Medicare Victory Caps Senate Leader’s Rookie Year

On Veterans Day, the Senate was sliding toward the year’s partisan low point. Democrats and Republicans were girding for a 39-hour talkathon on judicial nominations that would yield little more than gassy rhetoric, grist for liberal and conservative activists and ideological stalemate.

That evening, Senate Majority Leader Bill Frist of Tennessee made a move, with bipartisan help, that would clear the way for one of the signature legislative achievements of the GOP-led Congress in 2003: enactment of a Medicare prescription drug benefit.

With Medicare talks near an impasse, the rookie majority leader called House Speaker J. Dennis Hastert (R-Ill.) into his office for a meeting with two Democratic senators, John B. Breaux of Louisiana and Max Baucus of Montana, and, on the speakerphone, House Majority Leader Tom DeLay (R-Texas). They cut a tentative deal that preserved a limited, but important, role for private competition to the government health program.

That set in motion a chain of events that will culminate in President Bush’s signing of the Medicare bill into law, probably with the man he calls “Fristy” looking over his shoulder.

Frist “played a critical role,” Breaux said Wednesday, the day after the Senate gave final approval to the legislation. “It could well never have happened had he not stood up and said, ‘Look, we’re going to settle this at the leadership level.’ ”

Passage of the bill capped an extraordinary first year as majority leader for Frist, vindicating Bush’s faith in him as the best choice to take over the Senate during a leadership crisis that erupted in December after the Republican victory in midterm congressional elections.

But if the Medicare talks showed Frist’s skill as a back-room deal-closer, the circus-like debate on judicial nominations that he organized simultaneously showed he also could be a full-throated partisan ringmaster. That has earned him the trust of many conservatives initially skeptical of the man who succeeded Trent Lott of Mississippi as Senate Republican leader after a national furor over Lott’s apparent nostalgia for segregationist politics at a GOP senator’s birthday party.

“I told him to his face, I was very much prepared not to like him. I thought he was going to be a majority leader that always tilted toward the liberals,” said Paul M. Weyrich of the Free Congress Foundation, a conservative think tank in Washington.

Weyrich, in fact, briefly supported an alternative to Frist the day Lott stepped down. Now, Frist consults with Weyrich frequently, and one of the majority leader’s aides sends him daily e-mail updates on Senate business. “I’ve been pleasantly surprised,” Weyrich said. “He is doing as good a job as Republican leader as anybody I’ve seen.”

Weyrich compares him favorably to Lott, Bob Dole of Kansas and Howard H. Baker Jr. of Tennessee, each of whom had far more legislative experience before taking the Senate’s reins.

Frist’s first year as leader has not been without missteps. He has been severely tested by Democratic resistance in a Senate that is split effectively 51 to 49, with 60 votes needed to cut off debate -- a tactic that can be used to stall consideration of a bill. Two votes short of that hurdle on an energy bill that spun out of control, Frist was forced to acknowledge this week that a filibuster had for the year killed a top administration priority.

He has also failed so far to secure final passage of seven out of 13 annual appropriations bills, leaving much of the government to run on autopilot nearly two months into the new fiscal year. That is at odds with Republican promises to restore budgetary order in Congress.

Some critics wonder whether Frist is too beholden to a White House that cleared the way for his ascendance, too willing to bend on legislative details when a presidential veto threat hangs in the air. Several lawmakers chafed, for instance, when Senate-approved positions challenging the Bush administration on regulations easing limits on ownership of TV stations and stripping many workers of overtime pay protection were dropped in recent days from a compromise spending bill. Both provisions faced veto threats.

“I think he’s a nice man,” Senate Minority Whip Harry Reid (D-Nev.) said of Frist. But in a dig sure to resonate in a chamber that prides itself on independence from the executive branch, Reid added: “He’s working under a burden as the first majority leader ever to have been selected by the president.”

Frist’s allies responded that he was chosen by his 50 Senate GOP peers, not by the president. They insist that Frist has had as much influence with the White House as it has had with him, noting that the former heart-transplant surgeon was pushing for global AIDS relief long before Bush took up the cause.

They also note that Frist shepherded a budget through the Senate last spring calling for $350 billion in tax cuts over 10 years, less than half what Bush sought. Frist’s judgment that anything more than that sum would fail to pass Congress proved correct when Vice President Dick Cheney was forced to cast a tie-breaking vote to push a tax-cut package of about that size through a Senate split 50-50.

In a session with reporters at the Capitol on Tuesday, Frist said he had stood up for Congress as “a coequal branch of government.” But he focused on achievements that dovetailed with Bush’s agenda: the Medicare bill, a law banning a late-term abortion procedure, a law authorizing $15 billion to combat AIDS in impoverished nations in Africa and elsewhere. Later in the day, Frist would announce another deal to clear the way for bipartisan legislation to limit class-action lawsuits against corporate plaintiffs.

“We’ve had a very constructive year,” he said. “The important thing is action, solutions.”

A stethoscope lay near his right hand as he claimed credit for helping break the long-running logjam on prescription drugs. The prop was both a reminder of Frist’s medical expertise and a sign of how he used it to political advantage. The nameplate on the door to his second-floor Capitol suite identifies him as “William H. Frist, M.D.”

Frist, 51, comes from a medical background; his father and his older brother, both doctors, founded the Hospital Corp. of America, now known as HCA Inc., the largest private hospital company in the U.S. Although his fortune -- estimated at $20 million in 1994, when he ran for the Senate -- came largely from company stock, Frist never worked at the business.

Although his family lost control of the company in the late 1980s, Frist’s brother, Thomas, was chairman from January 2001 to January 2002, and held a 3.5% stake in the company, according to HCA’s 2003 proxy statement.

The first practicing physician elected to the Senate since the 1930s, Bill Frist was elevated to majority leader in only his second Senate term. He had served as Senate liaison to the Bush presidential campaign in 2000 and as the top Senate Republican campaign strategist in 2002, a year the party retook control of the Senate after a brief period of Democratic leadership. In many ways, Frist is ideologically indistinguishable from his predecessor. Both are strongly conservative Southerners. But Frist, first elected in 1994, was seen as a leader of a new generation from the South, which helped him vault past the weakened Lott last year. Lott was first elected to Congress in 1972, when segregationist politics in the South still resonated.

After his controversial remarks in December at Sen. Strom Thurmond’s 100th birthday party, where he reminisced positively about the South Carolinian’s 1948 Dixiecrat presidential campaign, Lott fervently apologized and renounced segregation. But Republicans believed that Frist would help them heal a racial wound that Lott had reopened.

Even Democrats concede that to some degree, Frist has made headway. Rep. Elijah E. Cummings (D-Md.), chairman of the Congressional Black Caucus, called Frist “an honest and decent man” and noted that the majority leader had crossed Capitol Hill to meet with him. That, Cummings said, was the first time any senator had walked over to his office.

Cummings lauded Frist’s role in pushing AIDS relief, legislation to eliminate minority health disparities and a just-passed bill to create a new national museum of African American history. But none of that, Cummings said, outweighed his political differences with Frist on Medicare and judicial nominations.

“He basically takes the script from the president and marches with great enthusiasm,” Cummings said.