The Senate-approved health measure lawmakers hope to send to Obama soon would steer $600 million over the next decade to Vermont in added federal payments for Medicaid and nearly as much to Massachusetts.
Connecticut would get $100 million to build a hospital. About 800,000 Florida seniors could keep certain Medicare benefits. Asbestos-disease victims in tiny Libby, Mont., and some coal miners with black lung disease or their widows would get help, and there are prizes for Louisiana, the Dakotas and more states.
“We’re going to do what we have to do to get a bill out of the House and Senate,” said James Manley, spokesman for Senate Majority Leader Harry Reid, D-Nev. As for Obama’s wish list of deletions: “We’ll certainly keep it in mind as we pull together a final bill.”
That tepid salute underscores the prickliness with which many senators have greeted what they consider Obama’s meddling in their business and raises questions about how successful the president will be in erasing the special projects from final legislation.
It also highlights a spat between a White House and Senate, dominated by the same party, that the president has ignited just as he needs to garner support to finally push his No. 1 legislative goal to passage over monolithic Republican opposition and nervous Democrats.
Obama’s proposal to eliminate state-specific items comes with polls finding heightened public opposition to backroom political deals. Republicans have been happy to fan that discontent. Many Democrats, particularly House moderates facing tight re-election battles this fall, are eager to dissociate themselves from such spending.
The president wants votes from House Democrats “who were deeply offended by those provisions in the Senate bill,” said Sheryl Skolnick, who analyzes federal health legislation for CRT Capital Group of Stamford, Conn. “Clearly the math was, ‘I gain more in the House by taking out those provisions than I lose in the Senate.’”
Obama has railed against the “ugly process” of cutting special deals, but the president and his top advisers were prime players in negotiations on the agreements to win votes and push the legislation forward.
Republicans say Obama’s push to remove deals for states won’t help. Because every Democratic senator voted for that chamber’s bill and all its special provisions, even voting later to remove them leaves those Democrats in a pickle, Senate Minority Leader Mitch McConnell, R-Ky., told reporters Friday.
“They will have then voted for them before they voted against them,” McConnell said of the bill’s projects, an echo of the line that 2004 Democratic presidential nominee John Kerry uttered that proved politically damaging.
Obama came out with a summary last month of the nearly $1 trillion health overhaul legislation he wants. It specifically eliminates $100 million in extra Medicaid money the Senate bill provided solely to Nebraska to help win support from that state’s Democratic Sen. Ben Nelson. The so-called Cornhusker Kickback drew such widespread scorn that even Nelson favors repealing it.
Obama also proposed changes in the Senate bill that, without mentioning it, deleted extra Medicaid money for Massachusetts and Vermont, the Florida Medicare exemption and some money for Michigan, according to White House officials.
Days later, at Obama’s nationally televised meeting with bipartisan leaders on health care, his 2008 presidential rival, Sen. John McCain, R-Ariz., criticized the Senate bill for exempting 800,000 Florida seniors from cuts in the privately run Medicare Advantage program. Obama surprised him by agreeing, and that tone has carried over as the White House and top congressional Democrats labor to complete a compromise health package.
“We’ve made it clear to the Senate that the president’s position in the final legislation should not contain provisions that favor a single state or a single district differently than others,” White House spokesman Robert Gibbs said this week.
There are exceptions. The White House says $300 million for Louisiana, which helped win support from moderate Sen. Mary Landrieu, D-La., should survive because of that state’s struggle to rebound from its 2005 pummeling by Hurricane Katrina.
Even so, Obama’s targeting of state projects is going over poorly in the Senate.
Take Sen. Patrick Leahy, D-Vt., who helped win extra Medicaid money for his state in the Senate health bill.
Vermont is one of several states that have already boosted the benefits they provide to many poor people. All states would get added federal financing for a nationwide Medicaid expansion under the Senate bill. But states such as Vermont — already providing more generous benefits — say they’re being shortchanged and don’t want Obama taking that money away.
“What I told Harry Reid is that Vermont does the right thing, and I don’t want Vermont to be penalized for doing the right thing,” Leahy said.
The White House asked lawmakers to delete $100 million to build a public hospital in Connecticut inserted by Sen. Christopher Dodd, D-Conn. But the money will remain in the final bill, according to people familiar with Democratic negotiations who spoke on condition of anonymity to disclose the unannounced decision. Less certain is the fate of other money the White House wants eliminated for Montana.
Sen. Max Baucus, D-Mont., put a provision in the Senate health bill allowing many of the 2,900 residents of Libby to qualify for Medicare benefits. Some of them have asbestos-related diseases from a now shuttered mine.
“It simply doesn’t make sense to ignore this obligation, or victims of these disasters,” Baucus said.
Sen. Robert Byrd, D-W.Va., won a Senate provision making it easier for longtime coal miners or miners’ widows to get compensation for black lung disease.
The Senate bill also has extra money for hospitals and doctors in North and South Dakota, Montana and Wyoming.
Associated Press writers Erica Werner and Charles Babington contributed to this report.
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