Karl Rove Demurs And Bemoans "The Real Price Of The Senate Health Bill".
The Real Price of the Senate Health Bill
Pushing health-care reform through the Senate will hurt Democrats.
By KARL ROVE
By now Majority Leader Harry Reid's explanation for how he is getting his health-care bill through the Senate has pinged its way across the country. "I don't know if there is a senator that doesn't have something in this bill that was important to them," he said this week. "And if they don't have something in it important to them, then it doesn't speak well of them." But take these comments two steps further and it becomes clear that how Mr. Reid reached unanimity in his caucus could hurt Democrats more than they realize.
First, taking Mr. Reid at his word means every Democratic senator got something. That implies there are even more howlers to discover that will dog Democrats next year.
After all, we now know Florida Sen. Bill Nelson got $3.5 billion to pay for seniors in his state to keep their Medicare Advantage policies when seniors in other states will be forced out of theirs. This wasn't a late add. It was just missed in the opaque language of the original Senate bill.
Second, any Democrat who assumes that it's OK to pass a bad bill because it includes a good deal for them is missing a larger dynamic of the Senate. When costs balloon, as they will, Congress will have to revisit health care. When it does, it will have little incentive to cut deals with individual senators when the public is clamoring about costs and there is no need to scramble for every vote.
Ah, a beam of light! And one that reveals the problem with getting short-term benefits for a state in exchange for long-term costs for the nation.
Consider that, thanks to senators from each state, Vermont gets $600 million for its Medicaid program and Massachusetts $500 million. But for the former the money runs out in six years and for the latter in just three.
Ben Nelson also won an exemption from the tax being levied on other Medigap insurance providers for Mutual of Omaha. There's also the "Nebraska-Michigan Compromise" in which Blue Cross/Blue Shield companies in both states get a carve-out on the insurance tax while the rest of the country's Blues get socked with it. How long that lasts may depend on how honest Democrats were in estimating costs. The pricier their bill is, the more likely this deal is upended.
There are two deals that won't be going away any time soon. One comes from Sens. Max Baucus and Jon Tester and extends Medicare to anyone exposed to a health hazard subject to a federal emergency declaration as of June 17, 2009. That would be people who live near the Libby, Mont., superfund site. Even a revenue-hungry Congress will find repealing that unpalatable. This provision involves a small number of people, but giving out special Medicare coverage is a dangerous precedent.
The other deal exempts insurance policies provided to longshoremen from the 40% excise tax slapped on "Cadillac" health-care plans. Unless the influence of the longshoremen's union wanes, this perk is about as permanent as you'll find in politics.
This is a partial list, but what we'll get for it all is rationed care and exploding deficits. Taxes start going up now, Medicare cuts begin after next fall's election, and spending for subsidies commences in five years. The price tag is not the first decade's announced $871 billion cost: It is $2.4 trillion. That's the cost of the tax credits in insurance exchanges, and the additional Medicaid costs the reform generates, over the first 10 years it's fully up and running, according to Congressional Budget Office numbers compiled by Republicans on the Senate Finance Committee.
Mr. Reid greased a Christmas Eve Senate passage of his bill, but he did so in a way that taints the product. It will hinder the Obama administration's efforts to fashion a House-Senate conference bill, as well as that 40-year majority Democrats once thought was within their grasp.
Mr. Rove, the former senior adviser and deputy chief of staff to President George W. Bush, is the author of the forthcoming book "Courage and Consequence" (Threshold Editions).
Pushing health-care reform through the Senate will hurt Democrats.
By KARL ROVE
By now Majority Leader Harry Reid's explanation for how he is getting his health-care bill through the Senate has pinged its way across the country. "I don't know if there is a senator that doesn't have something in this bill that was important to them," he said this week. "And if they don't have something in it important to them, then it doesn't speak well of them." But take these comments two steps further and it becomes clear that how Mr. Reid reached unanimity in his caucus could hurt Democrats more than they realize.
First, taking Mr. Reid at his word means every Democratic senator got something. That implies there are even more howlers to discover that will dog Democrats next year.
After all, we now know Florida Sen. Bill Nelson got $3.5 billion to pay for seniors in his state to keep their Medicare Advantage policies when seniors in other states will be forced out of theirs. This wasn't a late add. It was just missed in the opaque language of the original Senate bill.
Second, any Democrat who assumes that it's OK to pass a bad bill because it includes a good deal for them is missing a larger dynamic of the Senate. When costs balloon, as they will, Congress will have to revisit health care. When it does, it will have little incentive to cut deals with individual senators when the public is clamoring about costs and there is no need to scramble for every vote.
Ah, a beam of light! And one that reveals the problem with getting short-term benefits for a state in exchange for long-term costs for the nation.
Consider that, thanks to senators from each state, Vermont gets $600 million for its Medicaid program and Massachusetts $500 million. But for the former the money runs out in six years and for the latter in just three.
Ben Nelson also won an exemption from the tax being levied on other Medigap insurance providers for Mutual of Omaha. There's also the "Nebraska-Michigan Compromise" in which Blue Cross/Blue Shield companies in both states get a carve-out on the insurance tax while the rest of the country's Blues get socked with it. How long that lasts may depend on how honest Democrats were in estimating costs. The pricier their bill is, the more likely this deal is upended.
There are two deals that won't be going away any time soon. One comes from Sens. Max Baucus and Jon Tester and extends Medicare to anyone exposed to a health hazard subject to a federal emergency declaration as of June 17, 2009. That would be people who live near the Libby, Mont., superfund site. Even a revenue-hungry Congress will find repealing that unpalatable. This provision involves a small number of people, but giving out special Medicare coverage is a dangerous precedent.
The other deal exempts insurance policies provided to longshoremen from the 40% excise tax slapped on "Cadillac" health-care plans. Unless the influence of the longshoremen's union wanes, this perk is about as permanent as you'll find in politics.
This is a partial list, but what we'll get for it all is rationed care and exploding deficits. Taxes start going up now, Medicare cuts begin after next fall's election, and spending for subsidies commences in five years. The price tag is not the first decade's announced $871 billion cost: It is $2.4 trillion. That's the cost of the tax credits in insurance exchanges, and the additional Medicaid costs the reform generates, over the first 10 years it's fully up and running, according to Congressional Budget Office numbers compiled by Republicans on the Senate Finance Committee.
Mr. Reid greased a Christmas Eve Senate passage of his bill, but he did so in a way that taints the product. It will hinder the Obama administration's efforts to fashion a House-Senate conference bill, as well as that 40-year majority Democrats once thought was within their grasp.
Mr. Rove, the former senior adviser and deputy chief of staff to President George W. Bush, is the author of the forthcoming book "Courage and Consequence" (Threshold Editions).
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