Tag Archives: senate

Every Vote Counts: “Buying” Health Care Legislation in the Senate

In my last post I discussed the politics underlying today’s vote to invoke cloture in order to bring health care to the Senate floor for debate. Because it appears that not a single Republican Senator is likely to support bringing health care to a vote, Democrats must retain all 60 members who caucus with them in today’s vote.

With the margin so small – even one Democratic defection can sink this legislation – individual Senators are in a tremendous position to leverage their vote to extract tangible benefits from the party leadership.  These are the “side payments” I talked about yesterday that can be used buy the votes of wavering Senators who might otherwise be ideologically opposed to health care reform.

And that is precisely what appears to have happened. Media reports suggest the following four Democrats have not yet committed to voting yes today to invoke cloture:

Sen. Ron Wyden, (OR)

Sen. Mary Landrieu (LA)

Sen. Blanche Lincoln(AR)

Sen. Joe Lieberman (CT)

Lincoln is one of the five Senators whose roll call voting record suggests they are located near the pivotal 60th position on the Senate’s ideological spectrum – pivotal because it requires 60 votes to invoke cloture and end a filibuster in that chamber. The other three are ideological moderates within the party, but sit closer to the median voter position within the Senate. All arein a particularly advantageous position to extract some reward for siding with the party leadership. And, (courtesy of ABC’s The Note), it appears that is what has happened.  Landrieu has previously expressed concern that the health care legislation may drive up Medicaid costs in her state. (Medicaid is a joint federal-state program that provides health insurance for low-income families and is a huge budget-buster already for many state budgets, particularly poorer states like Louisiana that have a greater proportion of low-income residents.)

Now turn to page 432 of the health care bill, which, according to The Note, spells out some of the conditions for a state to receive a boost infederal Medicaid subsidies.  The relevant language, tucked in the legislative jargon, is as follows:(2) In this subsection, the term ‘disaster-recovery FMAP adjustment State’ means a State that is one of the 50 States or the District of Columbia, for which, at any time during the preceding 7 fiscal years, the President has declared a major disaster under section 401 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act and determined as a result of such disaster that every county or parish in the State warrant individual and public assistance or public assistance from the Federal Government under such Act and for which …”

Hmmm…a state that underwent a major disaster in the past seven years.  Thinking….thinking….could it be Landrieu’s state of Louisiana? Evidently, yes; if the Note is to be believed, Louisiana is the only state that qualifies under this legislative language for a boost in federal Medicaid subsidies.  The cost of implementing this language?According to the Congressional Budget Office: $100 million.

Will that side payment be enough to win Landrieu’s vote?  We’ll know by this evening.

But it is a nice illustration of the power of the moderate middle in a highly polarized Congress to leverage uncertainty over their vote as a means for acquiring side payments.  Note that, even though every Senate Democrat’s  vote is crucial, not every Democrat is equally capable of extracting concessions from the party leadership.  To do so, a Senator’s threat to defect has to be credible, or else the party leadership will simply call the Senator’s bluff. Evidently Landrieu’s threat was deemed credible.

If I get a chance I’ll be on a bit later to discuss the likely voting patterns one more time.  The actual Senate vote doesn’t occur until this evening, but we should know before then how it is likely to play out.

CORRECTION:  I incorrectly listed Blanche Lincoln as representing Nebraska – as Midd Alumn points out, she’s representing Arkansas.  Thanks for the catch – I’ve corrected it above.