Obama’s Healthcare Full of New Bribes

Real Change You Can Believe In

President Obama told us that there was a new sheriff in town – that the days of buying votes were over. Didn’t last long…

Just look at the most recent incarnation of health care “reform.” We all knew about the bribes to Mary Landrieu and Ben Nelson, but now, Rep. John Shadegg (R-AZ) has put out a more complete list of just how much change has been going on:

• THE CORNHUSKER KICKBACK: Blue Cross Blue Shield of Nebraska will be exempted from an annual fee on insurers; the exemption could also apply to nonprofit insurers in other states, possibly including Blue Cross Blue Shield of Michigan. Supplemental ‘Medigap’ policies such as those sold by Mutual of Omaha are exempted from the annual fee on insurers, something that would help other companies selling such policies. A physician-owned hospital being built in Bellevue, Neb., could get referrals from doctors who own it, avoiding a new ban in the Senate bill that will apply to hospitals built in the future.”

• THE LOUISIANA PURCHASE: Sen. Mary Landrieu Voted For Health Care Bill After Sen. Reid Gave Her A $300 Million for her state’s Medicaid program

• THE U CON: Sen. Chris Dodd (D-CT) Added $100 Million For A Hospital That He’d Like To Get For His State.

• GATOR AID: Sen. Bill Nelson (D-FL) Secured Extra Benefits For Medicare Advantage Beneficiaries.

• HANDOUT MONTANA: Sen. Max Baucus (D-MT) Got Medicare For Residents Of A Small Town With Asbestos-Related Illnesses.

• North Dakota Senators Byron Dorgan and Kent Conrad, both North Dakota Democrats, would enjoy a provision bringing higher Medicare payments to hospitals and doctors in ‘frontier counties’ of states such as — let’s see here — North Dakota!

• Hawaii Got A Special Exemption For Higher Medicaid DSH Payments.

• Sen. Patrick Leahy (D-VT) Got $600 Million For Medicaid. “SEN. PATRICK LEAHY, D-VT., negotiated $600 million in additional Medicaid benefits for his state over 10 years.

• Sen. Jeff Merkley (D-OR) Got Special Treatment For Union Workers. “Longshoremen were added to the list of high-risk professions shielded from the full impact of a new tax on high-value health insurance plans.

• New Jersey pharmaceutical companies were given a $1 billion research subsidy because of Senator Bob Menendez.

• A $5 billion reinsurance program for health plans was expected to largely benefit union members (it was believed that Michigan Senator Debbie Stabenow had this added.

Read the original article JedEckert.com

Rangel: Lawmakers writing compromise health bill

By ALAN FRAM
Associated Press Writer

WASHINGTON (AP) – Leading lawmakers hoping to revive President Barack Obama’s stalled health care overhaul have started writing a compromise bill, but it’s unclear when the legislation will be ready for votes, a top House Democrat said Tuesday.

The measure would change the massive Senate-approved health bill to what bargainers from the White House, Senate and House agreed to last month, Rep. Charles Rangel, D-N.Y., said in a brief interview.

Rangel’s remarks, if borne out, could be the first concrete sign that Democrats will try enacting major health legislation in the wake of the Republican upset in a Massachusetts special election that cost them their crucial 60th Senate seat. Stunned by that setback, the White House and top Democrats have been conceding that they no longer know if they have the votes to pass health legislation, or what such a bill would look like.

In January, White House and congressional negotiators agreed to ease a Senate-approved tax on high-cost health insurance plans opposed by unions and many House Democrats. They also planned to remove a Senate provision having the federal government fully pay for an expansion of Medicaid coverage solely for Nebraska, one of whose senators, Democrat Ben Nelson, was the crucial 60th vote for the Senate bill at the time.

Rangel said leaders have to decide whether the health package would begin moving before or after Congress tackles legislation aimed at creating jobs.

“The question is when are we going to do it,” said Rangel, who chairs the tax-writing House Ways and Means Committee. “We got to move on with jobs. It’s not clear to me what the priority is going to be.”

He said a fight between liberal and conservative Democrats over how to limit federal financing for abortion remains unresolved.

In a remark underscoring the political sensitivities Democrats have about their two top issues, Rangel said, “The major things we’re talking about now are, one, don’t let health care even look like it’s not on the front burner. And don’t forget that the priority of people in their districts is jobs.”

The measure Rangel discussed would be a so-called reconciliation bill, a seldom-used procedure that only requires a simple majority of votes for Senate passage. He said he believed both chambers could muster the votes needed for passage, despite virtually unanimous GOP opposition.

House Speaker Nancy Pelosi, D-Calif., also voiced optimism about the approach in a conference call Tuesday with bloggers, while cautioning that final decisions to move forward remained to be made.

“We will not be deterred from this course of getting something done one way or another, and I’m hoping it will … be mainly by passing the comprehensive bill. That’s our plan,” Pelosi said.

Pelosi also said the House plans to vote next week on a small element of the massive health bill it approved in November stripping insurance companies of their decades-old exemption from certain federal antitrust laws. Pelosi’s office provided audio of the conference call.

Industry analysts see the effort as largely symbolic as courts have long allowed federal regulators to intervene when competition could be jeopardized.

Also Tuesday, Senate Majority Leader Harry Reid, D-Nev., emerged from a meeting with Pelosi to say no decisions had been made about the health bill. Reid said a scenario in which the House produces a reconciliation package “seems like a strong possibility,” but is not the only option.

In a separate interview, former Senate Majority Leader Tom Daschle, who was Obama’s first pick to lead the health care effort, said he thinks Democrats are back on track to finishing a bill.

“The bottom line is that this is still doable” because many Democrats realize they may take a bigger hit politically if they fail to deliver a bill, Daschle said. Republicans will still use the legislation to attack them, but Democrats won’t have any of the overhaul’s benefits to defend themselves unless they approve it.

“I don’t think any of this is easy to solve,” he said, adding that the likeliest window for action would be between the Presidents’ Day recess and the late March break for Easter and Passover.

Read the original article on Breitbart

Obama W.H. likely to lose jobs debate as economists predict double-digit unemployment

By Jon Ward

The bloody-knuckled brawl this year over whether President Obama is bringing back jobs will go a long way toward deciding whether Democrats in Congress retain their hold on power past this year’s midterm elections. At this point, according to economists, it’s a fight that is stacked against the White House.

Even if the economy begins to show modest job growth, as it is expected to soon, the overall unemployment rate is likely to stay at its current level of 10 percent, or continue to rise, according to most economic experts.

“I would expect it to start drifting steadily up to 10.5 percent,” the president of the nonpartisan Economic Policy Institute, Lawrence Mishel, said.

That is a major problem for a White House that promised just a year ago that the unemployment rate would not rise above 8 percent as long as Congress passed the $787 billion stimulus bill.

“To show that the recovery is not a jobless recovery they need to get it back to where they initially projected it, around 8 percent,” the director of the New America Foundation’s economic growth program, Sherle Schwenninger, said.

All evidence suggests that will be an extremely tall order.

The Senate is set to take up a $154 billion jobs bill — the Congressional Budget Office scored it at $180 billion — passed out of the House in December. Mr. Mishel said that even with a $400 billion second stimulus, which he favors, the unemployment rate would likely only come down to 9.7 percent or so by the fall.

“The job numbers will go up, but the unemployment rate is still going to remain uncomfortably high for some time, even if it improves,” said Jeffrey Schott, with the Peterson Institute for International Economics.

The Democrats’ majority in the House and 60-seat filibuster-proof majority in the Senate – both at risk this fall – will likely rise or fall based on what judgment the country comes to on this central issue.

Complicating Democratic efforts to stimulate job growth is the growing concern among many Americans, and many foreign creditors, about the nation’s exploding budget deficit and national debt. Spend too much on jobs, and you push the deficit even higher. Spend too little, and the employment picture stays grim.

The president and congressional Democratic leaders have already begun to focus their rhetoric on the “job growth” metric, in an attempt to nudge public attention away from the unemployment figure and toward more favorable measurements. They’ll also point to gross domestic product, which contracted for much of 2008 and 2009 but is forecast to grow by 2 to 3 percent a quarter.

“I think we are on a path of, you know, of steady progress, that by all accounts, you know, GDP, which grew in the third quarter of last year, is going to grow even more strongly when we get the numbers for the fourth quarter,” said Christina Romer, the chairman of the President’s Council of Economic Advisers, during an appearance Sunday on ABC’s This Week with George Stephanopolous.

“And I think, you know, if you look at basically every forecast, they are saying steady GDP growth over 2010,” she said. ” The real question is going to be, is it going to be strong enough to really add a lot of people back into employment?”

The answer to that question is probably in the negative, but Democrats are trying to make the case that they can survive without that.

“If when in fact November rolls around, GDP has grown significantly, and people begin to see that job creation is existing and continuing, while we may not have a dramatic downturn [in the unemployment number] … they’ll reward us on election day,” said New Jersey Sen. Robert Menendez, the current chairman of the Democratic Senatorial Campaign Committee, in an interview.

The unemployment rate does not always go down even when there are job gains because the economy often needs to create at least 100,000 new jobs a month – sometimes even double that – just to keep pace with the number of new entrants into the work force.

Friday’s job number demonstrated another dynamic, where the economy lost 85,000 jobs but the unemployment rate stayed flat at 10 percent. The reason it did not increase is because the overall labor force shrank, as 661,000 jobless Americans gave up their search for work. If those unemployed workers had remained in the labor force, unemployment rate would have risen to 10.4 percent, according to EPI’s Heidi Shierholz.

The contraction of the labor force only adds to the Democrats’ challenge in nudging the unemployment rate down. If jobs do begin to return, that may encourage many of the jobless who gave up back into the market, increasing the size of the labor force and likely causing the overall unemployment number to rise.

There are currently about 3.6 million “missing workers” who are currently not looking for work but who likely will if jobs begin to be added to the economy.

So far, Obama has focused on a narrative of saving the economy from total collapse and beginning to turn the ship of state around and pointed in the right direction. But much of the country has not responded favorably to the White House’s decision to spend most of its first year on health-care reform.

“When Americans think the top priority for government … should be job creation, for six months all they’ve heard Congress talk about is health-care reform, not job creation,” Mississippi Gov. Haley Barbour told The Daily Caller.

Sen. Ben Nelson, the Nebraska Democrat who cast the deciding vote to pass the Senate health-care bill, said late last week that “it was a mistake to take health care on as opposed to continuing to spend the time on the economy.”

“Working on the economy would have been a wiser move,” he told the Fremont Tribune, a local newspaper in Nebraska.

It is an uphill slog for the Obama White House, which will try to persuade the country it is turning things around even as it faces renewed concerns over terrorism in the U.S. and manages two wars in Afghanistan and Iraq.

Obama acknowledged Friday that in December the job market “slipped back, losing more jobs than we gained.”

Romer, on Sunday, acknowledged that when she delivered the job numbers for December to him in the Oval Office Friday, the president was “subdued” and “disappointed.”

“We’re all desperate to see progress,” she said.

The president, on Friday, attempted to point to a positive: “The overall trend of job loss is still pointing in the right direction.”

While that is true, it is small consolation to most Americans, and the White House knows it. They also know that this issue will continue to plague them past this fall’s midterms.

Read the original article on The New Daily Caller

Change Nobody Believes In

A bill so reckless that it has to be rammed through on a partisan vote on Christmas eve.

And tidings of comfort and joy from Harry Reid too. The Senate Majority Leader has decided that the last few days before Christmas are the opportune moment for a narrow majority of Democrats to stuff ObamaCare through the Senate to meet an arbitrary White House deadline. Barring some extraordinary reversal, it now seems as if they have the 60 votes they need to jump off this cliff, with one-seventh of the economy in tow.

Mr. Obama promised a new era of transparent good government, yet on Saturday morning Mr. Reid threw out the 2,100-page bill that the world’s greatest deliberative body spent just 17 days debating and replaced it with a new “manager’s amendment” that was stapled together in covert partisan negotiations. Democrats are barely even bothering to pretend to care what’s in it, not that any Senator had the chance to digest it in the 38 hours before the first cloture vote at 1 a.m. this morning. After procedural motions that allow for no amendments, the final vote could come at 9 p.m. on December 24.

Even in World War I there was a Christmas truce.

The rushed, secretive way that a bill this destructive and unpopular is being forced on the country shows that “reform” has devolved into the raw exercise of political power for the single purpose of permanently expanding the American entitlement state. An increasing roll of leaders in health care and business are looking on aghast at a bill that is so large and convoluted that no one can truly understand it, as Finance Chairman Max Baucus admitted on the floor last week. The only goal is to ram it into law while the political window is still open, and clean up the mess later.

***

• Health costs. From the outset, the White House’s core claim was that reform would reduce health costs for individuals and businesses, and they’re sticking to that story. “Anyone who says otherwise simply hasn’t read the bills,” Mr. Obama said over the weekend. This is so utterly disingenuous that we doubt the President really believes it.

The best and most rigorous cost analysis was recently released by the insurer WellPoint, which mined its actuarial data in various regional markets to model the Senate bill. WellPoint found that a healthy 25-year-old in Milwaukee buying coverage on the individual market will see his costs rise by 178%. A small business based in Richmond with eight employees in average health will see a 23% increase. Insurance costs for a 40-year-old family with two kids living in Indianapolis will pay 106% more. And on and on.

These increases are solely the result of ObamaCare—above and far beyond the status quo—because its strict restrictions on underwriting and risk-pooling would distort insurance markets. All but a handful of states have rejected regulations like “community rating” because they encourage younger and healthier buyers to wait until they need expensive care, increasing costs for everyone. Benefits and pricing will now be determined by politics.

As for the White House’s line about cutting costs by eliminating supposed “waste,” even Victor Fuchs, an eminent economist generally supportive of ObamaCare, warned last week that these political theories are overly simplistic. “The oft-heard promise ‘we will find out what works and what does not’ scarcely does justice to the complexity of medical practice,” the Stanford professor wrote.

• Steep declines in choice and quality. This is all of a piece with the hubris of an Administration that thinks it can substitute government planning for market forces in determining where the $33 trillion the U.S. will spend on medicine over the next decade should go.

This centralized system means above all fewer choices; what works for the political class must work for everyone. With formerly private insurers converted into public utilities, for instance, they’ll inevitably be banned from selling products like health savings accounts that encourage more cost-conscious decisions.

Unnoticed by the press corps, the Congressional Budget Office argued recently that the Senate bill would so “substantially reduce flexibility in terms of the types, prices, and number of private sellers of health insurance” that companies like WellPoint might need to “be considered part of the federal budget.”

With so large a chunk of the economy and medical practice itself in Washington’s hands, quality will decline. Ultimately, “our capacity to innovate and develop new therapies would suffer most of all,” as Harvard Medical School Dean Jeffrey Flier recently wrote in our pages. Take the $2 billion annual tax—rising to $3 billion in 2018—that will be leveled against medical device makers, among the most innovative U.S. industries. Democrats believe that more advanced health technologies like MRI machines and drug-coated stents are driving costs too high, though patients and their physicians might disagree.

“The Senate isn’t hearing those of us who are closest to the patient and work in the system every day,” Brent Eastman, the chairman of the American College of Surgeons, said in a statement for his organization and 18 other speciality societies opposing ObamaCare. For no other reason than ideological animus, doctor-owned hospitals will face harsh new limits on their growth and who they’re allowed to treat. Physician Hospitals of America says that ObamaCare will “destroy over 200 of America’s best and safest hospitals.”

• Blowing up the federal fisc. Even though Medicare’s unfunded liabilities are already about 2.6 times larger than the entire U.S. economy in 2008, Democrats are crowing that ObamaCare will cost “only” $871 billion over the next decade while fantastically reducing the deficit by $132 billion, according to CBO.

Yet some 98% of the total cost comes after 2014—remind us why there must absolutely be a vote this week—and most of the taxes start in 2010. That includes the payroll tax increase for individuals earning more than $200,000 that rose to 0.9 from 0.5 percentage points in Mr. Reid’s final machinations. Job creation, here we come.

Other deceptions include a new entitlement for long-term care that starts collecting premiums tomorrow but doesn’t start paying benefits until late in the decade. But the worst is not accounting for a formula that automatically slashes Medicare payments to doctors by 21.5% next year and deeper after that. Everyone knows the payment cuts won’t happen but they remain in the bill to make the cost look lower. The American Medical Association’s priority was eliminating this “sustainable growth rate” but all they got in return for their year of ObamaCare cheerleading was a two-month patch snuck into the defense bill that passed over the weekend.

The truth is that no one really knows how much ObamaCare will cost because its assumptions on paper are so unrealistic. To hide the cost increases created by other parts of the bill and transfer them onto the federal balance sheet, the Senate sets up government-run “exchanges” that will subsidize insurance for those earning up to 400% of the poverty level, or $96,000 for a family of four in 2016. Supposedly they would only be offered to those whose employers don’t provide insurance or work for small businesses.

As Eugene Steuerle of the left-leaning Urban Institute points out, this system would treat two workers with the same total compensation—whatever the mix of cash wages and benefits—very differently. Under the Senate bill, someone who earned $42,000 would get $5,749 from the current tax exclusion for employer-sponsored coverage but $12,750 in the exchange. A worker making $60,000 would get $8,310 in the exchanges but only $3,758 in the current system.

For this reason Mr. Steuerle concludes that the Senate bill is not just a new health system but also “a new welfare and tax system” that will warp the labor market. Given the incentives of these two-tier subsidies, employers with large numbers of lower-wage workers like Wal-Mart may well convert them into “contractors” or do more outsourcing. As more and more people flood into “free” health care, taxpayer costs will explode.

• Political intimidation. The experts who have pointed out such complications have been ignored or dismissed as “ideologues” by the White House. Those parts of the health-care industry that couldn’t be bribed outright, like Big Pharma, were coerced into acceding to this agenda. The White House was able to, er, persuade the likes of the AMA and the hospital lobbies because the federal government will control 55% of total U.S. health spending under ObamaCare, according to the Administration’s own Medicare actuaries.

Others got hush money, namely Nebraska’s Ben Nelson. Even liberal Governors have been howling for months about ObamaCare’s unfunded spending mandates: Other budget priorities like education will be crowded out when about 21% of the U.S. population is on Medicaid, the joint state-federal program intended for the poor. Nebraska Governor Dave Heineman calculates that ObamaCare will result in $2.5 billion in new costs for his state that “will be passed on to citizens through direct or indirect taxes and fees,” as he put it in a letter to his state’s junior Senator.

So in addition to abortion restrictions, Mr. Nelson won the concession that Congress will pay for 100% of Nebraska Medicaid expansions into perpetuity. His capitulation ought to cost him his political career, but more to the point, what about the other states that don’t have a Senator who’s the 60th vote for ObamaCare?

***

“After a nearly century-long struggle we are on the cusp of making health-care reform a reality in the United States of America,” Mr. Obama said on Saturday. He’s forced to claim the mandate of “history” because he can’t claim the mandate of voters. Some 51% of the public is now opposed, according to National Journal’s composite of all health polling. The more people know about ObamaCare, the more unpopular it becomes.

The tragedy is that Mr. Obama inherited a consensus that the health-care status quo needs serious reform, and a popular President might have crafted a durable compromise that blended the best ideas from both parties. A more honest and more thoughtful approach might have even done some good. But as Mr. Obama suggested, the Democratic old guard sees this plan as the culmination of 20th-century liberalism.

So instead we have this vast expansion of federal control. Never in our memory has so unpopular a bill been on the verge of passing Congress, never has social and economic legislation of this magnitude been forced through on a purely partisan vote, and never has a party exhibited more sheer political willfulness that is reckless even for Washington or had more warning about the consequences of its actions.

These 60 Democrats are creating a future of epic increases in spending, taxes and command-and-control regulation, in which bureaucracy trumps innovation and transfer payments are more important than private investment and individual decisions. In short, the Obama Democrats have chosen change nobody believes in—outside of themselves—and when it passes America will be paying for it for decades to come.

Read the original article on WSJ

Harry Reid scrambles as deadline looms

By CARRIE BUDOFF BROWN & MEREDITH SHINER

Senate Majority Leader Harry Reid led a marathon negotiating session Friday with Sen. Ben Nelson (D-Neb.) in a hectic bid to persuade the last holdout to sign onto the health care reform bill ahead of a key deadline Saturday morning.

 Nelson was huddling into the evening with Reid, Sen. Chuck Schumer (D-N.Y.) and a circle of top White House officials that included deputy chief of staff Jim Messina and senior adviser Pete Rouse. Nelson was seeking stronger language to prohibit federal financing of abortions and additional relief for his state from future Medicaid funding obligations.

At 8 p.m., Nelson left a meeting in Reid’s office, telling reporters, “There’s no deal.”

 Three hours earlier Nelson had hinted at progress “if for no other reason than you understand each other’s position a little better.”

 Despite the ticking clock for the Democratic leadership, Nelson said he wasn’t operating on a deadline.

 “Harry has some time frames he is thinking about,” Nelson said. “But I don’t have a deadline. To me, you have to get it right.”

 No announcement was expected Friday night, Schumer said, because the Congressional Budget Office would first need to return a cost estimate on any potential deal.

 “All the pieces are beginning to fall into place,” Schumer said. “But we’ve still got a ways to go.”

 As a result, the outcome of President Barack Obama’s chief domestic priority was a cliffhanger. Democrats left the Capitol without knowing whether Reid would reach a deal overnight and present it to them when they returned at 7:30 a.m. Saturday for a vote on the Defense Department appropriations bill.

 Reid needs to get a deal in place by the morning so he can begin the procedural steps necessary to pass the health care bill by Christmas Eve. Immediately following the vote on the DOD bill, Reid is expected to introduce the health care compromise language as part of a “managers’ amendment.” Senate Republicans are then expected to ask for a full reading of the amendment, which could take several hours, depending on its length.

 Reid needs the reading to end by 11:59 p.m. Saturday. This is because Reid needs at least one day, which would be Sunday, between when he moves to end the debate on the amendment and when the Senate votes early Monday morning.

 Nelson may not signal his support for the deal publicly. But Senate Democratic aides say if Reid introduces the amendment Saturday, he has been reasonably assured that he has 60 votes to break a series of Republican filibusters next week. There is a chance Reid could still move ahead without private assurances, but that is widely considered a very high-risk strategy.

 By the evening, the negotiations had moved to an anteroom in Reid’s suite of offices on the second floor of the Capitol. Rows of bottled water were stacked on the coffee table, which was surrounded by antique sofas, where the senators and aides worked through Nelson’s lists of concerns.

“He’s not for major apple cart changes,” Schumer said. “He’s just for specific things that have to be talked through.”

 For the second night in a row, Nelson said he was preparing for a late night.

 “As long as it takes and/or as long as it is productive,” he said.

Read the original article @ page2 on Politico.com

Dems Already Done In By Buyers’ Remorse?

Posted by Charles Cooper

Whenever the Republicans fear that the political gods are aligned against them, they can always find cheer in knowing that at least they are not the Democrats.

Over the weekend, the Democrats got the 60 votes they needed in order to move their health care proposal onto the floor of the United States Senate for debate. A lot of good it did them. The moment faded almost immediately after key blue dog Democrats ran to the microphones to oppose any bill carrying a public option provision. The only celebration going on within Democratic circles was limited to the ranks of Panglossian optimists and congenital spinmeisters (often, one and the same.)
But this is shaping up to be a lot less than advertised. No less a party personage than the Democratic National Convention chairman Howard Dean spent Monday giving voice to the growing concern shared by Democratic activists about the way this story is unfolding. Speaking with the Huffington Post, Dean said that health care reform was in “deep trouble” and that Senate Majority Leader Harry Reid likely would need a miracle to win the day.

“I didn’t anticipate being in this position. I thought it would pass. Maybe Harry has some magic up his sleeve. But I don’t see how he gets those four votes [Sens. Joseph Lieberman (Conn.), Mary Landrieu (La.), Blanche Lincoln (Ark.) and Ben Nelson (Neb.)] without compromising the bill.” Check out his on-air interview with MSNBC’s Dylan Ratigan, where he offered a blunt critique of his fellow Democrats.

This rates as quite the memorable moment. Even with their commanding numerical lead in Congress, the Democrats still can’t summon the necessary party discipline to pass their political agenda. Remarkably, the few Senate holdouts – or at least those playing hard-to-get – are showing the rest of Washington D.C. how the game ought be played. Louisiana’s Mary Landrieu played her cards beautifully in gouging the administration for an extra $100 million for her state – and this just to get Landrieu’s vote to proceed with the debate. No telling how much of a bribe she’ll demand for Louisiana in order to get her to support something that even remotely resembles the health bill that Mr. Obama wants.

Watching the negotiations between the sides. Washington Monthly’s Steve Benen had it right when he wrote that “Lieberman, Nelson, & Co. don’t much care if this once-in-a-generation opportunity implodes, while reform advocates care very much. These rather obvious bargaining positions create a playing field that is anything but level.”

The liberal-left wing of the Democratic Party’s been down this road before – recalling Democratic support to authorize the use of force against Iraq – and they’re afraid of another double cross. In this case, they fear that the leadership will trade away too much in order to win enough votes for passage. (Dean warned as much in his MSNBC appearance, suggesting that conservative Democrats opposing the public option are trying to turn the bill into a “hodgepodge of nonsense.”)

And here’s the danger for the party leadership: If the legislation bears little resemblance to the lofty promise articulated in President Obama’s address to Congress last February, there’s real risk that Democratic activists will sit on their hands in 2010.

If that’s the case, maybe half a loaf is worse than nothing at all.

Read the original article on CBSBlog

What to watch for in today’s debate

By CHRIS FRATES

Nancy Pelosi did it. Can Harry Reid?

Two Saturdays ago, Pelosi passed health reform on a squeaker of a House vote. Today, Reid can’t spare a single Democrat as the Senate decides whether to start debate. If not, President Barack Obama’s reform hopes suffer immeasurable harm.

 That said, things were looking good at daybreak, as Reid can be reasonably confident of 59 votes, with Sen. Ben Nelson (D-Neb.) a yes vote and Sen. Mary Landrieu (D-La.) leaning yes. The holdout: Sen. Blanche Lincoln (D-Ark.), who has been a fan of reform generally but faces a tough 2010 re-election fight.

In theory, Reid’s job should actually be easier than Pelosi’s. The House voted on final passage. Reid is just asking the Senate to begin debate. But the vote is more than that – it’s a test lab for the ideas, arguments and battle tactics that both sides will carry into an epic showdown over health reform next month.

 The debate runs all day with the vote scheduled for 8 p.m. To cut through all the speechifying and straight to what matters, POLITICO offers these things to watch.

 Harry Reid’s three-step.

 The Patient Protection and Affordable Care Act is now a fully owned subsidiary of the Senate Majority Leader’s office and its fate and the political fortunes of its author are intimately intertwined. Reid needs to deliver reform.

 “His entire political future is predicated on a campaign that ‘I get things done and I can get things done for this nation and Nevada,’” said Nevada political analyst and columnist Jon Ralston. “It really undermines that campaign if he can’t get it done.”

 Reid’s decision to include a public insurance option was largely viewed as a political move to satisfy the labor unions and progressive activists he’ll need to campaign for him when he runs for re-election next year. That’s Harry Reid, the endangered Senate candidate.

 But Reid comes to the chamber in two other roles. As Senate ringmaster, he’s trying to keep his diverse constituency safe and away from too-tough votes. But as White House point man, he’s trying to deliver Obama-style reform, on an Obama-style schedule, before the end of the year.

 Those roles can conflict on the Senate floor. Already, the White House has signaled a preference for the “trigger” on a public option but Reid picked the plan with a state opt-out, arguably a more liberal version that could cause him trouble with moderates.

 Listening to Lincoln

 Look for Lincoln, Landrieu, Nelson and fellow centrists to go to great lengths to explain how their vote is not a vote for reform, but simply an OK to talk about reform.

 “If you don’t like the bill, then why would you block your own opportunity to amend it?” Nelson said earlier this week.

 Aside from the obligatory nods to small-d democracy, the real clue to Harry Reid’s future headaches is what else they say. Expect to hear Nelson’s concerns about federal funding for abortions, Sen. Joe Lieberman’s stiff opposition to a public insurance plan and Landrieu’s worries about how the plan will affect small businesses.

 Already, Lieberman and Nelson have said they’ll join Republicans in blocking the bill if their concerns aren’t met. Watch to see if any other moderates go that far Saturday.

 And listen for how forcefully the centrists make their demands. Landrieu spoke up and got an extra $100 million in Medicaid funding sent to Louisiana.

 But what will Lincoln say? She’s been cagey for months and has tried to calibrate her remarks – particularly on the public option – to avoid upsetting either side of the debate. Today’s her day to speak up and lay down the must-haves – part of the maze of moderate demands Reid must navigate before he can pass a bill.

 The future Republican TV ads

 In many ways, Saturday’s vote is the real kickoff to Campaign 2010 for the Senate. Republicans will begin sharpening their attacks into what will become familiar refrains over the next year should reform pass.

Read the rest of the article on page 2 Politico