen. Ben Nelson (D-Neb.), the last holdout on Senate passage, threw what could be a complication into the mix Wednesday, saying he didn’t want to see the overall cost of the bill grow much beyond the $871 billion in the Senate version.

"I am going to be much very aware of what goes into the conference committee and what comes out of the report and watching it very closely," said Nelson.

His ceiling on spending? "The current number — $871-ish," Nelson said.

House leaders have already indicated they want to make changes in the Senate bill, including possibly increasing tax credits to help people buy insurance and moving up start dates for some programs. But both steps would boost the cost of the overall bill, so Nelson’s comments signal there could be tough negotiations ahead.

The White House privately anticipates health care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.

Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.

Democrats originally hoped to finish before Obama’s speech to Congress to allow Democrats to turn their focus to the nation’s economy ahead of the 2010 elections. But by Wednesday, they weren’t so sure anymore that they could do it.

"I'm not making any promises on that one," Iowa Sen. Tom Harkin said about finishing before the speech. "We will have it to him, I would hope, before the end of January, but I don't know before the State of the Union. There are a lot of differences between the Senate and the House."

On the Senate floor Wednesday, the partisan sniping over the bill continued, with Republicans continuing to hit Democrats for last-minute changes to the bill designed to secure Democratic votes, such as a fix to win over Nelson that would save Nebraska nearly $100 million in state Medicaid spending in the first 10 years.

“There has been growing public concern that earmarks were used to buy votes for this legislation,” said Sen. Jim DeMint (R-S.C.). “It has been argued by some that this practice is acceptable because it’s necessary to get things done in the Senate. I reject that argument, and I urge my colleagues to put an end to business as usual here in the United States Senate.”

The Senate rejected a proposal from DeMint to prohibit earmarks for the explicit purpose of obtaining votes. Democrats objected, saying the idea sounded good in theory but would be unworkable in practice.

DeMint said he expected Democratic support because Majority Whip Dick Durbin (D-Ill.) co-sponsored a similar measure in 2007.

"Not anymore," Durbin said, waving off DeMint from the Senate floor.

Democrats made a last-minute attempt to recast the focus of the debate, away from the growing tensions between the parties and toward the people whom the majority leader said the bill would help.

“Each has been a party-line vote, and much of this debate has focused on politics,” Reid said shortly before the vote, pointing to a stack of letters. “But the health care debate is not about procedure … but about people.”

Health and Human Services Secretary Kathleen Sebelius and White House health reform director Nancy-Ann DeParle were on hand at the Capitol for the vote, as they had been Monday and Tuesday.

The only suspense in recent days had been when the Senate would take the final vote. Republicans were prepared to run out the entire clock on the procedural motions — a move that would have forced senators to vote at about 10 p.m. Christmas Eve. But Reid and Minority Leader Mitch McConnell (R-Ky.) worked out a deal Tuesday to have the final vote at 8 a.m. Thursday, and then Reid bumped it one hour earlier.

Unlike the three procedural motions, which required 60 votes, the vote on final passage requires only 51 votes.

Even though final passage is still hours away, Senate Democrats planned to celebrate early. The entire caucus was invited to a news conference at 4 p.m. Wednesday.

The Senate bill would extend coverage to 31 million uninsured Americans by expanding Medicaid, creating new insurance subsidies, setting up a national insurance marketplace and offering private plans nationwide administered by the same federal agency that oversees federal employee benefits. No longer could firms deny insurance over pre-existing conditions or set a lifetime limit on benefits.

But the plan falls far short of Obama’s initial vision for reform in one key regard — Democrats stripped out a government-run insurance option after several moderate Democrats said they’d block the bill if it remained.

That decision has drawn sharp fire from the party’s liberals, who have said the Senate plan isn’t true reform and would merely enrich private insurers — setting up a showdown with moderates, who have threatened to walk if liberals try to force it back in.


Sources: Politico

Richard Burr & State Prosecutors Probe Constitutionality Of Ben Nelson's Deal

Several State Prosecutors Probing Nelson Health Care Deal



The top Prosecutors in seven states are probing the constitutionality of a political deal that cut a funding break for Nebraska in order to pass a federal health care reform bill, South Carolina's Attorney General said Tuesday.

Attorney General Henry McMaster said he and his counterparts in Alabama, Colorado, Michigan, North Dakota, Texas and Washington state — all Republicans — are jointly taking a look at the deal they've dubbed the "Nebraska compromise."

"The Nebraska Compromise", which permanently exempts Nebraska from paying Medicaid costs that Texas and all other 49 states must pay, may violate the United States Constitution — as well as other provisions of Federal law," Texas Attorney General Greg Abbott said.

McMaster's move comes at the request of Republican U.S. Sens. Lindsey Graham and Jim DeMint of South Carolina.

We have serious concerns

In a letter to McMaster, Graham singled out the deal to win Nebraska Sen. Ben Nelson's vote on the massive health care bill the Senate is expected to adopt Thursday. Nelson held out as fellow Democrats worked to get 60 votes to foreclose a GOP filibuster and the bill was amended to shield Nebraska from the expected $45 million annual cost tied to expanding Medicaid programs.

"We have serious concerns about the constitutionality of this Nebraska compromise as it results in special treatment for only one state in the nation at the expense of the other 49," Graham and DeMint wrote.

Nebraska wasn't alone in getting Medicaid breaks. Vermont, Louisiana and Massachusetts also got help with their programs.

Along with Texas, officials in Washington, Alabama, Colorado and Michigan confirmed they were working with McMaster.

North Dakota Attorney General Wayne Stenehjem said he wasn't sure what could be done while the federal legislation remained under debate. Officials in the other states did not immediately respond to a request for comment.

Meanwhile on Tuesday, Tennessee's Republican Senate Speaker Ron Ramsey called for his state's attorney general to investigate the deal.

Ramsey, McMaster and Michigan's Mike Cox are running for governor in their states.

"Whether in the court of law or in the court of public opinion, we must bring an end to this culture of Corruption," McMaster said. The negotiations "on their face appear to be a form of vote buying paid for by taxpayers," he said.

We'll assist anyone

McMaster is encouraging a South Carolina citizen to step forward to sue to challenge the measure if it is signed into law. "We'll assist anyone to the extent that we're able," McMaster said.

Also Tuesday, U.S. House Majority Whip Jim Clyburn, D-S.C., said Republicans need to stop complaining about deals their colleagues made.

"Rather than sitting here and carping about what Nelson got for Nebraska, I would say to my friends on the other side of the aisle: Let's get together and see what we can get for South Carolina," Clyburn said.

For instance, Clyburn expects states will get more help covering Medicaid expansion costs. Critics say the federal government's coverage of 91 percent of those future costs will disappear, leaving states with huge holes in their budgets. Clyburn says the legislation the federal share should be 95 percent, with states picking up no more than 5 percent.

South Carolina Gov. Mark Sanford said the federal legislation is "well intended," but called it "fundamentally flawed in the same way the stimulus efforts were in that the states and the taxpayers are left footing the bill."

Sanford this spring was the nation's only governor to take a state legislature to Federal and State court to block federal stimulus money.




Schumer Goes Hunting, Bags Nelson



The perils of "Political hunting" trips range from mockery — as with Sen. John Kerry’s (D-Mass.) expensive gear — to mortal danger — as in ending up on the wrong end of Dick Cheney’s 28-gauge.

But Sen. Chuck Schumer (D-N.Y.) had another story in mind when he traveled recently to Nebraska, a cautionary tale told to him early in his career by an older, urban-oriented New Jersey congressman who had made the mistake of accepting a hunting invitation from a Midwestern colleague.

“He shot the dog,” Schumer recalled, referring to the outcome of the Jersey pol’s inept marksmanship.

Schumer did not shoot the dog. He bagged three pheasants. And six weeks later, he bagged Sen. Ben Nelson (D-Neb.), serving as key negotiator as Nelson held the fate of landmark health care legislation in the balance.

While the two Senate Democrats didn’t spend their morning in a field outside Omaha talking business, the hunting trip will go down as a key, if unconventional, detour on the road to the Democrats’ most important modern legislative accomplishment.

The senator from Brooklyn woke up early the morning of Nov. 8, a day after he’d watched Nebraska thump Oklahoma on the gridiron. He put on a blaze orange hunting vest and hat, refusing only the boots (“too big”). He received a crash course on shotgun safety and marveled at the dogs.

“They were just amazing,” he said of the pointers and retrievers. “I always thought hunting dogs were just for companionship.”

Then the senator from New York saw a pheasant, took aim and pulled the trigger. Nothing happened.

“He didn’t get the safety off, so he couldn't shoot,” his host, Nelson, recalled with a chuckle Tuesday morning. “You have to push the safety off to shoot. He figured that out.”

The next pheasant wasn’t so lucky.

“He thought I shot it,” said Nelson. “I said, ‘No, I know I didn’t shoot ‘cause I didn’t shoot.’ And I said, ‘So you either scared it to death or you hit it.’ He was ready to jump up and down.”

Schumer bagged, his companions told him, three pheasants that early November day in Nebraska, though he was “never 100 percent sure they weren’t helping me.”

Schumer and Nelson's friendship began in 2005, when Schumer was named chairman of the Democratic Senatorial Campaign Committee. Nelson was considering retiring instead of seeking reelection in a conservative-oriented state in 2006, and Schumer told POLITICO that when he assumed the DSCC chairmanship, Nelson was his first call.

The logic was clear, Schumer said: “He runs, we win; if he doesn’t run, we lose.” So he gave in, he says, to extensive demands from the Nebraskan, and Nelson cruised to what turned out to be an easy reelection.

Schumer’s bond with the Senate moderates he helped elect and reelect in 2006 and 2008 has powered his remarkable ascent within the chamber. Two years ago, Schumer seemed in danger of being overshadowed by his state’s junior senator, Hillary Clinton, or elbowed aside in the Senate leadership by Obama mentor Dick Durbin.

Beyond Majority Leader Harry Reid, the architect of the Democrats' successful health care strategy, Schumer has emerged as the dominant political force and go-to negotiator on Reid's leadership team. And the Senate is on the verge of passing landmark legislation that's deeply controversial in states such as Nelson's, a lesson Schumer said was drummed into him by the people he met that weekend in Omaha.

The apparent political victory has further enhanced Schumer’s stature. The jokes about the most dangerous place in Washington being between him and a camera have gone stale, replaced by a widespread recognition that he has evolved into one of the essential players on the American political landscape and, quite likely, a future majority leader.

The hunting story became legend in the Senate last month after Nelson passed photographs of the orange-clad, gun-toting Harvard grad, dead bird in hand, around an amused caucus lunch. But it also belongs in the broader legend of Schumer, the political animal par excellence.

“Chuck always wants to know where the other guy is coming from,” said Rep. Anthony Weiner (D-N.Y.), a former Schumer staffer, who added that he wasn’t surprised that Schumer acquitted himself well.

“He has handled more guns at crime bill press conferences than most hunters,” he said.

Indeed, word of Schumer’s hunting exploits was greeted with astonishment on both sides of the simmering gun control wars, in which Schumer came of age as a central player. His work on the Brady Bill’s handgun restriction turned him into, literally, a National Rifle Association poster child. The NRA’s favorite image pictures Schumer grinning under bright blue earmuffs as he demonstrates the deadliness of a stubby assault weapon.

“He just must have needed Nelson's vote very badly to do that,” said Tom King, the president of the New York State Rifle and Pistol Association, who called Schumer “patently anti-gun.”

Schumer says, however, that he favors only common sense and regionally varied restrictions on guns, and he has long bragged of winning, at summer camp, an NRA sharpshooting prize with a .22 rifle.

“It surprised me he went out with Ben Nelson shooting, but it doesn’t surprise me that he shot a couple of birds,” said Jim Kessler, a former Schumer aide who later founded Americans for Gun Safety, a gun control group that was later folded into the group Third Way. “In 1994, if Chuck thought the way to win the assault weapons ban vote was to go out and hunt with [former Democratic Rep.] Bill Brewster of Oklahoma and shoot three birds, he would have done it.”

Schumer and Nelson differ slightly about the origins of the hunting trip. Schumer recalls Nelson telling him, in the spring, “You have to come out.”

“I’ve always wanted to go hunting,” he said.

“I thought he was kidding at first; I said 'sure,’” Nelson said. “And I finally said, 'If you are serious, I can arrange this.' And he was, and so I did.”

Schumer and Nelson also shot skeet. They also tooled around on ATVs, with Schumer’s wife, former New York City Transportation Commissioner Iris Weinshall, hanging onto the back of Nelson’s vehicle. (Her city job hadn’t involved much off-roading.) Schumer posed with his dead quarry, though he left it for Nelson to dress, before they retired to the lodge for a lunch of pheasant.

(“He would definitely want to eat it,” Kessler said of his former boss. “He’s got to eat it. He’d eat anything.”)

They did not, both senators said, talk health care.

“There wasn’t any lobbying effort, just two guys having fun and going hunting and watching football,” said Nelson.

But the Nebraska senator’s warm regard for the New Yorker, and their relationship of trust, would prove central to getting the final health care deal done. Last Wednesday night, Nelson gave a list of must-haves to Schumer and Reid. At times on Thursday, Schumer was calling Nelson every 15 minutes, as part of what the Nebraskan called “pre-negotiations.” By nightfall, with progress being made, Reid asked Nelson to join a round of intensive talks Friday morning. Nelson was set up in one wing of Reid's suite of offices. Sen. Barbara Boxer (D-Calif.), one of the Senate’s most liberal members, was in another part. For 12 hours, Schumer and Reid shuttled between them.

Schumer “was extremely important,” Nelson told POLITICO just after the deal was done. “The thing about Chuck Schumer is he is very innovative, he doesn’t get ideological about something. …We may be an odd couple in a lot of respects, but we share some of the same qualities in trying to solve things.”

Schumer said the negotiations left him with deep respect for Nelson and that the hunting trip also taught a lesson.

“You can see where going hunting is a real bonding experience, kind of like golf,” he mused. “I’d like to do it again.”

“I’ve got a lot of invitations,” Schumer said.



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Sources: MSNBC, Politico, Youtube, Google Maps

Harry Reid's Deals To Get His 60 Votes, Defense Bill Clears

Mass., Vermont Bigger Medicaid Winners Than Nebraska


Perhaps the Republican criticism of Sen. Ben Nelson (D-Neb.) is misplaced: Nebraska is set to reap only a fraction of the $1.2 billion in special Medicaid deals for three states.

Vermont, which is represented by the once-wavering Sen. Bernie Sanders, would recieve $600 million over 10 years for its Medicaid costs, according to Congressional Budget Office figures requested by Senate Republicans.

Massachusetts would see $500 million, according to the CBO.

Nelson, who has been lambasted throughout the day, steered only (!) $100 million to his state to cost the full cost of the Medicaid expansion.





Payoffs For States Get Harry Reid To 60 Votes



Ben Nelson’s “Cornhusker Kickback,” as the GOP is calling it, got all the attention Saturday, but other senators lined up for deals as Majority Leader Harry Reid corralled the last few votes for a health reform package.

Nelson’s might be the most blatant – a deal carved out for a single state, a permanent exemption from the state share of Medicaid expansion for Nebraska, meaning federal taxpayers have to kick in an additional $45 million in the first decade.

But another Democratic holdout, Sen. Bernie Sanders (I-Vt.), took credit for $10 billion in new funding for community health centers, while denying it was a “sweetheart deal.” He was clearly more enthusiastic about a bill he said he couldn’t support just three days ago.

Nelson and Sen. Carl Levin (D-Mich.) carved out an exemption for non-profit insurers in their states from a hefty excise tax. Similar insurers in the other 48 states will pay the tax.

Vermont and Massachusetts were given additional Medicaid funding, another plus for Sanders and Sen. Patrick Leahy (D-Vt.) Three states – Pennsylvania, New York and Florida – all won protections for their Medicare Advantage beneficiaries at a time when the program is facing cuts nationwide.

All of this came on top of a $300 million increase for Medicaid in Louisiana, designed to win the vote of Democratic Sen. Mary Landrieu.

Under pressure from the White House to get a deal done by Christmas, Reid was unapologetic. He argued that, by definition, legislating means deal making and defended the special treatment for Nelson’s home state of Nebraska.

“You’ll find a number of states that are treated differently than other states. That’s what legislating is all about. It's compromise," he said.

It was Nelson who proved that he who plays hardest to get, gets the most.

He forced Reid to redraft the bill’s restrictions on federal funding of abortion. And while most insiders were focused on that deal, Nelson was quietly ensuring that his state would never have to pay for the Medicaid expansion being written into the bill – an agreement that had been in the works for weeks.

Medicaid is usually paid for with a mix of federal and state funding, but Nelson's carve out means that any Medicaid beneficiaries who join the program under the bill will be fully paid for by the federal government.

It's an important deal considering that many governors are worried that the Medicaid expansion will further strain already stressed state budgets – and one that came after Nebraska Gov.Dave Heineman called on Nelson to vote against the bill.

"The State of Nebraska cannot afford an unfunded mandate and uncontrolled spending of this magnitude,” the governor wrote to Nelson.

Nelson deferred all questions on the provision to Reid, saying only that he was “comfortable” the deal took care of Nebraska.

But Nelson’s deal could be a pittance compared to where the Nebraska compromise might ultimately lead – to 49 other states demanding that the feds pick up their share of health reform’s new Medicaid burden when it kicks in during 2017.

"When you look at it, I thought well, God, good, it is going to be the impetus for all the states to stay at 100 percent [federal funding]. So he might have done all of us a favor," Sen. Tom Harkin (D-Iowa) said of Nelson’s dealings.

Nelson and Levin also pushed a provision that exempts non-profit insurers in Nebraska and Michigan from an annual multi-billion dollar excise tax on insurance companies.

Not surprisingly, both states are home to non-profit insurers who control a high-percentage of the industry’s profits. In Michigan, non-profit insurers control 76 percent of the industry’s profits – one of the highest percentages in the nation – while Nebraska non-profits control 46 percent of their state’s profits.

And in an example of how closely senators guarded details, Levin’s office did not answer any questions about the proposal when asked about it on Friday.

Republicans, meanwhile, expressed outrage at the wheeling and dealing, as if their party had never cut a legislative deal in its 150-year history.

“This bill is a monstrosity, a 2,100-page monstrosity full of special deals for people who are willing to vote for it,” said Senate Republican Leader Mitch McConnell. “And they’re playing these kind of games with the nation’s health care. This is an outrage.”

But Sanders didn’t sound outraged when he talked about the extra Medicaid funding Vermont will get for six years. Massachusetts, meanwhile, received three years worth of additional Medicaid funding. Under the original bill, neither state had qualified for the money.

Republican Sen. Mike Enzi accused Democratic leaders of favoring Medicare Advantage beneficiaries in Pennsylvania, New York and Florida at the expense of seniors in other parts of the country.

“The Democrats are playing ‘Let’s make a deal’ with trillions of your hard-earned tax dollars. You and all the American people should know that the majority leader is buying his votes with your money,” said Enzi (R-Wyo.) “The Reid bill gives sweetheart deals to a few states and the rest of the country will foot the bill. Making unfair deals like this is the wrong way to legislate and the American people know it.”

And while there were plenty of state-specific deals, some of the changes were clearly aimed at pleasing specific Democratic factions. For instance, tightened insurance regulations went a long way toward putting a smile on the faces of liberal senators who have lost their much-loved public option.

The amendment mandates that insurers spend no less than 80 percent of their premium revenues providing medical care. Currently, insurers spend about 70 percent of their premiums paying for health care. The bill also eliminates insurers’ ability to cap annual coverage amounts.

In brief remarks at the White House, President Barack Obama also highlighted some new provisions, including penalties for insurers who “arbitrarily jack up rates” and an immediate prohibition on insures’ ability to deny children coverage.

Obama, too, talked of the deals as just the cost of doing business in Washington.

“As with any legislation, compromise is part of the process,” Obama said. “But I'm pleased that recently added amendments have made this landmark bill even stronger.”





War bill Survives Poisonous Vote



A $626 billion Pentagon budget narrowly advanced in the Senate Friday morning, but not before Washington’s political battles seemed to eclipse the real wars of Iraq and Afghanistan.

The Senate scene, played out in a post-midnight session on a freezing night, dramatized how poisonous the atmosphere has become in the health care fight.

Defense Secretary Robert Gates had to weigh in for fear the military would be left with only stop-gap funding while fighting two wars overseas. And ailing 92-year-old Sen. Robert Byrd (D-W.V.) was wheeled in for the 1 a.m. vote while his old friend Sen. Thad Cochran (R-Miss.) deserted the bill under pressure from his own leadership to slow action.

Senate Minority Leader Mitch McConnell (R-Ky.) made no secret of the fact that he was looking for leverage over Majority Leader Harry Reid (D-Nev.) to delay action on health care reform until after Christmas. The pressure on rank-and-file members was severe, and it was only after Democrats had secured the needed 60 votes that three Republicans broke ranks in support of cutting off debate.

“Not even the darkness outside can conceal the games being played inside this Senate chamber,” Reid said in closing remarks before the vote. “We are here in the middle of the night, but the reason is as clear as day.”

By contrast, the same defense measure — including $128 billion for operations in Iraq and Afghanistan — sailed through the Houseon Wednesday on a 395-34 vote. Cochran, the ranking Republican on the Senate Appropriations Committee, had worked closely with Chairman Daniel Inouye (D-Hawaii) to ensure passage. And toward this end, Democrats pared back extraneous provisions and devoted the bulk of the additional domestic spending to jobless benefits for the long-term unemployed.

“It is a good bill. It ought to be passed, and it ought to be passed as soon as possible,” Cochran said on the floor Wednesday. But after a health care blowup on the floor that day infuriated McConnell, Cochran was pressed by his leadership to slow progress at least until Reid comes forward with the text of proposed changes being made in the Democrats' health care package.

In a statement after the vote, the Mississippian said his party felt it was important to act in “unison,” but that he was confident the measure would soon pass. “I regret that its consideration is being affected by the divisive end-of-session debate on health care reform.”

Neither party is blameless in the sorry state of the defense budget, which should finally clear Congress on Saturday, almost three months into the fiscal year that began Oct. 1.

Democrats stalled action themselves for months, hoping to use it as the locomotive for an end-of-the-year train of legislative items. “The Republicans didn’t control the timing on this bill,” said Minority Whip Jon Kyl (R-Ariz.). “Why haven’t the Democrats been able to bring this most important bill to the Senate for a vote until a week before Christmas?”

Nonetheless the bare-knuckle Republican tactics are most striking because GOP members are typically very supportive of defense spending and reluctant to do anything to obstruct the annual Pentagon budget.

That tradition is wearing thin in today’s Washington. The 1 a.m. vote in the Senate echoed a fight last summer in the House during which Republicans opposed new war funding because they were upset that money for the International Monetary Fund had been added to the package.

“I think they picked the wrong bill for it,” said Senate Majority Whip Richard Durbin (D-Ill.). “Why are we putting the men and women in uniform in the middle of this debate? They didn’t ask for that.”

The three Republicans who supported cloture were Sen. Kay Bailey Hutchison of Texas and Maine Sens. Olympia Snowe and Susan Collins — all representing states with a major economic stake in the defense budget.



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Sources: Politico, Google Maps

Final Congressional Health Care Reform Negotiations Still In Progress

Health Care Bill Plans On Collision Course



Despite a last-minute weekend deal that put the Senate on the brink of passing health care reform this week, liberal and moderate Democrats remain on a collision course over the bill, as both sides dug in Sunday for the next phase of negotiations.

President Barack Obama’s liberal base and powerful union leaders once hoped the expected House-Senate conference would partly undo a year of retreats and compromises, with Obama weighing in to nudge the moderate Senate bill to the left.

But the titanic struggle to lock in Sen. Ben Nelson (D-Neb.) as the 60th senator for the first key test vote early Monday morning has changed all that. The need to hold Nelson and other moderates in line means major changes on the public option, abortion, taxes, Medicare and Medicaid are unlikely — and that the Senate’s vision of health reform is likely to prevail over the House’s in the final talks.

“It is very clear that the bill — the final bill — to pass in the United States Senate is going to have to be very close to the bill that has been negotiated here,” Sen. Kent Conrad (D-N.D.) said on “Fox News Sunday.” “Otherwise, you will not get 60 votes in the United States Senate.”

Nelson, who received assurances of a “limited conference” to secure his vote for the Senate bill, has already laid down at least two deal breakers in the House bill that he can’t support: the inclusion of a government insurance plan and an income tax increase on wealthy individuals.

“That would break it,” Nelson said on CNN’s “State of the Union.”

House Democrats acknowledge that they will be limited in how far they can tweak the Senate compromise. But House leadership also knows that its rank and file need to force some changes, however small, before they will accept the final package — as a face-saving measure to be able to swallow late changes to the bill in the Senate, most notably the decision to eliminate a public option.

But on the left, the sentiments of a liberal base that revolted over concessions to moderates were channeled Sunday by Howard Dean, the former Democratic National Committee chairman, who last week repeatedly called on Democrats to scrap the bill.

“This can’t be the final version of the bill,” Dean said on NBC’s “Meet the Press.” “It simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.”

In a slight shift, however, Dean tempered his words, saying the bill is better than it was earlier in the week.

“I would certainly not vote for this bill if this were the final product,” Dean said. “I would let this thing go to conference committee, and let’s see if we can fix it some more.”

Andy Stern, president of the Service Employees International Union, identified areas beyond the public option in which Democrats in both chambers could agree, including boosting the federal insurance subsidies for middle-income Americans and strengthening insurance regulations.

“It is about progress, and we now have to fight for the changes in the conference committee and decide, when it is over,” whether to support it, Stern said on CNN’s “State of the Union.”

Senior administration officials contend the conference will not be as difficult as predicted because the differences between the two chambers have been known for months. “Once the Senate passes this bill, obviously there’s work to be done,” White House senior adviser David Axelrod said on “State of the Union.”

Two big voices in the health-reform debate came out with endorsements of the measure moving ahead in the Senate this week: the Federation of American Hospitals, which represents private community hospitals, and AARP, the nation’s largest seniors organization, which urged the Senate to move ahead with debate.

In addition, Democrats desperately tried to avoid an ugly public fight over abortion, but it looks as though the issue will haunt them right up until the end.

Abortion-rights supporters and foes alike blasted the compromise Senate Majority Leader Harry Reid (D-Nev.) cut with Nelson late Friday night. But it’s unclear whether their opposition will be enough to sink the broader bill.

“I have some deep reservations with this Nelson language on first examination,” Rep. Diana DeGette (D-Colo.), a co-chairwoman of the Congressional Pro-Choice Caucus, told POLITICO on Sunday.

Rep. Bart Stupak (D-Mich.), a leading abortion opponent, said during the weekend, “While I and many other pro-life Democratic House members wish to see health care coverage for all Americans, the proposed Senate language is unacceptable.”

The final Senate bill grants state legislatures the right to prevent insurance plans that operate in the proposed health insurance exchange from covering elective abortions. The changes also require people who seek abortion coverage through the exchange to pay two separate checks each month to their insurance company to “segregate” federal funds from private funds that pay for abortion.

Reproductive-rights advocates argue the new system would create a more onerous burden for women seeking coverage for the procedure, while abortion opponents have argued throughout the debate that segregating payments still violates the existing prohibition on federal funds being used to pay for abortion.

Douglas Johnson, the legislative director of the National Right to Life Committee, called the changes “book-keeping contortions” and said that his group plans to put pressure on any senator who votes to consider the changes Reid unveiled.

But the real fight will occur in negotiations between House and Senate leaders over a final bill.

House Speaker Nancy Pelosi of California can’t afford to lose any Democrats. And with Stupak threatening to vote against the Senate compromise, she’ll need to offset his vote with other Democrats who voted against it the first time. She might be able to pick up some moderate-to-conservative Democrats who favor the Senate approach, but many of these lawmakers will need to be OK with the final abortion restrictions.

On the other side, a bloc of abortion-rights backers, led by DeGette, has already promised to vote against any bill that includes Stupak’s amendment, which would prevent people who receive government subsidies from purchasing coverage for elective abortions through the exchange. DeGette believes many of the 41 Democrats who voted for Stupak and “yes” on the House health care bill are willing to work with party leaders to find a middle ground.

The opposing camps are similarly entrenched on the public option and the method for financing the health care expansion. The House would create a government-sponsored insurance plan, but the Senate bill is silent on this point. After several attempts at compromise, Reid nixed the public option altogether.

The taxes could prove difficult to bridge. The House relies on a so-called millionaires’ tax, and has refused to consider the tax on expensive insurance plans. The Senate has taken the exact opposite posture. But because the White House has weighed in several times in favor of the tax on “Cadillac” plans, as a key component to slow the growth rate in health care spending, the Senate is likely to win this round.

Meanwhile, Republicans increaed their attacks on the bill Sunday, criticizing a variety of deals cut to win the votes of Democratic senators, such as Nelson, who got the federal government to pick up the cost of any Medicaid expansion under the health reform bill in the state of Nebraska forever. Republicans said Democrats have refused to say which state would get about $100 million inserted into the bill on behalf of a still unidentified university hospital.

“This process is not legislation. This process is corruption,” said Sen. Tom Coburn (R-Okla.). “And it’s a shame that that’s the only way we can come to consensus in this country is to buy votes.”

But Nelson defended his efforts. “I always put Nebraska first,” he told POLITICO in an interview Saturday. “But I looked at this through the standpoint of Nebraskans and the country. ... There is a difference between holding out for something and holding up. I was holding out for something to make it better.”


Sources: Politico, Washington Post, AP

Pro-Life & Pro-Choice Voters Hate Senate Bill, BCBS Loves It

Negotiating To 60 Votes, Compromise By Compromise


30 million people without health insurance stand to gain coverage under a deal announced on Saturday by Senate Democrats.

To get the 60 votes needed to pass their bill, Democrats scrapped the idea of a government-run public insurance plan, cherished by liberals, and replaced it with a proposal for nationwide health plans, which would be offered by private insurers under contract with the government.

The legislation also includes a proposal that would limit insurance coverage of abortion. The provision, which was the last piece of the puzzle to fall into place, was negotiated by the Senate majority leader, Harry Reid, Democrat of Nevada, to win the support of Senator Ben Nelson, Democrat of Nebraska, who is an opponent of abortion.

Under the agreement, states could choose to prohibit abortion coverage in the insurance markets, or exchanges, where most health plans would be sold.

But if a health plan did cover the procedure, subscribers would have to make two separate monthly premium payments: one for all insurance coverage except abortion and one for abortion coverage.

The compromise was denounced by advocates of abortion rights, including the Planned Parenthood Federation of America, the National Organization for Women, Naral Pro-Choice America and the National Women’s Law Center.

“We have no choice but to oppose the Senate bill,” said Cecile Richards, president of Planned Parenthood.

The United States Conference of Catholic Bishops and the National Right to Life Committee reached a similar conclusion for very different reasons.

“This bill should not be supported in its current form because it would allow federal money to go to health insurance plans that cover elective abortions,” said Richard M. Doerflinger, a spokesman on abortion for the bishops’ conference.

The final deal was packed with provisions calculated to appeal to various constituencies. The bill would provide extra Medicaid money to Nebraska, long-term-care insurance to people with severe disabilities, new services for pregnant teenagers and financial breaks to nonprofit insurance companies.

But there were also potential losers. To bring in more revenue, the bill proposes a range of new fees and taxes that would affect some high-income people, profitable health insurance companies and people who use tanning salons.

The proposals were drafted by Mr. Reid as part of an amendment to a sweeping health care bill, which embodies President Obama’s top domestic priority.

Mr. Reid’s amendment would expand eligibility for a small-business tax credit, increase penalties on certain uninsured people and increase the payroll tax on higher-income individuals and families beyond the increase that Mr. Reid proposed last month.

Mr. Nelson — whose home state of Nebraska received the additional Medicaid money — embraced the bill on Saturday.

“A number of states are treated differently from other states,” Mr. Reid said. “That’s what this legislation is all about, compromise.”

The Senate Republican leader, Mitch McConnell of Kentucky, said the bill was “a monstrosity full of special sweetheart deals for a few states,” including Nebraska and Vermont.

Under Mr. Reid’s amendment, the federal Office of Personnel Management, which provides health benefits to federal employees, would sign contracts with insurers to offer at least two national health plans to individuals, families and small businesses. At least one contract would have to be with a nonprofit entity.

Blue Cross and Blue Shield companies could offer a single national plan. The new national plans would be separate from the program for federal employees, and premiums would be calculated separately.

Under the bill, most Americans would be required to have insurance. The penalty for violating this requirement could be as high as 2 percent of a taxpayer’s household income. Penalties would total $15 billion over 10 years, up from $8 billion under Mr. Reid’s original proposal, the Congressional Budget Office said.

In the next 10 years, the government would also collect $28 billion in penalties from employers who did not offer health benefits to employees.

Mr. Reid dropped a proposed tax on cosmetic surgery and replaced it with a tax on “indoor tanning services.” Senate Democrats said the 10 percent tax was justified because ultraviolet radiation from tanning devices could increase the risk of skin cancer.

The bill would significantly increase the Medicare payroll tax on people with high incomes. Workers now pay a tax equal to 1.45 percent of wages to help finance hospital care for Medicare beneficiaries.

Mr. Reid’s proposal would impose an additional tax: 0.9 percent of income above $200,000 for individuals and $250,000 for families. This is nearly twice the extra tax of 0.5 percent that he proposed last month.

To help finance coverage of the uninsured, the bill would levy annual fees on insurance companies and manufacturers of medical devices and prescription drugs. Under the proposal unveiled on Saturday, nonprofit insurance companies could be exempted if they spent a large share of their premiums on medical care rather than administrative costs.

Senator Carl Levin, Democrat of Michigan, had sought such an exemption to spare companies like Blue Cross Blue Shield of Michigan, which he said provided a valuable service as the “insurer of last resort.”

The biggest source of revenue under the bill is a new tax on employer-sponsored group health plans with high premiums. The bill provides a special dispensation to police officers, firefighters, miners and construction workers, who have high premiums because they work in high-risk occupations.

Mr. Reid would grant a similar dispensation to longshoremen.

In what they described as an effort to reduce the demand for abortion, Democrats would provide money to help pregnant teenagers and new mothers so that they could stay in high school and attend college.

The federal government would provide $25 million a year for a “pregnancy assistance fund.” The money could be used for “maternity and baby clothing, baby food, baby furniture and similar items,” the proposal says.

Children could benefit from Mr. Reid’s proposal in two other ways. He would immediately prohibit insurers from denying coverage to children because of pre-existing medical conditions. And he would provide money to extend the Children’s Health Insurance Program for two more years, through 2015, as proposed by Senator John D. Rockefeller IV, Democrat of West Virginia.





Blue Cross Blue Shield Lobbyists Quietly Helping Extreme Effort To Declare Health Reform Unconstitutional


Think Progess has documented how the private health insurance industry is waging a duplicitous, “two-faced” campaign to kill health reform. Because the industry understands that the public views it in a largely negative light, the industry presents itself as proactively working hand-in-hand with legislators to produce reform. However, behind the scenes, the industry is coordinating a massive effort to kill all reform — employing attacks from front groups, allied politicians, think tanks, lobbyists, and right-wing media.

The Blue Cross Blue Shield Association, which is a lobbying group representing 39 independent Blue Cross and Blue Shield Plans, is also engaged in this two-faced campaign. Like most of industry, the BCBS Association says it fully supports the concept of health reform, but continually demands drastic changes to the bills in Congress. Some have begun to question the BCBS Association’s claim of support given its new study attacking reform legislation in the Senate. The criticism of BCBS is bolstered by a new revelation that BCBS Association lobbyists are helping to orchestrate a right-wing movement to invalidate all of health reform.

Yesterday, the BCBS Association released yet another industry-sponsored study to distort health reform and falsely claim that premiums will skyrocket because of the legislation. However, the nonpartisan CBO reported earlier this week that under the Senate health reform bill, “most Americans would pay the same or less in premiums.” A New York Times editorial yesterday criticized BCBS Association’s study, and noted correctly that it is yet another example of the private insurance industry doing whatever it can to frighten Americans.

But while the study certainly damages BCBS’ credibility, BCBS is involved in another anti-health reform ploy that they do not bother to promote on the BCBS website. The American Legislative Exchange Council (ALEC), founded in 1973 by conservative activist Paul Weyrich, is a DC-based front group which helps state lawmakers craft corporate-friendly legislation. As the Atlantic has noted, ALEC developed template health care “states’ rights,” legislation to declare aspects of health reform unconstitutional. ALEC has promoted this “tenther” legislation using its network of mostly far right Republican state lawmakers. The bills, which have been adopted in some form in 24 states so far, aim to invalidate federal regulations of health insurance, the public option and the individual mandate using the Tenther Amendment.

According to the ALEC website, the resolution was developed by a three member task force of industry representatives. One of the of the members is Joan Gardner, who is executive director of state services with the BCBS Association’s Office of Policy and Representation. In an interview with ThinkProgress, Christie Herrera, the director of ALEC’s health task force, confirmed that Gardner played a pivotal role in crafting this anti-health reform states’ rights initiative. Herrera told us that Gardner’s unique position at the BCBS Association brought “great knowledge” to the issue, and that Gardner voted to press forward with the campaign.

Part of the reason the BCBS Association has claimed that it opposes the reform bill in its current form is because of what it perceives as a weak individual mandate. However, the BCBS Association-supported ALEC campaign depicts the very notion of an individual mandate as “anti-freedom.” So either way the Senate acts, BCBS will be able to trash the bill and try to kill reform.

Private insurers have already been caught using a stealth lobbying firm to send employees to rowdy town halls (and radical tea party events), sharing lobbyists with slash-and-burn anti-health reform attack groups, and paying a number of conservative pundits who regularly appear in major media outlets to slam health reform. Now that it is clear that BCBS helped write the script for the radical tenther movement, any claim that the industry supports reform must be viewed with heightened skepticism.



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Sources: NY Times, Think Progress, Huffington Post, Google Maps