Health care bill this sweet can't really be lean
Skipping through the Candy Land of the health care bill, one is tempted to hum a few bars of "Let Me Call You Sweetheart." What a deal. For deal-makers, that is.
Not so much for American taxpayers, who have been misled into thinking the sweetheart deals have been excised. Not only are deals still there, but they're bigger and worser, as the bard gave us permission to say. And the health care "reform" bill is, consequently, more expensive by billions.
Yes, gone (sort of) is the so-called "Cornhusker kickback," extended to Nebraska Sen. Ben Nelson when his 60th vote needed coaxing. Meaning, Nelson is no longer special. Instead, everyone is. All states now get their own Cornhusker kickbacks. Nelson had secured 100 percent federal funding for Nebraska's Medicaid expansion - in perpetuity - among other hidden prizes to benefit locally based insurance companies. When other states complained, President Obama and Congress "fixed" it by increasing the federal share of Medicaid to all states through 2017.
Nelson's deal might have escaped largely unnoticed, if not for his pivotal role on the Senate vote last December. The value of what he originally negotiated for Nebraska - about $100 million - wasn't that much in the trillion-dollar scheme of things, but the cost of the "fix" runs in the tens of billions, according to a health lobbyist who crunched the numbers for me. Other sweetheart provisions remain.
Wearily, one might concede this is, well, politics as usual. But weren't we supposed to be finished with backroom deals? Whither the transparency of the Promised Land?
During the health care summit, Sen. John McCain had the audacity to raise the specter of deal-making, whereupon Obama reminded his former foe that the campaign was over. Which isn't exactly true, of course, but point taken.
The effort to push any health care bill through Congress is relentless, no matter how many Americans oppose it. All reasons are known and understood, at least politically. But taunting comprehension is how any member of Congress can view his reflection while carving out expensive deals instead of seeking every possible way to cut costs and reduce the likelihood of crippling taxes.
It's not as though any of this is free. To his credit, Obama conceded McCain's point in a post-summit letter to Congress, noting that some provisions had been added that shouldn't have been. His own proposal does not include the Medicare Advantage mentioned by McCain that allowed extra benefits for Florida, as well as other states.
More fair? Sure, but at mind-boggling cost to taxpayers. To correct a $100 million mistake, we'll spend tens of billions instead. Throughout the health care process, the Democrats' modus operandi has been to offer a smarmy deal and then, when caught, to double down rather than correct course. The proposed tax on "Cadillac" insurance policies to help defray costs is another case in point. Pushed by the president, and initially passed by the Senate, the tax was viewed as an effective way to bend the cost curve down. But then labor unions came knocking and everyone caved.
The tax will be postponed until 2018. And the cost of the union compromise? According to the Congressional Budget Office (CBO), the original Cadillac tax would have saved the Treasury $149 billion between 2013 and 2019. Under the postponed tax, the savings will likely plunge to just $65 billion, or a net loss to the Treasury of $84 billion.
Regardless of what the CBO reports in the coming days on the current legislation, no one can claim the bill is as lean as it could be. A spoonful of sugar may indeed help the medicine go down, but even King Kandy and the Gingerbread People can choke on too many sweets.
© 2010, Washington Post Writers Group