60th senator wields power over healthcare

Last June, a long time ago in politics, Democrats in the Senate were briefly jubilant. For the first time in a generation, they held 60 seats, the “supermajority” required to control the Senate’s proceedings. The road to enacting President Obama’s center-left agenda looked, for a moment, almost smooth.

But that’s not how the Senate works. It’s an assembly of 100 independent egos, not a parliament of two disciplined parties. The word “control” doesn’t apply.

Last week, as Majority Leader Harry Reid struggled to corral 60 votes to move a healthcare bill forward, the jubilation of summer gave way to desperation on cold winter nights -- with occasional flashes of recrimination.

“Everybody gets to be the 60th senator,” observed Sen. John D. Rockefeller IV (D-W.Va.), a liberal champion of healthcare reform. What he meant was that when any one senator can threaten to stop a bill, many senators will be tempted to try -- if only to see what they can get in return for their support.

Last week, three senators each held the role of No. 60 in turn -- and each held the fate of Obama’s healthcare proposals in his (or her) hand.

First was Joe Lieberman of Connecticut, who lost his party’s primary election in 2006, won reelection as an independent, campaigned against Obama in 2008 -- but still claims a seat in the Democratic majority.

Lieberman won several days in the spotlight for abruptly announcing that he would vote against any bill that included either of two measures favored by liberals: a government-run health insurance plan (known as the “public option”) or a plan to offer Medicare to people younger than 65 (known as “Medicare buy-in”).

In an instant, both ideas were vaporized. Liberals outside the Senate excoriated Lieberman as a traitor and a hypocrite, noting that he had once advocated allowing people over 55 to buy in to Medicare.

But inside the Senate, Lieberman’s colleagues were not as harsh -- at least, not on the record; you never know when you’re going to need a 60th vote.

And in fact, Lieberman may have done his colleagues a favor. Several centrist Democrats weren’t happy about the public option or Medicare buy-in either. Neither proposal was likely to attract 60 votes, even if Lieberman had stayed in the fold.

In effect, Lieberman volunteered for the role of scapegoat (intentionally or not), taking the blame for shooting down liberal ideas that were already doomed. At any rate, by the end of the week, he was promising to help Reid move a rejiggered bill forward.

The second holdout was Ben Nelson of Nebraska, a taciturn former insurance executive from a solidly conservative state. (Republican presidential nominee John McCain won Nebraska by 57% last year.) Nelson votes with Republicans more often than any other Democrat (even Lieberman), and he warned colleagues long ago that he would insist on tough provisions barring any federally funded insurance policies from covering abortions before a healthcare bill could win his vote.

Reid deputized Bob Casey of Pennsylvania, another antiabortion Democrat, to work out a compromise -- essentially to allow women in those plans to pay for abortion coverage with their own funds -- but Nelson warned that he’d be a tough sell. The Nebraskan said he would submit any abortion proposal to his “constituency groups” -- antiabortion organizations that are opposed to any form of compromise.

And even if he got his way on abortion, Nelson warned, he wasn’t sure he would vote to move the bill forward -- leaving Reid still uncertain where he would find his 60th vote.

Which revived the name of the third “60th senator,” a moderate Republican, Olympia J. Snowe of Maine. Snowe has worked for months on healthcare legislation, says she wants to pass something and broke with her party to vote in favor of a bill drafted by the Senate Finance Committee. Obama and his aides have lavished private attention on her, knowing that her single vote would give them the right to anoint the result as “bipartisan.”

But Snowe has a flaw: She’s serious about the substance of healthcare. All week long, as Reid struggled to find a way to amass 60 votes among Democrats, he kept his version of the bill under wraps, to maximize his negotiating room. Snowe said she might be willing to vote for a bill -- but she’d have to see it first, and let it be analyzed, and think about it awhile. That meant: not before Christmas.

So on Friday, Reid went back to Nelson, who finally said yes -- as long as states were given the right to prohibit plans from covering abortion, and as long as Nebraska got a special deal on the cost of expanding Medicaid coverage to the poor.

Meanwhile, the rest of the Republican caucus, which took a walk from the Democrats’ bill last summer, had a much easier task: obstruction and delay.

They handled their role

expertly, demanding that the Senate clerk read the full text of a 700-page amendment aloud, threatening to torpedo a defense funding bill that they actually favor, and generally making Democrats miserable.

As a result, Reid’s “optimistic” timetable had the Senate passing the bill at 7 p.m. on Christmas eve.

Strangely, amid the frustration and farce of Reid’s search for a 60th vote, some parts of the bill may actually be improving. Liberals were unhappy that they lost their public option, but most vote counters believe that’s been a lost cause for months.

Several Democrats, including Rockefeller and, yes, Lieberman, have proposed expanding programs that would test new models for healthcare delivery and payment -- alternatives to the costly and inefficient “fee for service” model that pays doctors

for individual medical procedures instead of patients’ overall healthcare.

That’s one reason Rockefeller, a thoroughgoing liberal, favors passing whatever bill can attract 60 votes; he sees this year’s legislation -- which has already become next year’s legislation -- as the beginning of a longer process.

“You never get everything that you want,” he said. “You try to keep improving the bill, and you do it next year or the year after.”

doyle.mcmanus@latimes.com