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Stand up to extortion or get used to getting rolled over

December 31, 2009 - Mike Maneval

To get the health care bill through the Senate so the legislation can be reconciled with the version passed by the House, the leadership of the Democratic caucus had to make compromises and concessions. And the last holdout, centrist Democrat Ben Nelson of Nebraska, extracted quite the price.

Nelson, according to progressive blogger Jon Walker, "played a big role in removing the public option (and) preventing the bill from ending the anti-trust exemption for health insurance companies." Katie Connelly, blogging for Newsweek, says Nelson fought successfully to change language in the bill regarding abortion and reducing the availability of the procedure even for women whose health care is in no way subsidized by tax dollars.

But these matters plausibly of policy and principles - and even on matters like the antitrust exemption I can concede it may well be principle for Nelson - were not enough. Nelson needed something else - a giant pile of cash for his neighbors in Nebraska.

Under the Senate plan, Nebraska will be waived part of the state's future share of Medicaid's costs. It is not a proposal to shift financing of Medicaid from any state contribution to full federal funding - it's the federal government picking up a tab for Nebraska nearly every other state will still be expected to pay. 

The special deals - one for Nebraska and a similar one for Louisiana - taint a reform plan the merit of which was already dubious and gives ammunition to opponents like Republican Senator Jim DeMint of South Carolina, who according to Human Events said the Democrats "voted to retain the culture of corruption in Congress" after Nelson's cynical gambit to barter his way into being the 60th vote.

When the House Democrats debate reform again, they would be well-served to demand, first and foremost, the Nebraska and Louisiana Medicaid deals be stripped back out of the legislation. Otherwise, this feat of political extortion may well overshadow not only the debate on reform, but the Democrats' agenda moving forward.



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