Watching Health Care Get Built

[babylonsister]

Watching Health Care Get Built

by BooMan
Wed Jul 15th, 2009 at 10:39:21 AM EST


For a good part of the day, yesterday, I had the option of watching the confirmation hearing of Sonia Sotomayer on CSPAN or the mark-up of America's Affordable Health Choices Act (AAHCA) in the Senate's Committee on Health, Education, Labor, and Pensions (HELP) on CSPAN2. I was somewhat surprised to discover that the HELP committee coverage was more interesting and less predictable than the coverage of the Senate Judiciary Committee.

To explain why, first let's take a look at the makeup of the HELP committee.



Sen. Chris Dodd has been chairing the committee in Teddy Kennedy's absence. Two things of note about this: as Dodd is Kennedy's best friend, we can be sure that he is faithfully executing Kennedy's wishes, and, as Dodd also chairs the Banking Committee, we owe him a debt of gratitude for performing double duty. There is a certain level of pathos involved in watching Dodd try to fulfill Kennedy's life-long dream of universal access to medical coverage while Kennedy struggles to survive an aggressive form of brain cancer. It adds an uncommon touch of drama to what is an otherwise dry congressional procedure.

The first surprise in watching this committee operate is the level of comity. Over the last two days the committee has discussed or dispositioned over two hundred amendments. After having the committee staff review them, the Democrats accepted over sixty Republican amendments without debate and by unanimous consent. In other words, the Republicans have worked hard to improve the bill and have made many constructive and well-thought out contributions. This is especially true of Tom Coburn, who is an obstetrician. As he does on the floor of the Senate, Coburn is in the habit of introducing a blizzard of amendments. But what might be less well understood is that Coburn's offerings are a mix of obstruction, poison pill, peeve, delay, and smart. It was not uncommon for Coburn to get unanimous support for his amendments, and he has clearly played a large role in writing a bill that he has absolutely no intention of voting for.

Yet, Coburn also introduced a dozen or more amendments seeking to prevent the public option from paying for any abortions. With Bob Casey voting with the Republicans in every case, these amendments were beaten by a 12-11 vote over and over again. But even the tedium of beating back so many vain attempts at restricting a women's right to reproductive care did not result in any testiness. Dodd (or, in his absence, Harkin) calmly explained their difference of opinion on the issue and held the votes.

As you watch the Republicans operate, an interesting dynamic comes into view. Part of their motivation for offering so many amendments is simple delay. They clearly hope to slow down the process to make it harder for the Democrats to complete the mark-up and have a vote before the August recess. That's why they offer ten or twelve amendments on the same issues (with only minor variations) that they know will not be accepted. Another category of amendments are intended to slip something by the Democrats that will undermine the intent and effectiveness of the bill. These amendments are usually caught by either Senator Jeff Bingman of New Mexico, Senator Sheldon Whitehouse of Rhode Island, or by chairman Dodd. Watching the proceedings, it quickly becomes obvious how critical it is to have some senators who have a holistic understanding of the health care system sitting in the room at all times. As senators are constantly moving in and out of the hearing room, some of what winds up in a bill is a matter of pure accident. Had Whitehouse or Bingaman been absent, several bad amendments may have passed simply because the other Democrats didn't understand the sleight of hand being offered by the Republicans.

Some senators are making only a cursory contribution. John McCain, Lamar Alexander, Pat Roberts, Patty Murray, and Johnny Isakson are almost never in the hearing room. Sen. Lisa Murkowski is offering a mix of poison and sincerity, and is also the only Republican to occasionally side with the Democrats on party-line votes. Sen. Judd Gregg provides a mix of budgetary knowledge and silly talking points. Ranking Member Enzi is prone to impotent bitching, but adds value here and there.

more...

http://www.boomantribune.com/story/2009/7/15/9482/84961