By Jonathan Blakely

Mar 15, 2010 8:31am

White House Seems to Have New Policy On “Special Deals” in Health Care Reform Bill

President Obama has decried deals such as the so-called “Cornhusker Kickback,” wherein the federal government would foot the bill for Nebraska’s Medicaid expansion, inserted to secure the vote of Sen. Ben Nelson, D-Neb.

So on This Week Sunday morning, I asked senior White House adviser David Axelrod if he would be willing to pledge that the final health care reform bill will not include any special deals inserted to secure the support of individual members of Congress.

He wasn’t willing to be so definitive.

“The president does believe that state-only carve-outs should not be in the bill,” Axelrod said.

But, he added, “the principle that we want to apply is that are these applicable to all states?  Even if they do not qualify now, would they qualify under certain sets of circumstances?” He said “that is different than a special state-specific thing.  In the case of Nebraska, what everyone was outraged about was that it seemed to be a special deal just for one state.  That is not going to be in this bill.”

Under the previously passed Senate bill, one provision would give $100 million to the state of Connecticut to build a hospital. Victims of asbestos-related illnesses in the home state of Finance Committee Chair Sen. Max Baucus, D-Montana, Libby, Mont., secured aid. Massachusetts and Vermont secured extra Medicaid funding. Seniors in Florida and New York would be able to keep Medicare Advantage benefits being cut for seniors everywhere else .

Axelrod defended the deal secured for Sen. Mary Landrieu, D-La., saying “what has been portrayed as a provision relating to Louisiana says that if a state, if every county in a state is declared a disaster area, they get some extra Medicaid funds.”
Last week, White House press secretary Robert Gibbs said of special deals: “Massachusetts and Vermont I'm told are not in there.  The Medicare Advantage stuff for New York and Florida is not in there.  There’s a provision I think that benefited Michigan that is not in there, and I think as the story said today, and as I've said earlier, there are additional things like maybe Montana and Connecticut that we've asked the Senate to take out.”

It’s unclear whether that still stands. Senators have pushed back against the president’s request that the deals be removed and Axelrod’s statement seemed to reflect a new policy pertaining to the deals.

-jpt

User Comments

What’s good for the corn fed goose is good for the foie gras gander?

Posted by: DontGet818onMeNow | March 15, 2010, 8:47 am 8:47 am

Look deep in the reconciliation bill.
The gifts to the union VEBAs are back. Abortion appears to be funded. The Public Option is back.
There is a sick shell game with the health care bills right now. Why don’t the White House and the dems in congress want the American people to know what is in this bill?

Posted by: Robert J Chester | March 15, 2010, 8:58 am 8:58 am

Thanks for this update, Jake. Can you let us know if the current plans are for the “Deliverance” deal for West Virginia to remain in the final form of the reform bill? And what do ABC’s lawyers say about the constitutionality of the approach the House plans to take to pass the bill?

Posted by: AlekGeorge | March 15, 2010, 9:25 am 9:25 am

“If every member pledged to not vote for it if they hadn’t read it in its entirety, I think we would have very few votes,” Hoyer told CNSNews.com at his regular weekly news conference.
Pelosi: ‘We have to pass the bill so you can find out what is in it…’
I’m sorry, but just how damned stupid to do you have to be to be a Democrat?

Posted by: drjohn | March 15, 2010, 9:30 am 9:30 am

Death panels and rationing are in the bill, all in one paragraph!
p.1557
(1) IN GENERAL.—The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research (in this section referred to as the ‘Center’) to conduct, support, and synthesize research (including research conducted or supported under section 1013 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003) with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.
p. 1557

Posted by: drjohn | March 15, 2010, 9:32 am 9:32 am

Democrats declare war on small business
P.22:
Such report shall include any recommendations the Commissioner deems appropriate to ensure that the law does not provide incentives for small and mid-size employers to self-insure

Posted by: drjohn | March 15, 2010, 9:34 am 9:34 am

The “special deals” are one of those issues that clearly delineate the desire of the Dems, to utilize methods to pass legislation that borders on dictatorship…..and everyone in this country should be up in arms, over it!!!!

Posted by: Rick McDaniel | March 15, 2010, 9:49 am 9:49 am

And if Eric Massa supported Obamacare, he’d still be in office. Democrats would have continued to shield him. They threw him under the bus when he decided to vote against this health care monstrosity.

Posted by: drjohn | March 15, 2010, 10:01 am 10:01 am

And if Eric Massa supported Obamacare, he’d still be in office. Democrats would have continued to shield him. They threw him under the bus when he decided to vote against this health care monstrosity.

Posted by: drjohn | March 15, 2010, 10:01 am 10:01 am

It is entirely un-American to insist that a people accept something as law before they get to learn what it is.
It is anti-American. It is tyrannical. It is Democrat.

Posted by: drjohn | March 15, 2010, 10:19 am 10:19 am

“affordability for the middle class,”
Affordability being defined as costing more than it does now.
Democrat math.

Posted by: drjohn | March 15, 2010, 10:20 am 10:20 am

BTW, it is reported that this is but a shell bill. The Democrats will gut it, add all the little details behind closed doors, and then “deem” it the same as the Senate bill and try to declare it passed it without a vote.
Democrats could give a rip about the Constitution.

Posted by: drjohn | March 15, 2010, 10:24 am 10:24 am

Posted by: drjohn | Mar 15, 2010 9:34:19 AM
Increasingly, small business owners have tired of the so-called “conservatives” (many slaves and apologists to/for the corporate nanny state) speaking for them when many have very little experience with small business, and don’t really care about the rock and hard place we’ve been between for years. In truth, the main street alliance, a a network of state-based small business coalitions, has been pushing for both health care reform AND financial reforms.
Time to get this done. The status quo is unsustainable and its put huge pressures on entrepreneurs, small businesses and the self-employed.

Posted by: progresssive mama | March 15, 2010, 10:34 am 10:34 am

““The president does believe that state-only carve-outs should not be in the bill,” Axelrod said.”
Apparently that Obama statement has expired. Eventually, all Obama pledges expire. It’s amazing that some people never figure it out.

Posted by: drjohn | March 15, 2010, 10:39 am 10:39 am

“Time to get this done. The status quo is unsustainable and its put huge pressures on entrepreneurs, small businesses and the self-employed.”
Exactly what would you know about the self-employed? I am self-employed and I don’t want government doing for health care what they’ve done for the financial sector of this country.

Posted by: drjohn | March 15, 2010, 10:41 am 10:41 am

Look at what Democrats have done for the economy! Look what they’ve accomplished with the stimulus package!
NOTHING!
And now you want them to control health care?
JUST SAY NO

Posted by: drjohn | March 15, 2010, 11:01 am 11:01 am

Hope and Change Baby!!!

Posted by: Aaron | March 15, 2010, 11:28 am 11:28 am

Exactly what would you know about the self-employed? I am self-employed and I don’t want government doing for health care what they’ve done for the financial sector of this country.
Posted by: drjohn | Mar 15, 2010 10:41:12 AM
I own a small business and have been self-employed. Many of my friends own small businesses or are self-employed. Several of us have banded together to push for health care reform. Your ilk doesn’t speak for us.

Posted by: progressive mama | March 15, 2010, 11:51 am 11:51 am

Nancy DeParle with todays number:
“1 — in every six dollars in the U.S. economy is spent on health care today.1
If we do nothing, in 30 years, 1 out of every three dollars in our economy will be tied up in the health care system.2
Skyrocketing health care costs aren’t just crippling the U.S. economy — they’re emptying the pocketbooks of American families. If we do not enact health insurance reform, individual and family spending on premiums and out-of-pocket health care costs could increase 79 percent in just 10 years.3
1 Department of Health and Human Services, National Health Expenditure Data
2 Congressional Budget Office, The Long-Term Budget Outlook, June 2009
3 Robert Wood Johnson and Urban Institute, The Failure to Enact Health Reform: 2010-2020
The status quo is unsustainable. As Nancy Pelosi put its, “Republican opponents and their special interest allies are spending millions on ad campaigns based on misinformation, distortion and fear. We cannot let them stand in the way of these critical reforms.”
I agree. Onward. Call your reps and tell them to support comprehensive health care reform. Its time.

Posted by: progressive mama | March 15, 2010, 12:06 pm 12:06 pm

Pelosi: ‘We have to pass the bill so you can find out what is in it…’
I’m sorry, but just how damned stupid to do you have to be to be a Democrat?
posted by drjohn
You tell it like it is drjohn,Keep up the good work.

Posted by: Johnny L | March 15, 2010, 12:15 pm 12:15 pm

Pelosi: ‘We have to pass the bill so you can find out what is in it…’
I’m sorry, but just how damned stupid to do you have to be to be a Democrat?
posted by drjohn
____________
LOL. I see you have a sock puppet now.
Ah well.
Pelosi: “They’ll take food out of the mouths of children in order to give tax cuts to the wealthiest.” (about Republicans)
I’m sorry but how just how in the tank do you have to be, how under the spell of collective amnesia, to be a Republican apologist– particularly after the 00′s which saw a two term income decline, growing poverty, escalating medical inflation and a growing number of uninsureds, near econonmic collapse, the year and a half of the bailout, an unnecessary and mismanaged war of aggression funded on borrowed money. Why would anyone be beholden to those who are wholly owned subsidiaries of special interests?
As Tim at Balloon Juice reminds us: “Please do not sit around and hope that your Rep does the right thing. Pick up a phone and call. Even friendly Representatives will appreciate a break from the nonstop abuse from tea {people}

Posted by: progressive mama | March 15, 2010, 12:44 pm 12:44 pm

Look deep in the reconciliation bill.
The gifts to the union VEBAs are back. Abortion appears to be funded. The Public Option is back.
There is a sick shell game with the health care bills right now. Why don’t the White House and the dems in congress want the American people to know what is in this bill?
Posted by: Robert J Chester | Mar 15, 2010 8:58:42 AM
Would anyone expect anything different? Amazing how one of the main factors Obama talks about is ‘fraud and abuse’, yet that seems to be what the American public has been getting from day one from this Congress regarding the healthcare bill(s). As of now, the people of the US STILL do not understand the wording, meaning, cost, or effectiveness of this bill. You’d think over the course of a YEAR, someone could have carved out television and/or internet time to EXPLAIN, line by line, what is going to happen IF the bill passes.
It’s bad enough that the process of passing the bill is in question at the least, but what’s worse is the fact that people don’t understand. I realize individuals COULD take the time to read it, but that doesn’t answer the questions either. Changes are being made almost everyday, deals are being made everyday… who can keep up with all that? As I’ve said before, this entire deal is political. If the interest of the public was the top priority, the bill would have passed a year ago. The Democrats have told us repeatedly that thousands of people are dying due to lack of insurance, yet, they’ve put off passing a bill that could have ‘saved’ those people (according to their assesment) for over a YEAR. Wonder if they want to explain the reasoning behind that? Politics perhaps? Or maybe they grossly overstated the deaths? We all know that people will be treated regardless of ability to pay, so that doesn’t hold too much water. We also know that people die whether they have insurance or not. Anyway, it seems their political standing has taken the place of thousands of lives-that’s a heavy burden to bear.

Posted by: Shoe | March 15, 2010, 12:53 pm 12:53 pm

politics daily: “The head of the national association of Catholic hospitals, which holds great sway in the health care debate, threw her support Saturday behind the contested Senate reform bill in a move that could give a major boost to the legislation’s prospects.”
see also the NYT blog called Prescriptions and specifically the post titled, “Senate Abortion Restrictions Are Sufficient, Catholic Group Says”
“According to the National Catholic Reporter, Catholics in Alliance for the Common Good, a Washington-based advocacy group, sent a letter to members of Congress on Friday urging support for the Senate-passed health care bill and expressing its view that the bill contains sufficient provisions to prevent the use of federal money to pay for insurance coverage of abortions. “

Posted by: progressive mama | March 15, 2010, 1:13 pm 1:13 pm

Adding on, per Matthew Yglesias:
“One of the real oddities of Bart Stupak’s refusal to get back on board the health reform train is that virtually everyone who looks at the current language thinks it’s close to Stupak’s own language, and basically achieves what Stupak says is his goal—avoiding taxpayer subsidies of abortion. The people who agree with Stupak are overwhelmingly conservative reform opponents, who are casting about for things to object to. People who want to see health coverage expanded, including anti-abortion Catholics, generally don’t see things Stupak’s way. … Obviously both Stupak and the US Conference of Catholic Bishops are entitled to make up their own minds. But Keehan [Sr. Carol Keehan, President and CEO of the Catholic Health Association] is not just a Catholic, her organization—unlike the Bishops—has actually expertise in health care administration and finance.

Posted by: progressive mama | March 15, 2010, 1:20 pm 1:20 pm

In our country we currently have three entitlement programs, Medicare, Medicaid, and Social Security. Unless you live under a rock you would know that ALL THREE of these programs are close to liquidation. But yet wait lets fund (50%) a fourth entitlement with found money from Medicare. Rather than helping the program’s future financial situation.
Nobody will ever dispute the need for health care reform. At issue is how this process is shoved down our throats. How about some basic common sense changes?
1-everybody gets it regardless of their health condition
2 not popular but everybody has to get insurance or pay a fine of the equivalent
3- allow everyone to deduct health care from their taxes, not just self employed
4-medicaid is an all or nothing entitlement. If you make $1 over the maximum allowed you cannot get it. How about a sliding scale well if you make $1 over the limit you pay the $1 etc.
I don’t know but would this be an over 2000 page document? I don’t think so.

Posted by: bill | March 15, 2010, 2:21 pm 2:21 pm

All bills proposed should end with this..
‘..and they all lived happily ever after.’

Posted by: DontGet818onMeNow | March 15, 2010, 2:42 pm 2:42 pm

.. as soon as it passes.. the GOP will field the short kickoff and start the two minute drill toward repeal.. this might never go away…

Posted by: DontGet818onMeNow | March 15, 2010, 3:03 pm 3:03 pm

The status quo is unsustainable.
___________________________
Posted by: progressive mama | Mar 15, 2010 12:06:48 PM
I’m with you P-Mom!
Call your reps and tell them to vote NO on this current health care reform bill.
Like the doctor’s creed says – first, do no harm.
Tell your reps to come back after recess and try again but this time get it right!
Its time to do something right for a change.

Posted by: Noz | March 15, 2010, 3:21 pm 3:21 pm

The gifts to the union VEBAs are back. Abortion appears to be funded. The Public Option is back.
________________________________
Nonsense. Abortion does NOT appear to be funded. The public option is NOT back.
Where did you get this information?

Posted by: tierra | March 15, 2010, 3:32 pm 3:32 pm

Why are free Americans being asked against their will to purchase the products of for-profit corporations?
Symptom management (which passes for health-care in our country) is out of the reach of serfs, yet, no proceeds from the profit ‘trickle’ back into the economy. Where is all this money going?
I mean if insurance is getting filthy rich off of us, what are they doing with that money if not re-investing in America?

Posted by: Losing Freedom | March 15, 2010, 3:48 pm 3:48 pm

“Abortion does NOT appear to be funded.” -tierra
Did you inform Stupak?

Posted by: keys2truth | March 15, 2010, 3:51 pm 3:51 pm

Its time to do something right for a change.
Posted by: Noz | Mar 15, 2010 3:21:27 PM
Actually, letting the perfect be the enemy of the good isn’t the brightest idea (think Republican failure to reform oversight of the GSE’s and financial institutions in the 00′s). Meanwhile the Commonwealth Fund blog has a great post up which looks at “The Costs of Failure: Economic Consequences of Failure to Enact Nixon, Carter, and Clinton Health Reforms”– check it out.
How long can we kick the can down the road and let those who value windfall profits over real people derail and deny? Time to pass reform and press for further reforms after intial legislation passes.
The status quo is unsustainable and the obstruction has gotten stale.

Posted by: progressive mama | March 15, 2010, 3:52 pm 3:52 pm

Abortion funding IS in the bill. REQUIRES private insurance to cover abortion at the states discretion. Abortion IS included as a mandate in the government option.

Posted by: mjishernameo | March 15, 2010, 3:53 pm 3:53 pm

Call your elected officials and inform them a vote in favor of health care reform is a vote for humongous new taxes to drive our country into the worst depression in 200+ years. Health care cannot be passed , no new taxes, say NO to the new world order / bilderbergers that one government health care, carbon credits and one world government, and destruction of our sovereignty and constitution !!

Posted by: Dr. Balm | March 15, 2010, 3:53 pm 3:53 pm

I went into the clinic today and randomly asked nuses, doctors, therapists, how they feel about this bill. Even the Obama supporters (ones who voted for him) are enraged ! They’ve scheduled protests at local rep. offices this week…some are heading to DC…across the board…ENRAGED.!!!! Talk about election regret, these folks really feel had.
America doesn’t want it…Heath care PROFESSIONALS do not want it…consumers don’t want it…
Why is Obama fighting America sooo hard?
Seems rather “precidented”, doesn’t it?
Change.

Posted by: mjishernameo | March 15, 2010, 3:56 pm 3:56 pm

Actually, letting the perfect be the enemy of the good isn’t the brightest idea (think Republican failure to reform oversight of the GSE’s and financial institutions in the 00′s).
__________________________________
Good point. It’s what apparently happened with Fannie and Freddie where nothing was done by the Bush administration due to a failure to achieve the possible rather than the perfect.
“The president spent years pushing . . . to toughen regulation of the companies, but was unwilling to compromise when his former Treasury secretary wanted to cut a deal. And the regulator Mr. Bush chose to oversee them — an old prep school buddy — pronounced the companies sound even as they headed toward insolvency.”
NY Times
We saw some of the terrible results of that failure.

Posted by: tierra | March 15, 2010, 3:58 pm 3:58 pm

Abortion funding IS in the bill. REQUIRES private insurance to cover abortion at the states discretion. Abortion IS included as a mandate in the government option.
Posted by: mjishernameo | Mar 15, 2010 3:53:26 PM
____________________________________
Nonsense. The bill specifically states that no tax money will be used in abortion services.
This maintains the current status of non-abortion funding.

Posted by: tierra | March 15, 2010, 4:01 pm 4:01 pm

The Senate-Approved Health Care Reform Bill “Patient Protection and Affordable Care Act” (HR 3590 EAS/PP). . .
· Prohibits insurance companies from using federal funds, including federal tax credits and cost-sharing assistance, to pay for abortion services except for those services allowable under the Hyde amendment (pg. 2071)
The Hyde Amendment is legislative provision barring the use of certain federal funds to pay for abortions.

Posted by: tierra | March 15, 2010, 4:08 pm 4:08 pm

I went into the clinic today and randomly asked nuses….
Posted by: mjishernameo | Mar 15, 2010 3:56:50 PM
Careful, mj, your faux conservative and Republican comrades will be accusing you of “anecdotitis”– unless of course they’re hypocrites.
LOL.
Meanwhile, many health care provider groups continue to support health care reform and Obama’s proposal– as does the Catholic Health Alliance and Catholics in Alliance for the Common Good.

Posted by: progressive mama | March 15, 2010, 4:26 pm 4:26 pm

We must remember that Obama is a product of corrupt Chicago politics. “Promise them everything, give them nothing” is how the Chi-Town game is played. And now it’s on a national level. Yep! Those special deals to obtain backing for this health care bill is a great Chicago tactic. This is why ALL incumbents should be voted out of office.

Posted by: johnny | March 15, 2010, 7:17 pm 7:17 pm

The HC Bill pushes me further away from DEM. This is the CHANGE he brought to me.
Am I the only one … I guess not. I don’t like REPUB … but if Obama continues to ignore our will, he and his DEM PARTY will face consequence.

Posted by: talk from sf | March 15, 2010, 7:53 pm 7:53 pm

Tierra, why would you quote the NYT on Fannie & Freddie Regulation? You’ve got it bad, woman!

Posted by: mitchscove | March 15, 2010, 8:08 pm 8:08 pm

You people are sick. 10 years of obstruction that most likely would have averted a crisis — when did the Democrats relent — when the economy was at the edge of the cliff? When it was too late.

Posted by: mitchscove | March 15, 2010, 8:19 pm 8:19 pm

Actually, letting the perfect be the enemy of the good isn’t the brightest idea (think Republican failure to reform oversight of the GSE’s and financial institutions in the 00′s).
__________________________________
Good point. It’s what apparently happened with Fannie and Freddie where nothing was done by the Bush administration due to a failure to achieve the possible rather than the perfect.
“The president spent years pushing . . . to toughen regulation of the companies, but was unwilling to compromise when his former Treasury secretary wanted to cut a deal. And the regulator Mr. Bush chose to oversee them — an old prep school buddy — pronounced the companies sound even as they headed toward insolvency.”
NY Times
We saw some of the terrible results of that failure.

Posted by: tierra | March 15, 2010, 8:26 pm 8:26 pm

You people are sick. 10 years of obstruction that most likely would have averted a crisis —
__________________________________
We at least know the facts. it was in the hands of a Republican president and congress for almost 6 straight years – during which time they prepared for what?

Posted by: tierra | March 15, 2010, 8:29 pm 8:29 pm

Why does nobody address the bottom line? This bill is either a 1) huge new tax for the middle class or 2) new dictate from our government about what we must purchase. Still think you live in a free country? There is an ongoing battle in America between the Communists and Theocracists over who will get to rob us of the most freedoms in the name of saving us from ourselves.

Posted by: Media Scatter | March 15, 2010, 8:32 pm 8:32 pm

but if Obama continues to ignore our will, he and his DEM PARTY will face consequence.
Posted by: talk from sf | Mar 15, 2010 7:53:31 PM
What a laugh.
Ezra Klein has a humorous point up that is semi-related:
“If they jam through health care,” said Senator Lindsey Graham of South Carolina, then Democrats will have “poisoned the well” on other issues. He was interviewed Sunday on ABC’s “This Week.”
Stimulus didn’t get a single Republican vote in the House. The Gang of Six didn’t secure Republican votes for health-care reform. Bob Corker won’t support the financial regulation plan that he admits has been fundamentally transformed to address many of his concerns. Graham himself has declared cap-and-trade dead in the Senate. If Graham doesn’t think the well is already poisoned, then I dare him to take a sip from it.” (Wa Po)
the concern from those who offer no good ideas or solutions about what will happen to Obama and the Democrat party is hilarious.
Maybe it would be best if both parties splintered and we have a four or five party system without special interest alliances.
In the mean time, let’s take a step toward doing something about our unsustainable and outdated health insurance system.

Posted by: Truth has a liberal bias | March 15, 2010, 8:35 pm 8:35 pm

You people are sick. 10 years of obstruction that most likely would have averted a crisis —
__________________________________
We at least know the facts. it was in the hands of a Republican president and congress for almost 6 straight years – during which time they prepared for what?
Posted by: tierra | Mar 15, 2010 8:29:17 PM
_______
LOL. mitch needs to read up and what went down.
Also, I read a review (Steven Pearlstein) of a good new book about the economic crisis called The Big Short by Michael Lewis. I haven’t read the book yet, but I liked this quote from the review:
“There is nothing subtle about the dark portrait Lewis creates of the financial community. Through his lens, all bond salesmen are out to cheat their customers, all top executives are clueless and all ratings analysts are second-raters who could not get jobs in investment banks.”
And this:
“What Lewis writes of two of his characters, young Ledley and Mai, might just as well apply to Lewis himself, or to us:
They “had always sort of assumed that there was some grown-up in charge of the financial system whom they had never met; now they saw there was not.”

Posted by: progressive mama | March 15, 2010, 8:50 pm 8:50 pm

Am I wrong or isn’t any government program supposed to be admininstered throughout the states the same? No state is supposed to benefit more from any program than the other. So, how is it that such promises are made and kept apparently in order to buy votes? I HOPE EVERY PERSON OLD ENOUGH TO VOTE WILL REGISTER AND GET VOTE EVERY SENATOR AND REPRESENTATIVE OUT OF OFFICE THAT IS WILLING TO BE BOUGHT OFF AND PUT PEOPLE IN OFFICE WHO UNDERSTAND THE IMPORTANCE OF ETHICS AND A SENSE OF REAL RESPONSIBILITY TO THE PEOPLE NOT TO THEIR OWN SHORT-SIGHTED NEEDS AND DESIRES.

Posted by: fmbyrd9909 | March 19, 2010, 11:03 am 11:03 am

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