Enter Harry Reid -- Now Health Care Is in His Hands

Now it's Harry Reid's turn to take a crack at health care reform. And it's unclear if that's a good thing -- or not -- for Democrats, especially those on and off Capitol Hill who yearn for a public insurance option.

With Sen. Max Baucus (D-Mont.) finishing up his finance committee's version of the health care bill, Reid, the Senate majority leader, will have the Herculean task of merging the Baucus-built bill with legislation passed earlier by the Senate health committee. The two measures differ on numerous points, including the public option. The health committee legislation includes one; the finance committee package does not. The health committee measure also has more generous subsidies for workers who will have to purchase insurance. (Baucus voted against two versions of a public option, claiming he supported it as policy but opposed it politically because he figures a bill with a public option cannot win the 60 votes in the Senate needed to break a filibuster.)

For his part, Reid's been playing ping-pong -- with himself -- on the public option. Early last week, he said that putting off a decision on a public option for a few years was a "pretty doggone good idea." Then days later, he declared, "We are going to have a public option before this bill goes to the president's desk." Hours after making that statement, he revised his position once again, with his office stating that he would only guarantee to "include a mechanism to keep insurers honest, create competition and keep costs down." A public option would do that. But a handful of conservative Dems have claimed that non-profit (but non-governmental) health insurance co-ops could also achieve those ends -- a position easily challenged because no one yet has a clear idea how these co-ops would operate.


So within one week, Reid took three different sides on this central issue. (Quick aside: Why is the public option a critical matter? If the health care reform package is going to mandate that some people must buy insurance, then legislators need to ensure insurance is affordable. The existence of a public plan would force the oligopolistic private insurance companies to keep the price of their plans low to compete.)

Reid has much to juggle. His own caucus is split, with a few conservative Dems claiming they won't vote for legislation that includes a public option. Other Senate Democrats say they won't vote for a bill without it. (Sen. Jay Rockefeller, the great-grandson of the famous billionaire, has stepped out of the shadows to be a leader of this band.) And there are several dozen liberal House Democrats who also vow they will not back a bill that doesn't contain a public option.

But Reid has concerns outside the Senate cloakroom. Most notably, he's in trouble in his home state of Nevada. A recent poll showed Reid, who's up for reelection next year, with an unfavorable rating of 52 percent in Nevada; only 36 percent of his constituents viewed him favorably. The poll even had Reid -- arguably the most powerful Democrat in Congress -- losing to Sue Lowden, a former chair of the Nevada state Republican Party. And it's not as if Lowden is a political superwoman. She last held elected office as a state senator from 1992 to 1996, before she was defeated for reelection. Yet she is a former co-owner of the Sahara casino, and she and her husband walked away with almost $200 million after selling the place in 1995. (Yes, in Nevada you can own a casino and at the same time serve in the state legislature. You got a problem with that?) Reid is a prodigious fundraiser, but the prospect of running against an opponent with access to hundreds of millions of dollars must spook him.

That means that as he pulls together a health care bill, he has to keep looking over his shoulder, and make darn sure that it is darn good for Nevada. And he has to cut some special deals of his own. During the finance committee's consideration of its bill, Reid managed to win a provision for Nevada related to Medicaid. Reid took public credit for doing so. Given that he must preserve that measure in the final bill, he might have to yield to Baucus or other senators on other matters. With such pressing needs of his own, it won't be any easier for him to satisfy the competing interests and ideas of all the Democratic senators and negotiate one of the most significant pieces of social legislation in years.

A word of advice to would-be Reid-watchers: Don't try to figure out where he's going on all this. Reid can be an uneven leader. Earlier this year, when GOP'ers were trying to stir up a fuss about transferring Guantanamo detainees to high-security prison facilities in the United States, Reid, falling for the Republican demagoguery, declared that he, too, didn't want terrorist suspects in U.S. prisons. Apparently, he forgot that there are dozens of terrorists already in U.S. jails. Days later, though, Reid shifted his position and said he was open to moving some Gitmo detainees to U.S. prisons.

From the start of the health care tussle, President Obama has placed the all-important details in the hands of Congress, an institution far less popular than he is. By doing so, he has allowed his most important social initiative to become the property of the sausage-makers on Capitol Hill. That's not likely to cause his reform plan to be more readily embraced by voters throughout the land. (How many voters have faith in Baucus?) And in this next round, health care reform will be identified more with Reid than with Obama. (House Speaker Nancy Pelosi will be in the picture, too, as she now pushes ahead with the House version.) Is there any question that an "Obama bill" would fare better than a "Reid bill"? Yet Obama has chosen this course of action, and perhaps at the end of the tunnel he will get a bill out of Congress that he can endorse and sell to the public. In the meantime, the spotlight's on a much less popular fellow, and it's been years -- perhaps decades -- since a Senate majority leader has been so tested.

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