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Why the Senate Finance Committee vote mattered

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"The Senate Finance Committee vote was a relatively small procedural hurdle in itself -- despite all the hoopla," writes Josh Marshall. I see where he's coming from, but I'm not sure that's actually correct. In my reporting, nothing has done as much to transform the momentum of the issue as the Senate Finance Committee's vote. Rightly or wrongly, it convinced many that health-care reform was more of an inevitability than a possibility -- and this after August, when many had begun to write its obituary.

Two factors accounted for most of this optimism: the Senate Finance Committee faced the hardest issues. And it faced (some of) the hardest senators.

The HELP Committee, which is the other committee in the Senate that handles health care, doesn't have jurisdiction over Medicare, Medicaid or taxes. If health-care reform didn't have to mess with Medicare, and didn't have to annoy the states with Medicaid reforms, and didn't have to raise any taxes, it would be a whole lot easier. The fact that the Senate Finance Committee was able to report out a bill that did all three was a larger achievement: If you couldn't achieve enough consensus to solve those issues in committee, where you'd simply need a majority of the votes, you couldn't do health-care reform.

The impact was magnified, though, because the composition of the Finance Committee is not friendly to grand social policy schemes. The committee includes Kent Conrad, Blanche Lincoln, Tom Carper and Bill Nelson. The committee is led by Max Baucus. When you're doing something like health-care reform, these aren't the votes you rely on. These are the votes you worry about. The fact that Finance was not only able to secure universal Democratic support for its bill, but also attract Olympia Snowe, was evidence of something that many in Washington simply did not believe: This is doable. Democrats could hang together, and even pick off the occasional Republican.

Less symbolically, in featuring a lot of the same actors that worry people in the final vote, the Finance Committee vote did more than demonstrate that health-care reform could clear their concerns: it bought them into the project. The result was that health-care reform moves forward with some key moderates attached. So long as the Finance Committee members stick close to the bill, it will be hard for Ben Nelson or Evan Bayh to blow up the negotiations at the last minute. It's not credible to claim that legislation supported by Conrad, Snowe, Carper and Lincoln is somehow overly liberal.

Photo credit: Marvin Joseph -- The Washington Post.

By Ezra Klein  |  October 19, 2009; 2:00 PM ET
Categories:  Health Reform  
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Comments

It also says that if the final Senate bill doesn't change too drastically from what the Finance Committee voted for, then any Senator who voted for the SFC bill (all the Dems, plus Snowe) wouldn't have a decent argument for filibustering it.

Which is why a quick summary of what was, and what wasn't, in the bill that the Finance Committee voted for would be really useful for those of us in the cheap seats. Got a linky to one, Ezra?

Posted by: rt42 | October 19, 2009 2:24 PM | Report abuse

I don't agree that Bayh or Nelson or Blanche Lincoln or the Conservadems on the finance committee itself won't try to blow up HCR when it includes features from the HELP committee or when it comes back from conference blended with the more liberal (read sane) version from the House. If the final bill sticks close to the Finance committee bill with no public option and miserly subsidies and an individual mandate, then it will be the progressives that will blow it up because it doesn't provide people with a choice of a public option if care is mandated. This is a bottom line requirement for the bill to get through the House. Splitting the difference here will not work.

Posted by: srw3 | October 19, 2009 2:31 PM | Report abuse

Oh fer crying out loud, the Baucus bill didn't include a public option, a huge piece of the puzzle in driving down long-term health care costs. And Big Pharma got a huge sweet deal. Instead of focusing on affordability for the middle class, the Baucus bill is concerned with enrolling more Americans in a broken, pricey system, essentially putting the cart before the horse.

If you want to call that a 'victory', you sure can Ezra.

Posted by: jasonr3 | October 19, 2009 2:34 PM | Report abuse

srw3,

Will the progressives be explaning to those with pre-existing conditions why they sold them a bill of goods and wasted years for holding out hope for a public option?

Will we hear a teary-eyed speeches from Keith Olbermann on the subject?? I expect the progressives to apologize AND EXPLAIN to every single person out there with a pre-existing condition exactly why they sold them out.

Maybe they can re-hash what Dems said back in the 70's when the Nixon/Kennedy healthcare plan stalled.

Posted by: visionbrkr | October 19, 2009 2:52 PM | Report abuse

It was a fatal error for the White House not to recognize the public option as the touchstone for reform. They now find themselves a few steps from the finish with no way to get over the line.

The WH was too focused on the inside game and not on how a mandate to buy crummy private insurance would play with the public. Even if Congress waives the penalties for everybody at first--which they probably will--I don't see how they get past 71% opposition without the public option.

Posted by: bmull | October 19, 2009 3:10 PM | Report abuse

visionbrkr, who is going to explain to those who are fined for not having insurance why it is that they have to subsidize profits for large insurance companies, their mostly very wealthy shareholders and obscene pay packages for senior executives, that have routinely practiced the 3 d's (delay, defer, deny) on claims for the last 40 years? Hey, pass preexisting conditions legislation as a separate bill and call it health insurance reform (it is very weak reform), but it is not health care reform. There is a lot of support for this provision so pass it as a separate bill. If I am mandated to buy insurance, I want to buy the best, cheapest plan out there, which would be medicare. I want the lowest administrative costs and 93% of my premium going toward paying claims, not to redundant corporate administration of plans that suck up 30% of my premium. I don't want to subsidize bean counters trying to deny care so that the CEO can buy another yacht.

Posted by: srw3 | October 19, 2009 3:23 PM | Report abuse

I hope you're right that the SFC vote has some symbolic significance which will aid in the ultimate passage of an acceptable bill, but:

1) The SFC bill is worse than the status quo - it further enriches the insurance companies and fails to provide even pre-existing condition and rescission protection for the self-employed.

2) The SFC bill, as written, would ultimately, and rightly, be considered a ripoff and a failure and the democrats would suffer electorally as a result.

3) The senators you're talking about are straight-up criminals - taking millions in supposedly legal bribes and providing mountains of legislative and rhetorical quid pro quo in return - in complete opposition to the positions, as polled, of the people of their states.

4) The entire system is broken - rotten from the head to the tail and the US will continue to be the laughing stock of the civilized world as long as we continue to be governed by any of the senators to whom you lend credibility with this column, when you should be exposing them for what they are.

Posted by: akmakm | October 19, 2009 3:36 PM | Report abuse

"If you want to call that a 'victory', you sure can Ezra."

Ezra's culinary training over the summer has been concentrated upon garnishing a Max Baucus turd sandwich.

Posted by: pseudonymousinnc | October 19, 2009 4:55 PM | Report abuse

No to the public option, no to cap and trade, no to more bail-outs, more debt, more printing and borrowing trillions.

When will the idiots in Congress figure out that the Countries economy is nose diving and we are bleeding jobs. Stop spending, borrowing and printing worthless dollars. The stimulus is a joke and now they are trying to pass more stimulus, only call it something else so people will not go berserk when they hear more of their hard earned money is being flushed down the crapper.

Run everyone of these Spendocrats out of office starting in 2010.

Posted by: Bubbette1 | October 19, 2009 5:34 PM | Report abuse

Today's WaPo poll underscores what those who are informed about the country have known for some time: that the vast majority of the nation wants a Public Option in this health care reform bill.

Criminally however, the Finance Committee is made up disproportionately of Senators representing insurance companies and states where the out-of-touch minority live.

What is the correct phrase to describe this situation? It certainly isn't "democracy". Perhaps, "taxation without representation"? Or at least "taxation with a bizarre, very skewed representation"? The insurance companies are represented on that committee, and the delusionally nuts right wing of the country is. But America isn't.

Shameful. And the rest of the world still laughs at the US. Last one on the developed block to get their backward minds around universal coverage.

Posted by: B2O2 | October 19, 2009 5:39 PM | Report abuse

or when it comes back from conference blended with the more liberal (read sane) version
Posted by: srw3 | October 19, 2009 2:31 PM
*********
Excuse me, but I am a liberal (or was) and you grossly flatter these individuals. Sane left town awhile ago for the far left.

Posted by: vickie105 | October 19, 2009 5:41 PM | Report abuse

I wish to be so clear even the Congress, the White House and yes that valiant 4th Estate can understand. Here it goes. Listen up!
The American people, and I am one of them, should have the exact same taxpayer funded health-dental plan(s), options and premium costs ($550 per YEAR) that all members of Congress and their families have. That includes the same alternative options and access to the military health system that members of congress have 24/7. Seem's simple enough to me. If it is good enough for Congress it is good enough for me. That's it.

Posted by: KBlit | October 19, 2009 5:55 PM | Report abuse

The reason why the Senate Finance Committee vote mattered is because its thinking appears to be the best representation of a number of centrist Democratic senators whose votes are needed to pass the bill. Many people still seem to have trouble getting the basic reality that you need a certain number of votes to get a bill enacted into law. There is always some room for surprises as the legislative process unfolds. But the limiting factor in getting a bill passed appears to be the votes of something like 10 Democratic Senators in the center of the political spectrum and the Finance Committee bill is the one closest to what they are willing to vote for.

Posted by: dnjake | October 19, 2009 6:06 PM | Report abuse

srw3,


do you mean that efficent Medicare that denies more claims than private insurers as well as takes longer to pay? The ONLY reason why Medicare or a public option would be cheaper is because it would FORCE prices lower to providers, not because its more efficent. Stop it already with the silly 30% talking points profit margins that we all know are nonsense that the left puts out.

Medicare fraud, waste and abuse >>>>>>>> insurers profits.


And you say fines? Who is being fined anything substantial? The poor will have a free pass and the fines are basically the cost of a cup of Dunkin Donuts coffee a day. (Not starbucks as they used to be, crappy DD coffee). Sorry that's not a fine. Its a paltry slap on the wrist so they can SAY they're all for personal responsibility. Get me to the MASS. level of those insured and then I'll be impressed. I don't expect it to ever get there sadly. 18-25 million still uninsured isn't the goal and shouldn't be the goal of an almost trillion dollar undertaking.

Posted by: visionbrkr | October 19, 2009 6:18 PM | Report abuse

vickie105, I stand corrected. Real sanity is not in the congress or at least in the bill the house passed.

visionbrkr the 30% is not only profits but administrivia, especially hordes of folks figuring out how NOT to pay claims. And administrative costs for medicare are significantly lower than private insurers, even without the profit skimming that insurance companies do. Please read more carefully.

Fines are fines. You may be able to afford coffee out every day but not everyone can. I don't want to be forced to buy insurance from for profit corporations that actively try to deny me care when I have a claim. What part of that don't you understand?

Posted by: srw3 | October 19, 2009 6:26 PM | Report abuse

Klein: "It's not credible to claim that legislation supported by Conrad, Snowe, Carper and Lincoln is somehow overly liberal."

It's also not credible to claim that it's health care reform.

Posted by: PeterPrinciple | October 19, 2009 6:33 PM | Report abuse

very clever peter principle

Posted by: srw3 | October 19, 2009 7:33 PM | Report abuse

Thank goodness all the Presidents on the Finance Committee voted out a bill. Without Presidents Baucus, Lincoln, Conrad, Carper, Nelson, and supreme President Snowe, we'd never have gotten so far. All god's Presidents got wings.

Posted by: NealB1 | October 19, 2009 10:25 PM | Report abuse

srw3,

you're brainwashed by the left. There are no HORDES of people looking to deny claims. THey do not exist. Its called utilization review and it helps keep fraudulent claims from being paid. Do some get denied that shouldn't be, absolutely but this is the ONLY thing that helps to rein in costs to make insurance somewhat affordable to the masses. If we required everything under the sun to be covered at the level that liberals want then NO ONE could afford it. Medicare could use some of this as they've just started to scratch the surface of the fraud, waste and abuse that's out there in Medicare. But again as I expect you have little to no training in this area so I'm not surprised. Your only training seems to be in liberal views of which you have in abundance.

Posted by: visionbrkr | October 20, 2009 10:26 AM | Report abuse

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