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Today in Health Care Reform

9:57 AM, Dec 21, 2009 • By MATTHEW CONTINETTI
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Early this morning, around 1 a.m., the Senate took a major step toward passing Harry Reid's roughly 2,400-page, $871 billion health care reform compromise. The strictly partisan vote was 60 to 40. Sen. Kennedy's widow Victoria looked on from the Senate gallery as the senators voted from their desks. The Senate should pass its version of health care reform by Christmas.

Lesson for the future: If you want to make major changes to the American welfare state, it helps to have 60 senators on your team.

It also helps when you're willing to make questionable side deals with senators to gain their support. Robert Pear:

Items were inserted into the bill by the Senate majority leader, Harry Reid, Democrat of Nevada, to get or keep the support of various lawmakers. He needs support from all 60 members of his caucus to overcome a Republican filibuster and pass the bill by his self-imposed Christmas deadline.

Senator Ben Nelson, Democrat of Nebraska, was the critical final Democrat to endorse the bill. He obtained tighter restrictions on insurance coverage of abortion, and additional Medicaid money and other benefits for his state.

Another item in the package would increase Medicare payments to hospitals and doctors in any state where at least 50 percent of the counties are "frontier counties," defined as those having a population density less than six people per square mile.

And which are the lucky states? The bill gives no clue. But the Congressional Budget Office has determined that Montana, North Dakota, South Dakota, Utah and Wyoming meet the criteria.

Another provision would give $100 million to an unnamed "health care facility" affiliated with an academic health center at a public research university in a state where there is only one public medical and dental school.

Senators and their aides said on Sunday that they were not sure who would qualify for this money or who had requested it.

A comprehensive list of the side-deals can be found here.

In his column today, Robert J. Samuelson has some pungent criticisms of Obamacare:

Even if Congress passes legislation -- a good bet -- the finished product will fall far short of Obama's extravagant promises. It will not cover everyone. It will not control costs. It will worsen the budget outlook. It will lead to higher taxes. It will disrupt how, or whether, companies provide insurance for their workers. As the real-life (as opposed to rhetorical) consequences unfold, they will rebut Obama's claim that he has "solved" the health care problem. His reputation will suffer.

And one of the more persuasive speeches against the Reid bill came from none other than Olympia Snowe:

This bill has taken a dramatically different direction since the Finance Committee bill - it is now 1,200 pages longer and includes a new employer mandate that could annihilate the job growth potential that is so vital to our economic recovery. As the Small Business & Entrepreneurship Council has stated, this mandate "will only burden firms with more costs and red tape which means they will not grow, invest, or create jobs."

This bill also creates the CLASS Act on long term care insurance, a brand new program which the Medicare Actuary has said is projected to go into the red just five years after it begins paying out benefits. And the legislation requires a $90 billion increase in Medicare payroll taxes - a provision that was not part of the bill I voted for in Finance Committee - that predominately affects the self-employed and the very same small business owners we are counting on to create new jobs and lead us out of this recession. And that's just to name a few of the vital issues.