Critical Condition

NRO’s health-care blog.

The Medicare Reimbursement Cloture Vote


As I am sure everyone has noted, the attempt to hide almost $250 billion (over ten years) of Obamacare spending–the proposed “permanent” fix for the sharp scheduled cut in provider reimbursements–failed yesterday on a motion to impose cloture, 53-47 against.  So Harry Reid and the White House failed even to get a simple majority.

Thirteen Dems (including Lieberman) voted against cloture.  Of greatest interest to me was Blanche Lincoln’s vote: she voted Yea.  The question is: Why?  After all, it would seem that she has few incentives to vote for health-care socialism as she runs for reelection in Arkansas.  My guess is that she wants to vote for it–perhaps the Senate leadership is promising her something–but has to have a bill that ostensibly costs less than the $900 billion and adds zero to the deficit.  This reimbursement bill would have furthered that goal by playing an obvious shell game with the numbers.  Does anyone have a better explanation for her vote?

Snowe and Collins voted Nay; this may suggest that they might not vote for a final bill that has spending numbers more rather than less honest.  (Fingers crossed; after all, history may call again.)  Among the Dems, Byrd, Conrad, Dorgan, Lieberman (Independent), and Nelson voted Nay.  I assume that Byrd has not yet obtained a deal with respect to the tax on health-care benefits for the coal miners.  Conrad and Dorgan must have little confidence at this point that “reform” would not include a Medicare basis for reimbursements for the rural hospitals in N.D.  Does Lieberman’s vote suggest that he will not support cloture on an actual reform bill written by Baucus, Dodd, and Rahm Emanual?  Aren’t Aetna and some other insurers based in Connecticut?  (But then why does Dodd support this monstrosity?)  Nelson’s vote also is interesting: It is obvious that Medicare cuts of one kind or another will have to be part of a final bill–particularly Medicare Advantage for ideological reasons–and it simply cannot be the case that he wants to vote for a package including that.  So Nay on cloture seems like a natural vote for him.

I am starting to believe/hope that Mike Cannon and Doug Holtz-Eakin and some others are right: Too many Dem constituencies will bear too many costs to make this thing work under the advertised constraints ($900 billion, no deficit impact, etc.).  Am I thinking about this the right way? 

 – Benjamin Zycher is a senior fellow at the Pacific Research Institute.


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