KHN Morning Briefing

Summaries of health policy coverage from major news organizations

How The Senate Health Reform Deal Happened

A number of news outlets deconstructed the activity before Senate Democrats achieved the 60th vote for their health reform bill.

The Washington Post: "The Democrats wouldn't even sit in the same room. At one end of the majority leader's office, Ben Nelson (D-Neb.), the antiabortion senator whose support was crucial to health-care legislation, huddled with White House staff in a conference room. At the other end, Sens. Barbara Boxer (D-Calif.) and Patty Murray (D-Wash.), the chamber's leading advocates of abortion rights, hunkered as far from Nelson as possible, in the office of Reid's chief of staff."

"Shuttling between the two parties Friday afternoon and evening were Majority Leader Harry M. Reid (D-Nev.) and Sen. Charles E. Schumer (D-N.Y.)."

"But by 10:30 p.m. Friday, a handshake deal sealed a hard-won compromise over abortion. Within minutes senators were on the phone with Obama ... 'We did it, Mr. President,' Reid told Obama" (Kane, 12/20).

Politico reports that Nelson "excused himself for a tense phone call with a Nebraska anti-abortion activist. But what was supposed to be a short break in the negotiations Friday night turned into a 90-minute nail-biter. ... Schumer milled around Reid's office, popping Christmas cookies and fudge. Reid slumped in his chair. Two top administration aides raced back to the White House screening room to catch part of the Montana-Villanova football game, but had returned to the Capitol, where they were now waiting with a pair of nervous Democratic leaders. Soon enough, Nelson walked through the doors. 'We can live with this,' he announced to the group" (Budoff Brown, 12/20).

CongressDaily: "The abortion language allows states to elect to prohibit abortion coverage in the exchanges and requires those plans that offer abortion coverage to collect separate checks from enrollees to ensure federal subsidies are not used to cover the procedure. Reid also gave Nelson a sweetener, directing the federal government to pick up the entire cost of the Medicaid expansion in Nebraska."

"After reaching the agreement with Nelson, Reid won a raucous ovation from Senate Democrats as he rose to address them in a special meeting Saturday. ... Reid cinched the deal with Nelson just days after some observers claimed the effort was near collapse" (Edney and Friedman, 12/20).

Roll Call: "Democrats said the turning point came during a Tuesday afternoon meeting at the White House. President Barack Obama had called the meeting after Sen. Joe Lieberman (ID-Conn.) threatened to torpedo the health care bill over its expansion of Medicare. ... But then Sen. Evan Bayh (D-Ind.) - a moderate and an initial holdout on the health care measure - gave what many described as a rousing speech, arguing that Democrats could not afford to let the reform effort collapse in the face of Republican attacks. One Senate Democratic aide said Bayh made clear that 'if we don't [pass a bill] the only ones who win are Republicans, and [Bayh] doesn't want to see that happen.' Bayh's speech seemed to crystallize the situation for Democrats and helped them refocus their energy away from intraparty disputes and onto the GOP and Minority Leader Mitch McConnell (R-Ky.)" (Stanton, 12/21).


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