Wednesday, November 12, 2008
Baucus Green Lights Health Care Reform
Written by Matthew Locke at 4:00 PM
When it comes to President-elect Barack Obama's plans to overhaul American health care, Montana Democrat Max Baucus holds the keys to the castle. Baucus's position as Chair of the powerful Senate Finance Committee gives him power to mold any such legislation and debate that comes before the Upper House.
This has made some reformers nervous. Baucus is a heterodox Democrat, a low-key wheeler-dealer fluent in the long-forgotten art of bipartisan compromise. This is an essential quality on a committee upon which the very functioning of the federal government depends: charged with disbursing funds, if the Finance Committee fails to forge consensus or pass legislation seniors might stop receiving their Social Security cheques. It does not, however, make for many friends in progressive circles (or the Democratic leadership). Ezra Klein's detailed profile of Baucus outlines some occasions on which he's bucked Dem party lines -- supporting Bush's first round of tax cuts, pushing for repeal of the estate tax, supporting the bankruptcy bill, and negotiating with Republicans on the Medicare expansion, among others.
But Baucus also successfully led the charge against Social Security privatization. He fought a proposed reduction in Medicare physician reimbursement. This summer he suggested a willingness to hustle health care reform through the budget reconciliation process, thus limiting debate and calling for a straight up-and-down majority vote.
And now he might be the Democrats' best hope -- and greatest champion -- for comprehensive health care reform.
In his profile, Klein paints a portrait of a politically complex man. Baucus emerged in an era of Montana progressivism, rode out decades of Republican ascendancy in his state, and now seems to be moving back to the left as Democrats expand their foothold in the mountain west and their control in Washington. His relationship with Senate Majority Leader Harry Reid is a close one, and he has ties to President-elect Obama as well. (Obama's campaign chief of staff came out of Baucus's office.) For some time Baucus has emphasized the need for health care reform.
And this morning he released a draft plan that's even more ambitious than Obama's. Baucus's plan, like Hillary Clinton's in the Democratic primaries, would mandate universal coverage, whereas Obama's proposal includes mandates only for children. (Beyond that, obtaining health insurance would be voluntary.)"My door is open and I seek partners with 'can do' spirits and open minds," Mr. Baucus wrote in an introduction to his 89-page plan. "I believe -- very strongly -- that every American has a right to high-quality health care...and I believe Americans cannot wait any longer."
Ben Smith points out that Obama planned to approach health care incrementally, making do with an increased State Children's Health Insurance Program or some similar measure until major action was taken on the economy. And Obama's transition team has responded gingerly to Baucus's proposal:"President-elect Obama applauds Chairman Baucus’s work to draw attention to the challenges of the health system and looks forward to working closely with the Chairman and other Congressional leaders, as well as the American public, to make quality, affordable health care a reality for all Americans."
Obama is a deliberative consensus-builder who tends to take time making decisions, so it's not surprising that he hasn't taken a stronger stand. Nevertheless, Baucus's public backing now makes swifter and more comprehensive action on health care likely.
I can't overemphasize the importance of this to health care reform. One of President Clinton's major stumbling blocks -- and a symptom of his strained relationship with Congress -- was the opposition of Democratic Senator Daniel Patrick Moynihan, who held Baucus's position at the time, to Clinton's doomed 1994 initiative. However, Obama's time spent in the Senate, his long coat-tails (which helped plenty of centrist Senators win or maintain their seats), and his selection of Rahm Emanuel for Chief of Staff all point to a stronger working relationship with Democrats in the Senate. The emerging Democratic consensus on health care, now under Baucus's leadership and made tangible with his plan, clears the way for a White House initiative.
Baucus's bipartisan tendencies and close working relationship with Finance's ranking Republican, Chuck Grassley, also bode well. The health care reform that emerges after months of intra- and inter-party wrangling and compromise between both legislative bodies will be far different from the 89-page document Baucus put forward today. And it might not be possible to move it through budget reconciliation and an up-and-down vote. But the chance of sweeping changes being hammered out and given the imprimatur of the Senate Finance Committee is now pretty strong, and there's an increased possibility it will pass even the Senate's sixty-vote margin.
This is an exciting opportunity for the incoming administration. More important, however, is the relief this could bring to the millions of Americans who lack adequate health insurance (or any insurance at all).
Photo provided under a CC license by Holley St. Germain
