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Deconstructing Harry
Ten things to watch in the Senate health-care debate.


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Robert Costa

What a week . . . and weekend. After a torturous battle to get his $848 billion health-care bill onto the floor, Senate Majority Leader Harry Reid (D., Nev.) was finally able to begin debate on it last Monday. Since then, debate has hummed along at full Senate speed, which means lots of talk, lots of amendments, and lots of questions. 

Now in day eleven, Reid finds himself laboring toward the finish line of what’s become a marathon. Whether he’ll be able to secure the 60 votes he needs to reach cloture by Christmas is unclear.

Some Democrats, like Sen. Ben Nelson (Neb.), are miffed that tougher language to restrict abortion coverage was axed from the bill on Tuesday. Others on the far left are worried about whispers that Reid is more than ready to compromise on the inclusion of a strong public option. Most Republicans, meanwhile, are sweating. They know that the GOP senators need to stick together — all 40 of them — if they want any shot of peeling off one Democrat and halting Reid’s bill in its tracks.

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With so many variables, watching the debate on C-SPAN 2 can be confusing. Amendments rise and fall, bulky charts are displayed, and fingers are wagged. The continual question: What’s really going on? To find out, keep an eye on these topics as the final days of debate unfold.

1. Abortion. Will Nelson play hardball and push for his amendment’s language to be included in the bill via Reid’s manager’s amendment? If Reid balks, will Nelson jump across the aisle and vote with Republicans? How will the U.S. Conference of Catholic Bishops shape the debate? All of these questions need answers. My prediction: Nelson talks about walking away, only to be cajoled back by Reid. The Nevadan knows how to sweeten pots (See Landrieu, Mary).

2. Public opinion. It’s slipping. Gallup, Rasmussen, and Quinnipiac have all published polls showing the public’s opinion of Obamacare to be souring. Senators, especially moderate Democrats like Sen. Blanche Nelson (Ark.), are catching hell from constituents back home. The GOP is banking on an angry groundswell to upset Reid’s momentum. While public frustration with Washington may not be enough to block Reid’s bill from passing this winter, it ultimately could deplete the political capital of Obamacare’s namesake via election returns next fall.

3. Grandma. Last Thursday, Sen. John McCain (R., Ariz.) proposed an amendment that would eliminate $500 billion in proposed Medicare cuts from Reid’s bill. It failed by a vote of 58 to 42. Yet among the 42 votes in support were two Democrats, Nelson and Sen. Jim Webb (Va.). Those crossover votes, says Sen. Lamar Alexander (R., Tenn.), are a sign of what’s to come. “Senator Reid’s insistence on keeping in the half-trillion of Medicare cuts is lethal,” says Alexander, the GOP conference chairman. “It’s double trouble for Democrats to cut Medicare only to then spend Grandma’s money on somebody else. That’s what this bill does.” With Reid pivoting this week to propose opening up Medicare to middle-aged Americans, will Granny rebel?

4. Sen. Joe Lieberman. Even after Reid announced his “deal” with Democrats on Tuesday night, Lieberman was back at it, questioning Reid’s leadership and promises. If he even sniffs a public option, he’s gone. “My opposition to a government-run insurance option, including any option with a trigger, has been clear for months and remains my position today,” the Connecticut independent said in a statement. “It is my understanding that at this point there is no legislative language so I look forward to analyzing the details of the plan and reviewing analysis from the Congressional Budget Office and the Office of the Actuary in the Centers for Medicare and Medicaid services,” he added. Watch out, Reid. Lieberman’s no pushover.

5. The manager’s amendment. This is Reid’s safety net should he continue to stumble in cloakroom negotiations on his bill’s specifics — a bundle of amendments he can pin on his bill at the last minute to satisfy those on the fence. Of course, there’s no guarantee that such a move would save him. As William Kristol of The Weekly Standard points out, “The much hyped (if utterly incoherent) deal that Harry Reid is touting doesn’t look as if it’s doing the trick — the trick being to cobble together anything (and I mean anything) that can get 60 votes in the Senate, introduce it as a manager’s amendment later this week, and jam it through.” The reason: Some senators frown upon last-minute promises, especially on tricky issues like abortion or a public-option trigger. They want to see their concerns worked out in the bill’s language rather than accept some legislative wink and nod.

6. The CBO score. What exactly is in Reid’s “broad agreement” on health-care reform? Who knows? Well, the Congressional Budget Office knows, and they should be returning a score on Reid’s recent proposal soon. Democrats may cheer when the numbers come back, but what about Lieberman, Lincoln, and the moderate Republicans such as Olympia Snowe? Reid may need them if one of his caucus members bolts. Keep an eye on how Republicans handle the report: Will they find a way to pick off a couple of wary Democrats?

7. PhRMA. Over the summer, the lobbyists at PhRMA, the group representing pharmaceutical companies, thought they had it made. Commit $80 billion to Obamacare and they’d be free of most hassles should a health-care bill pass. It looks like they’ve been duped. On Wednesday, the Senate debated a drug-import amendment introduced by Sen. Byron Dorgan (D., N.D.). Dorgan lashed out at Big Pharma for its commercials advertising prescription drugs, going as far as to read scripts from direct-to-consumer advertising spots. Sen. Ben Nelson (D., Fl.) has also provided a kill-pharma-profits amendment to shift the dual-eligible from Medicaid to Medicare, which would save the federal government money and cost drug companies billions. The White House has said that Obama backs the general idea of the amendments. Will PhRMA bail on its $80 billion pledge?

8. The White House. President Obama came to the House of Representatives last month to prod his health plan forward. It passed soon after. This past Sunday, he came to the Senate to do the same. His chances of success in the upper chamber are increasing — if you buy Reid’s ramblings about a “broad agreement” — but it’s way too early for a celebration. On Wednesday, Obama backed Reid’s proposed compromise on the public option and Medicare enrollment. “The Senate made critical progress last night with a creative new framework that I believe will help pave the way for final passage and a historic achievement on behalf of the American people,” said Obama. If the president stays hands-off from here on in, you’ll know Reid is close to garnering the 60 votes he needs. If Obama wades back into the debate or comes back to the Hill for a pep talk, you’ll know there’s trouble within the Democratic caucus.



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