I’m posting this mainly for my own future reference. It’s an article from July 2015 by Norm Ornstein recounting the passage of Obamacare. From time-to-time, a conservative friend will complain about how the plan was “jammed” through without trying to enlist Republicans. It’s baffling to me when I hear such things because my recollection is of (what seemed at the time) interminable delays as Democrats courted Republican votes in the Senate, and what seemed like Democrats bidding against themselves as Republicans complained about this or that but didn’t propose provisions or alterations that would cause them to vote for the plan.
The Ornstein account of the process squares with my recollection. This long account of the Senate Finance Committee process is what stuck with me and makes me look sideways at folks who say that the Democrats acted precipitously on health care and didn’t try to negotiate the healthcare plan.
But with Obama’s blessing, the Senate, through its Finance Committee, took a different tack, and became the fulcrum for a potential grand bargain on health reform. Chairman Max Baucus, in the spring of 2009, signaled his desire to find a bipartisan compromise, working especially closely with Grassley, his dear friend and Republican counterpart, who had been deeply involved in crafting the Republican alternative to Clintoncare. Baucus and Grassley convened an informal group of three Democrats and three Republicans on the committee, which became known as the “Gang of Six.” They covered the parties’ ideological bases; the other GOPers were conservative Mike Enzi of Wyoming and moderate Olympia Snowe of Maine, and the Democrats were liberal Jeff Bingaman of New Mexico and moderate Kent Conrad of North Dakota.
Baucus very deliberately started the talks with a template that was the core of the 1993-4 Republican plan, built around an individual mandate and exchanges with private insurers—much to the chagrin of many Democrats and liberals who wanted, if not a single-payer system, at least one with a public insurance option. Through the summer, the Gang of Six engaged in detailed discussions and negotiations to turn a template into a plan. But as the summer wore along, it became clear that something had changed; both Grassley and Enzi began to signal that participation in the talks—and their demands for changes in the evolving plan—would not translate into a bipartisan agreement.
What became clear before September, when the talks fell apart, is that Senate Republican Leader Mitch McConnell had warned both Grassley and Enzi that their futures in the Senate would be much dimmer if they moved toward a deal with the Democrats that would produce legislation to be signed by Barack Obama. They both listened to their leader. An early embrace by both of the framework turned to shrill anti-reform rhetoric by Grassley—talking, for example, about death panels that would kill grandma—and statements by Enzi that he was not going to sign on to a deal. The talks, nonetheless, continued into September, and the emerging plan was at least accepted in its first major test by the third Republican Gang member, Olympia Snowe (even if she later joined every one of her colleagues to vote against the plan on the floor of the Senate.)
Obama could have moved earlier to blow the whistle on the faux negotiations; he did not, as he held out hope that a plan that was fundamentally built on Republican ideas would still, in the end, garner at least some Republican support. He and Senate Democratic leaders held their fire even as Grassley and Enzi, in the negotiations, fought for some serious changes in a plan that neither would ever consider supporting in the end. If Obama had, as conventional wisdom holds, jammed health reform through at the earliest opportunity, there would have been votes in the Senate Finance Committee in June or July of 2009, as there were in the House. Instead, the votes came significantly later.
To be sure, the extended negotiations via the Gang of Six made a big difference in the ultimate success of the reform, but for other reasons. When Republicans like Hatch and Grassley began to write op-eds and trash the individual mandate, which they had earlier championed, as unconstitutional and abominable, it convinced conservative Democrats in the Senate that every honest effort to engage Republicans in the reform effort had been tried and cynically rebuffed. So when the crucial votes came in the Senate, in late December 2009, Harry Reid succeeded in the near-impossible feat of getting all 60 Democrats, from Socialist Bernie Sanders and liberal Barbara Boxer to conservatives Joe Lieberman, Ben Nelson, Mark Pryor, and Blanche Lincoln, to vote for cloture, to end the Republican filibuster, and to pass their version of the bill. All sixty were needed because every single Republican in the Senate voted against cloture and against the bill. Was this simply a matter of principle? The answer to that question was provided at a later point by Mitch McConnell, who made clear that the unified opposition was a ruthlessly pragmatic political tactic. He said, “It was absolutely critical that everybody be together because if the proponents of the bill were able to say it was bipartisan, it tended to convey to the public that this is O.K., they must have figured it out.”
Now the Republican Congress is in a difficult position if they want to govern. They’ve made so much hay out of the evils of Obamacare and the need to replace it, that they probably feel like they have to do it. There isn’t much of a plan to “replace” it because Obamacare was what used to be the Republican plan. (Democrats were more on the single-payer plan that seems to result in better health care results for less money spent in most other western countries.) Obamacare was derived from Romney care, implemented in Massachusetts and that was based on the Chafee / Grassley / Durenberger / Hatch Republican alternative to the Clinton plan of the early 90s.
Republicans behaviour towards ObamaCare is utterly disgraceful.
And I still am in awe of the red states who said no to the Medicaid expansion. Unbelievable.
Well, it looks like the dog finally caught the car. Now they have to do something besides yell “NO” at the top of their voices, but lo and behold, there is nothing in the box to replace what they don’t want. How many of us have known teenagers like this? On the other hand, the folks on the other side of the aisle can also say “NO”, but with the knowledge that they are suggesting options. With a demagogue as president and folks who like to shoot themselves in the foot, I suspect that this will not turn out well. One would think that 350 million people could find better people than this.
I appreciate the history on Obamacare – the need for healthcare reform was never a question for me at the time Obamacare was passed.
As a Republican, my beef was with HOW the PP&ACA passed. Greater than 2000 pages in a bill dropped off at end of business Friday for review and voted on at approx 0200 Sunday morning with a large portion of “how to apply” the spending of benefits as yet to be written.
I was and am ashamed of BOTH sides of the aisle. Spending money which didn’t exist on promises made for enormous costs not yet outlined was irresponsible. Posting last second regulations over the years that followed for hospitals to abide by in order to receive a portion of the governmental grants was also irresponsible. An end goal of national connectivity for Healthcare as the driving force being superimposed upon Healthcare as a service sector without actual specifications on what means should be deployed to meet the ends. It has become a recipe for failing rework and IT departments and administrators chasing the next dangled carrot like a herd of toddlers on a soccer fileld… Shouldn’t planning and efficiency be a factor in reform at some point?
All the while, a majority of the cost for the ACA is due to be paid by the taxpayers in the coming 2017.
I will be the first to call for much of Romneycare/Obamacare to stay. Likewise, much of it needs to be reevaluated and replaced.
The necessary reform is multifaceted and includes identifying and eliminating abuses, applying appropriate limits, and expecting recipients of care free-to-them to respond with value-added input to society.
President Obama signed the bill into Law with administrators from the American Nursing Association flanking him at the table… Administrators who noted it’s not perfect [because it was not yet written], but at least it is something. The fantastical “At least it is something” that the lawmakers will not subject themselves to utilize has a pretty hefty pricetag and not enough American revenue to pay for it.
it’s painfully apparent additional time to review the bill would not have changed one single vote. That’s a pretty thin complaint about the bill.
Meanwhile, repeal and replace is repeal and delay because the six years the Republicans have had to come up with a plan wasn’t enough.
I hope the Democrats let the Republicans go off the cliff on this one, but I wouldn’t hold my breath. I’m sure some of them will try to “help” the Republicans “fix” their plan.
Could you translate this to actionable English sans the buzz words, or did you just copy/paste it from whatever “plan” the Republicans supposedly have?
People are going to ask to keep their Obamacare as soon as they realize Trumpcare is a joke by comparison. It’s really easy to complain about how “bad” Obamacare is until you realize the alternative will cost a lot more and cover for a lot less.
Is that you Rush?
It’s long past time for you Republicans to either put up or shut up.
Where is the bill and when can we expect a vote. It’s been 7 years for God’s sake.
This is exactly how I remember it too. The “jammed it through” line always makes me wonder why, had the Democrats been bullies about it, don’t we have single payer or a public option?
This summary reminds me of how hateful Mitch McConnell is.
I think the Republican “leadership” is about to reveal to us just how fragmented the Republican majority is. Not a good time to show how unified the party is. If the Democrats stand back and “let it roll”, people will be surprised to see just how many positions there are on this matter and may begin to understand why it was so difficult for President Obama to negotiate with these people who appear to range from foaming-at-the-mouth reactionaries to sensible moderates. I suspect we are about to see just how dysfunctional and incompetent these people are, which is not such a good thing, considering that the recent Quinnipaic poll shows that 62% of the people surveyed believe that Donald Trump is not “level headed”, and 52% believe that he doesn’t care about the average American. Not a good start.