In the 2008 presidential race, John McCain often dueled with Barack Obama over health care. Over a year later, Obama is in the White House and McCain finds himself back on Capitol Hill. The battle, however, continues.
With the president and Senate Majority Leader Harry Reid (D., Nev.) making a final push to pass Obamacare in the upper chamber, McCain tells NRO that it is crucial for Senate Republicans to make every effort to defeat Reid’s 2,074-page blueprint, which is expected to come to a cloture vote on Saturday night. That vote will determine whether the bill can move to the Senate floor for a final debate. Reid, who leads a caucus of 58 Democrats and two independents, needs to secure 60 votes in order to proceed.
Democrats, says McCain, “are trying to fundamentally change health care in America.” Reid’s bill, he adds, is “like a big fish in the sun: After a short period of time out there, it really begins to stink.” McCain’s concerns are numerous: the bill’s spending, its new taxes, its Medicare cuts, its abortion language, its public option, its employer mandates, and its lack of medical-malpractice reform. The last item really irks the Arizona senator. “The total absence of meaningful malpractice reform just shows you the incredible influence of the trial lawyers of America,” says McCain. “It’s just blatant.”
The Congressional Budget Office’s recent score of Reid’s bill puts the cost at $848 billion over ten years. McCain says that number is misleading. Unlike the House and Senate Finance Committee health-care bills, whose reforms were set to start in 2013, Reid’s bill pushes back the implementation date to 2014. McCain calls the move “outrageous.”
“People will start paying taxes right away, but now the benefits won’t kick in until years later,” says McCain. “It’s like buying a house and starting mortgage payments only to be told that you have to wait five years to move into your home. And when you look at the actual cost of implementation, once the taxes come into effect, the ten-year cost is $2.5 trillion.”
Beyond the CBO numbers, “this bill is an atrocity, it’s awful,” says Sen. John Barrasso (R., Wyo.), an orthopedic surgeon. “The overall costs are hidden. A huge part of Medicare that seniors depend on is going to be cut, and the bill includes major new taxes.”
Also worrisome, says Barrasso, is that rationing is on the horizon: “The U.S. Preventive Services Task Force, a government panel, just came out with an astonishing report on mammograms that [encourages the government to step] between people and their doctors. It’s amazing that the government and the Democrats would show their hand this soon. This report is clearly the first step toward rationing and a glimpse into the future of health care in America.”
Knowing that the public is growing increasingly uneasy about Obamacare, the Senate GOP is more than ready to raise objections at every turn, says McCain.
“Our amendments will be our alternative,” he adds. “We’ll propose a group of reforms to bring down costs, from malpractice reform and enabling people to purchase insurance across state lines to rewards for wellness and fitness and cost-savings for small businesses. Cost is the fundamental schism here. Republicans know that the focus needs to be on bringing down costs. The Democrats, meanwhile, are intent on changing the whole system.”
But before the Senate GOP has a chance to offer those amendments on the floor, they’ll have to try to topple Reid’s bill this weekend. Abortion is already at the center of the debate, a major hurdle for Reid as he attempts to cobble together 60 votes.
Pro-life Democrats are giving Reid heat for his decision to leave out the abortion language from the health-care bill that recently passed in the House. There, pro-life congressman Bart Stupak (D., Mich.) was able to force Speaker Nancy Pelosi (D., Calif.) to adopt a strict limit on abortion funding when he secured 240 votes for a related amendment. Now, in similar fashion, pro-life senator Ben Nelson (D., Neb.) has threatened to filibuster a final vote on Reid’s bill if the language on restricting federal funds for abortion is not strengthened.
“Saturday’s vote is not just some meaningless procedural vote,” says Sen. Lamar Alexander (R., Tenn.), chair of the Senate Republican Conference. “In this case, procedure equals policy, as it often does in the Senate. If you care about right to life, if you’re a pro-life senator, then you know that this is probably the only chance we have to get that provision changed.”
“I’ve always thought that Senator Reid could get his 60 votes on the motion to proceed,” adds McCain. “He’s good at that kind of thing. But there will be a backlash in this country when they find out that federal dollars may be given to cover abortion. That is a radical departure from the Hyde Amendment. When the abortion language in this bill is correctly analyzed by experts, Americans will notice. The majority of Americans, be they pro-life or pro-choice, do not want federal dollars directly or indirectly funding abortion.”
Sen. Mike Johanns (R., Neb.) agrees. “Saturday’s vote is an abortion vote,” he says. “We often use arcane procedures in the Senate that just lose people. Things can get complicated on the process side here, so let me be clear: This cloture vote is a make-or-break vote on the pro-life issue. Reid’s bill has language that includes a mechanism for public funding and a significant extension of abortion coverage. If this bill moves to the floor with 60 votes this weekend, the only way to change it is to get 60 votes again. That will be very tough to achieve once the bill goes to the floor. A vote to proceed is thus a vote for extending abortion coverage.”
Republicans and pro-life Democrats need to unite on Saturday night, says Johanns. “Stupak didn’t give in to Speaker Pelosi. Every Democrat who has run as a pro-life senator, anyone who has gotten an endorsement from the National Right to Life, needs to stand up on this. This is the pro-life vote of their Senate career.”
Thanks to these and other concerns, three Democratic senators remain publicly undecided on whether to move Reid’s bill toward a floor debate — Arkansas’s Blanche Lincoln, Louisiana’s Mary Landrieu, and Nelson. Lincoln is facing growing unpopularity back home and a tough reelection battle in 2010. So far, she and Nelson have issued noncommittal statements. Landrieu has said she may deep-six the Democrats’ plan. Knowing this, Reid gathered the wary trio in his office on Thursday for a private briefing on the bill’s “particulars.”
“I’m sure they were talking about more than the weather,” says McCain, who’s concerned that Reid may be sweetening the bill at the last minute for the three fence-sitters. “There should not be a surprise boost in Medicaid funding for states that have been declared disaster areas in the last seven years,” says McCain. “If you look at what’s in that provision on page 432, you see the benefits those states will receive, especially Louisiana, which suffered from Hurricane Katrina in 2005.”
ABC News reports that the Congressional Budget Office expects this added component of Reid’s bill to cost $100 million. “We need to engage in an extensive debate over these things,” says McCain. Reid, he adds, with such fine-print favors, could be seen as trying to “buy” Landrieu’s vote. “In a 2,074-page bill, there’s a lot of room for mischief.”
Reid isn’t the only Democratic leader trying to help Obamacare along tomorrow, of course. The White House is also doing everything it can to make sure Reid gets 60 votes. For example, a handful of top Obama strategists — including Deputy Chief of Staff Jim Messina and pollster Mark Mellman — addressed Democratic senators on Thursday afternoon. Vice President Biden, they said, is ready and willing to travel to help any worried Democrat sell voters on Obamacare in red-tinged states. Obama himself has also gone out of his way, even during his recent trip to Asia, to praise Reid’s bill.
GOP Senate staffers tell NRO that they expect Reid to get his 60 votes. Nonetheless, Alexander says that he’s not giving up on trying to change some minds. The GOP is “doing everything we can” to reach out to moderate Democrats,” says Alexander. “We respect their autonomy, but we know they pay attention to what happens in their states. For example, Senator Johanns held two press conferences recently about Saturday being a right-to-life vote. Those events were surely noticed in Nebraska and especially by Senator Nelson.”
Alexander adds that in the final run-up to the Saturday-night vote, the GOP will continue to remind Democrats that they “won’t be able to explain away a ‘yea’ vote on Saturday night as ‘just trying to move the bill to the floor.’ They’re going to have to realize that if they vote for cloture on Saturday, then they’re going to have to go home and explain to voters why they think voting to raise premiums, raise taxes, encourage taxpayer-funded abortions, and cut Medicare equals ‘health-care reform.’”
The debate on Reid’s bill is set to begin at 10 a.m. on Saturday, with the cloture vote to come around 8 p.m. If it passes, then the Senate will likely take a week off for Thanksgiving and come back to begin the floor debate on Monday, November 30. If it doesn’t pass, it will simply be a disaster for Democrats. President Obama would have little to no chance of signing any piece of legislation until early 2010 and the Senate would become mired in even more debate over cloture that could stretch on for weeks.
Regardless of Saturday’s outcome, it will be important for Republicans to “keep going out to the American people,” says McCain. “I intend to try and get out of Washington during the final weeks of debate to have town-hall meetings. We need to keep the American people stoked up and informed and do everything we can to galvanize support. The American people overwhelmingly do not want this legislation. They’re already fired up and frustrated in a way I have never seen before. We have to help make sure that their voices are heard and engage in an extensive debate.”
Alexander says he already has a plan. “We’re going to organize Republican senators today and Saturday into teams to go to the floor and read the text of the bill to help the American people understand how it affects their individual health care,” he says. “If the American people have a chance to read the text of the bill and understand its costs, then it has no chance of passing. That’s a very big challenge for the next few weeks, but we’ll take Friday and Saturday to explain the bill to the American people, through the Internet and town halls. We’ll be very active now and all through December.”
Then again, some staffers say that if Reid clearly has 60 votes, then the GOP may back off its promise to read the bill in order to let their colleagues go home for the recess, keeping their procedural weapons in their holsters, if only for a week.
Whether the Republicans will have much to give thanks for over the break is unclear. Though Reid may appear to be a couple of votes short on cloture, his ability to toss around big-dollar carrots to cautious Democrats like Landrieu should help to pave the way for a floor debate.
Saturday night’s debate may be nothing more than a preview of politics to come. Don’t discount it, though, says Barrasso, the doctor.
“The Reid bill is the wrong prescription,” he adds. “On Saturday, we’ll give Americans a second opinion.”
– Robert Costa is the William F. Buckley Jr. Fellow at the National Review Institute.