Yesterday saw some rare good news on the health-care front, with the stealth Democratic plan to move $247 billion in ObamaCare costs off the books collapsing in the Senate on a procedural vote of 47 to 53. Maybe there's more anxiety among Democrats about a huge permanent increase in government health spending than the White House is willing to let on.
A dozen Democrats (plus independent Joe Lieberman) voted against Majority Leader Harry Reid's gambit, which would have superseded automatic cuts in Medicare payments to doctors scheduled for 21% next year and higher after that. Democrats had included this fix as part of "comprehensive" reform but that pushed costs too high, while President Obama is insisting on a bill that doesn't increase the deficit on paper.
So Mr. Reid's inspiration was to decouple these payments from ObamaCare as stand-alone legislation, while hoping everyone ignored the phony budget math. The media did mostly ignore this subterfuge. But enough Republicans developed enough backbone that they spooked Democrats like North Dakota's Kent Conrad, who for once stood by their supposed deficit-hawk convictions. Notwithstanding the anesthetizing effect of Congress's now-routine trillion-dollar cost estimates, more than a few Democrats are still capable of sticker shock.
The bill sank with a 47-53 vote (roll call found here).
If this bill had been added as an amendment to the Obamacare bill, it would have raised the total past the $900 billion mark, so Reid tried to sneak it in on it's own and failed miserably.
Reid then lashed out at Republicans, while ignoring the 12 members of his own caucus that voted with Republicans against Reid's attempt to juggle the numbers.
"I want everyone within the sound of my voice to understand that Washington is being driven by a small number of people on that side of the aisle that are preventing us from doing things that help the American people," Reid said. "We're not trying to run over people with the 60 votes we have. We want to work with people. We want to get along."
Better yet, Reid is trying to blame the fiasco and his own failure at trickery on the AMA, claiming they promised to "deliver" 27 Republican votes.
Reid angrily blamed the loss on bad intelligence from the American Medical Association, which he said promised him 27 Republican votes (he got none), as well as Republican dirty tricks designed to impede Democrats' progress on meaningful reform.
The AMA says they never promised Reid 27 Republican votes and any discussions on the matter were had before introduced the legislation.
But J. James Rohack, the president of the AMA, said that Reid was working with old information and that his organization never claimed it could deliver more than two dozen Republicans for a 10-year fix of Medicare doctor payments.
“The reference to 27 votes was made well before [the bill] was introduced and in the context of bipartisan health reform legislation,” said Rohack.
More from NYT:
The Senate majority leader, Harry Reid, Democrat of Nevada, needed 60 votes to proceed. He won only 47. And he could not blame Republicans. A dozen Democrats and one independent crossed party lines and voted with Republicans on the 53 to 47 roll call.
The Medicare bill has become a proxy for larger issues in the debate over legislation to overhaul the health care system.
Mr. Reid said the bill, by averting big cuts in physician fees, guaranteed that doctors would continue accepting Medicare patients. But since none of the costs were offset or paid for, Republicans said it was fiscally irresponsible, and some Democrats said they shared that concern.
By addressing doctors’ fees in a separate bill, Senate Democrats could hold down the cost of the broader health legislation, keeping it within the limits set by President Obama. House Democrats are considering a similar tactic. Republicans said it was a transparent ploy to hide the cost of a health care overhaul.
The Senate Minority Leader, Mitch McConnell states
"In the Senate’s first vote on health care spending this year, a bipartisan majority rejected the Democrat leadership’s attempt to add another quarter-trillion dollars to the national credit card without any plan to pay for it. With a record deficit and a ballooning national debt, the American people are saying enough is enough."
A Democratic Senator who voted against this bill, Bill Nelson of Florida, states his reasoning for voting against the Doc Fix by saying "I will vote for the doctor fix — when it is funded."
Reid can blame Republicans all he wants, but his own party's caucus couldn't even justify that amount of spending without any way to pay for it and Reid couldn't even deliver his own members.
Over at The Corner, Yuval Levin makes a very good point about how Democratic Senators truly haven't the confidence in Harry Reid that they would need in order to jump off the very high cliff named Obamacare
The problem for Reid is more than substantive — more than unhappy doctors and an unhappy AMA. The biggest problem is the danger of losing the confidence of his Democratic senators. Passing health-care reform remains an extremely difficult challenge: There are two Senate bills, with very significant substantive differences between them, which need to be combined, voted on, then merged with an even more different House bill, and voted on again. Each of these votes would require the support of just about every (if not indeed every single) Senate Democrat, and each would be a very tough vote for one or another group in their caucus. It is an exercise in serial needle-threading that will call for an extraordinary degree of discipline by the Senate Democrats — a group not known for discipline. To work, it will require Reid to pressure nervous members, strike multiple precarious compromises, and hold it all together, which will require him to command a great deal of authority and confidence among his members. None of them wants to be left out in the cold having taken a tough vote on a very unpopular bill that still ends up going nowhere. Today’s vote showed these senators a leader unsure of himself, lacking an accurate vote count, and surprised by developments on the Senate floor — embarrassed and embarrassing. This is not what the Democrats need in the buildup to a very tense and complicated legislative maneuver.
I will give him the last word on this because I happen to agree. Reid doesn't have the brains nor the backbone for this fight and Democrats facing hard reelections in 2010 might not be willing to put their careers on the line to follow Harry Reid off the cliff.
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