The Moderates Seize Control!!

On Thursday and Friday, I spent an intensive two days on Capitol Hill with various staffers, Senators, and Congressmen.  I have three observations.  First, everyone from Senate Finance was near exhaustion after an intensive two weeks of negotiation.  Second, many on the House side are moving from legislative confrontation that would require a public health insurance option to legislative accommodation of other alternatives.  Third everyone, everywhere in the District has now openly come to the same conclusion I stated in August – we are at the beginning of a much longer period of healthcare reform.  Most accept the notion that we are in for a two to three year legislative reform period for our nation’s healthcare system, and the current reform packages are just the beginning.

After months of wrangling inside crowded town hall events, the cloak rooms of Capitol Hill, and in front of news cameras, a significant step was taken when the Senate Finance Committee completed their mark-up.  It’s a 263-page tome that represents weeks of public and back room negotiations.  The mark-up – and probable vote this coming week – will undoubtedly shape the debate on where healthcare reform is headed.  Call it what you will – a late game-changing moment for Republicans, an interception for Democrats, or a touchdown for the moderates – Tuesday afternoon’s rejection of a publicly financed insurance option by Senate Finance was a critical step forward in creating a healthcare legislative package. Following a summer of near gridlock over what would or would not be included in such a proposal, the American people finally have a better outline of the much debated and highly scrutinized direction of the United States Senate.

While some consider the rejection of the public option as a setback for the Obama administration, others view the Senate Finance 15-8 vote as a clear signal toward bi-partisanship with Senators Baucus (D-MT), Conrad (D-ND), Lincoln (D-AR), Nelson (D-FL), and Carper (D-DE) all voting with Republicans against Senator Rockefeller’s (D-WV) proposal to create a public option.  Even when Senator Schumer (D-NY) introduced a more tempered version of his publicly financed option, the measure was still voted down by the Committee.

Though neither proposal passed the Committee, a sense of shift in the Senate was palpable.  Senator Rockefeller’s (D-WV) plan called for the government to pay doctors, hospitals, and providers based on a rate structure tied to Medicare and then renegotiated the rates after two years. After realizing that many members on both sides of the aisle were disapproving of his plan, Rockefeller put forth an amendment which mirrored the public option being debated in the House. The second approach would have based payment rates on Medicare for three years with the government paying an additional 5 percent premium above Medicare rates for providers that accepted the program.  But, it failed.  Then, Senator Schumer (D-NY) – in a final attempt to drive the public option home – proposed negotiating the payment structure later.  But, the Republican and Democrat centrists were not swayed.  In the final analysis, neither Rockefeller nor Schumer could convince their colleagues that a public option was the best way forward as a step toward healthcare insurance reform.  

So what does all this mean? Well, it certainly signifies that there was no overwhelming consensus among the Democrats.  Mitch McConnell (R-KY), the Senate Minority Leader, wryly observed: “All the queasiness about this bill is on the Democratic side, not the Republican side … They ought to be able to do anything they want to.  The question is – will they?”  Tuesday’s vote clearly illustrates the power of the centrists over the entire healthcare debate.  As I have been saying through the last month, in order to ultimately be successful the Obama administration needs a bi-partisan strategy to be at the forefront. So, no matter how much face time the politicians have on television, no matter how many sound bites are generated, it all comes down to what the moderates think.  History strongly suggests that the middle is where reform occurs, and history is repeating itself. 

The views and opinions expressed herein are my own and do not necessarily represent the views and opinions of Dell Services or its affiliates.