Looking For A Reason

by digby

Lindsay Beyerstein gives us a nice overview of the state of the health care debate going into conference. She highlights some of the areas which are likely to be subject to improvement or further compromise, but pointedly notes Mark Schmitt’s essay on which he cautions, “everything will have to be cleared with the 59th and 60th most liberal senators.” Same as it ever was.

I am wondering, however, whether even the tiniest deviation from the Senate bill will peel off of Ben Nelson. He is under tremendous pressure from the right and I wouldn’t be surprised if he finds a way to back out. The Nebraska sweetheart deal embarrassed him, the Governor abandoned him and the anti-choice zealots are squeezing him just because they can. And Nebraska is the home of Mutual of Omaha (and other big insurance concerns.) He may very well be looking for a way out.

It’s possible that the Democrats will be able to finesse this. Nelson obviously doesn’t want to face his Democratic colleagues and tell them that he’s voting no after they did their big Mission Accomplished victory lap. But I would also guess that the party blithely allowing Lieberman to stab everyone in the back for whatever petty reason he pleases has not gone unnoticed. Nelson has no reason to fear that he would lose anything tangible if he bails. (Lieberman either, for that matter.) And the way the Democrats look at these things, I’m not sure they wouldn’t value keeping a 60th Senator in the “D” column over passing health care reform. Why that magic number would mean anything at all at that point is questionable, but I doubt that would sway them.

Nelson doesn’t personally care if health care reform is passed. But he’s being blamed for passing it by his conservative constituents and the national Republicans. We’ll see if he can hold the line, but I wouldn’t be at all surprised to see him find some technicality at the last minute. And if he bails, there’s good reason to think Lieberman or Lincoln or some of the others might do the same.

As for the Democrats, the one thing we can all rally around in this Rube Goldberg contraption of a bill is the Medicaid expansion. Unfortunately, it’s also at the center of this Nelson problem and is being challenged by big Blue State Governors, Schwarzenneger and Paterson, as well. They say they can’t afford it and Nelson claims he stuck in the sweetheart deal in order to pave the way for all states to demand 100% funding of medicaid. Now, I think we liberals can all agree that would actually be ducky, since some states are barely willing to pitch in as it is, even if people are dying in a gutter, and federalizing medicaid completely would standardize health care for the poor across the country. It would be great if that’s where it led.

Except there’s one tiny little problem. The deficit vultures are nearing a state of shrieking hysteria already about federal spending and Obama’s most enduring principle in all this has been that it be deficit neutral. There is no way that the congress can expand Medicaid entirely on the federal budget’s dime. It’s possible that they can hold off this problem for another day and squeeze it through on this bill. But the funding issue is going to return again and again. It’s one reason why I am so skeptical that this Medicaid expansion is going to hold. Poor people don’t vote much after all.

It’s unlikely that Nelson won’t end up voting for the reforms. But this threat from the right very effectively tilts the playing field to the Senate bill because everyone knows that Nelson must be desperate to find a good reason to back off. They are going to be very nervous about making any changes with which he can possibly find fault. And that, unfortunately, means no changes at all.

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