Only The Beginning

By Sarah O’Connor

President Barack Obama’s mission to reform US healthcare vaulted another legislative hurdle over the weekend, but the scramble to secure his own party’s votes sheds light on the messy compromises that may be needed to get it to the finish line.

Fissures between liberal and centrist Democrats cracked open on Sunday in the aftermath of a procedural vote, which paved the way for the estimated $848bn (€570bn, £514bn) draft Senate bill to be debated on the floor.

Leaders hope there will be a vote on the bill by Christmas. If passed, the House and Senate versions will have to be mashed together.

If this weekend is anything to go by, it will not be a pretty process. All Democrats and Democrat-leaning independents voted to push the bill forward – creating a filibuster-proof majority of 60 – but some of those votes came far from quietly. A group of centrist Democrats, unhappy about elements of the bill such as a public insurance option, managed to wring concessions from the leadership in return for their acquiescence.

In what wags have already dubbed the “Louisiana Purchase”, Mary Landrieu was offered at least $100m in extra federal money for her state. Ben Nelson won the omission of a provision that would strip health insurers of their anti-trust exemption. Blanche Lincoln won more time.

The group’s disproportionate power in the debate has antagonised some liberal Democrats. “In the end, I don’t want four Democratic senators dictating to the other 56 of us and to the country, when the public option has this much support, that it’s not going to be in it,” said Sherrod Brown of Ohio on Sunday on CNN.

“But in the end, I think that all four of our colleagues surveyed this . . . and I don’t think they want to be on the wrong side of history. I don’t think they want to go back and say, ‘You know, on a procedural vote, I killed the most important bill in my political career’.”

As the debate gets going, the centrists will face increased pressure at home, where they are vulnerable to losing their seats if they are seen to let their colleagues in Washington push them too far to the left. Lobbyists on both sides of the debate are well aware of this, and are blitzing their home states with adverts.

Ms Lincoln claimed that groups had spent $3.3m on advertising in her state of Arkansas. She said she would refuse to yield to either side, but was shocked by the “unbelievable type of threats” she had received.

“These ad groups seem to think this is all about my re-election. I simply think they don’t know me very well,” she said on the Senate floor.

The group, which also includes independent senator Joe Lieberman, all said they wanted more changes made to the bill in the coming weeks.
“When I saw the bill I said, ‘This can be amended, this can be improved’,” Mr Nelson said on Sunday on ABC. He said language on federal funding for abortion, which is softer than that of the House bill, was one problem. He did signal he was willing to compromise on a public option, but said it would have to be much weaker than the current version, which has already been watered down to allow states to opt out.

“We could negotiate a public option of some sort that I might look at, but I don’t want a big government, Washington-run operation that would undermine the . . . private insurance that 200m Americans now have,” he said.

Mr Lieberman, though, was more intransigent.

“[A public option] is a radical departure from the way we’ve responded to the market in America in the past,” he told NBC. “We rely first on competition in our market economy. When the competition fails then what do we do? We regulate or we litigate.”

The weekend’s vote was a victory for Harry Reid, Senate leader, but he acknowledged that it was simply an opening skirmish in a battle that is now set to break into full force. Much of that battle will take place within his own party.

“Tonight’s vote is not the end of the debate,” he said on Saturday night. “It is only the beginning.”