Sausage-making greases overhaul votes and fuels criticisms

Last-minute, multimillion-dollar deals with wavering Democrats helped secure the support of all 58 Democrats and 2 independents needed to pass the overhaul bill, but they may also set a new bar for future horse trading, Politico reports. Sen. Ben Nelson, D-Neb., "won a provision exempting his state from paying the usual share of costs for new Medicaid patients. The deal critics have dubbed the Cornhusker Kickback is expected to cost the federal government $100 million over 10 years." Sen. Mary Landrieu, D-La., got an extra $300 million for her state's Medicaid program. "After Nelson and Landrieu, what will key congressional swing votes want from future White Houses?" Politico asks. On government watchdog responds, "Sooner or later, other members are going to be saying: Why didn't I think of this?" (Gerstein, 12/22).

Of course, Nelson and Landrieu weren't the only senators to think of it this time around, either. The Associated Press/Boston Globe has a tally: Sen. Max Baucus, D-Mont., the Finance Committee chairman got help for people in Libby, Mont., who may have been exposed to asbestos; Sen. Chris Dodd, D-Conn., won $100 million for hospital construction; Bernie Sanders, I-Vt., scored $10 billion in extra funding for community health centers (12/22).

Dodd's hospital money isn't exactly an earmark, but is an example of many provisions that benefit "only a handful of states," CQ Politics reports. While Dodd may hope the money goes to the University of Connecticut, 11 other institutions around the country appear to fit the profile: Facilities affiliated with academic health centers that house the sole public dental and medical schools in their respective states. CQ reports, "The result is a bill that does not treat all areas of the country equally, something that Republicans loudly denounced — though they legislated in similar ways when they controlled Congress earlier this decade (12/21).

Roll Call reports that Senate Majority Leader Harry Reid, D-Nev., defended his legislation, saying, "Never have we been so close to reforming America's broken health insurance system. … That's what legislating is all about; it's the art of compromise" (Drucker, 12/21).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.