How Harry Reid shepherded healthcare reform through the Senate


Rahm Emanuel was agitated. With only seven weeks until Christmas, the opportunity to pass healthcare legislation seemed to be fading. The White House chief of staff feared that if the Senate left for the holiday without passing a bill, President Obama’s top domestic priority would wither as lawmakers turned to other concerns next year.

Democratic senators and administration officials gathered in a conference room outside Majority Leader Harry Reid’s Capitol office. Emanuel wanted to know: Was there a chance the chamber could still act in time?

As one participant placed a calming hand on Emanuel’s sleeve, Sen. Charles E. Schumer (D-N.Y.) told him there was one chance: The White House would have to put its trust in Reid.


The quirky, taciturn majority leader had no background in health policy and a less-than-commanding public image. Yet today Reid delivered as the Senate moved to take its final vote on the most sweeping healthcare legislation to make its way through the chamber in nearly half a century.

Along the way, Reid’s effort sometimes revealed an unseemly, if time-honored, side of congressional business as he struck bargains with senators who traded their votes for aid to their states or help for supportive interest groups.

“This bill is a mess, and so is the process that was used to get it over the finish line,” Senate Minority Leader Mitch McConnell (R-Ky.) charged this week, encapsulating a new GOP line of attack.

But the process -- as described by senators, Capitol Hill aides and White House officials -- also revealed that oft-fractious Democrats could achieve remarkable unity under the guidance of a politician with an unparalleled understanding of the arcane institution he leads -- and a sure grasp of the particular needs of the individual lawmakers who serve there.

“So many people find Harry Reid incomprehensible as a leader in large part because he is so unprepossessing as a public speaker,” said Ross K. Baker, a Rutgers University political scientist. “But his virtue and his value to his caucus is his mastery of the mechanics of the Senate.”

“There are Senate leaders like that who come along every few decades,” he said.

Over the last two months, Reid, a slight, soft-spoken man who makes listeners strain to hear him, gambled. He pulled senators back to the table when deals fell apart. And with the clock ticking down, he prodded his colleagues to make agonizing concessions for a larger goal.


The $871-billion bill, paid for with a mix of tax hikes and Medicare cuts, would expand coverage to an estimated 31 million more people over the next decade.

There were doubters this fall when Reid began trying to meld healthcare legislation developed by two Senate committees. In particular, the conventional wisdom held that the proposal for a new government insurance plan -- which was contained in the House bill -- was a poison pill for the Senate.

The night before a crucial meeting with Obama, Emanuel and other senior administration officials warned Reid that the idea could sink the bill. As usual, the majority leader listened quietly, not saying much.

But he had already made up his mind to go his way. The White House misread the Democratic caucus, Reid believed: He could not even get liberal senators to vote to take the bill to the floor for debate, Reid had concluded, unless he included a new government plan.

The next afternoon, Reid informed Obama at the White House that he would include a public option with a provision allowing states to opt out.

The move won plaudits from liberals and helped win the votes to take the bill to the Senate floor the Saturday before Thanksgiving. Hurdle No. 1 was cleared, helped by support from the likes of Sens. Ben Nelson (D-Neb.) and Joe Lieberman (I-Conn.), who opposed the public option but wanted the bill to remain alive.


By the time lawmakers returned from Thanksgiving recess, however, the momentum seemed to have evaporated as conservative criticism mounted and second thoughts began to affect some members.

Gathering his leadership team and a delegation of administration officials in his office on Monday, Nov. 30, Reid sought help in reeling in wayward Democrats.

He had already brought several hesitant Democrats on board. Indiana’s Evan Bayh became a yes vote after receiving a promise of tax relief for his state’s medical device makers. And Louisiana Sen. Mary L. Landrieu signed on after Reid pledged additional aid for her state’s Medicaid program.

Unlike the president, who hoped to woo moderate Republican Olympia J. Snowe of Maine, Reid held out little hope that she would vote for the bill this year; her complaints about the rushed timeline were too deeply felt, he believed.

“Harry laid out where he thought things were,” said one participant in the Nov. 30 meeting. “He thought he had something over 55 votes, but didn’t have 60. . . . We walked through the people who were open question marks, and talked about how much of a coordinated effort we could make.”

Rather than impose a top-down compromise on his party’s warring factions, Reid asked a group of 10 senators to hammer out a compromise.


He included the staunchest supporters and opponents of a public option, but added moderate voices that he hoped could help cool the passions. And he chose lawmakers who had been left out of earlier healthcare deal-making, such as Sens. John D. Rockefeller IV (D-W.Va.) and Russell D. Feingold (D-Wis.).

The “Group of 10,” as it came to be called, began meeting on a Friday night in the same room where Emanuel had demanded speed a month before. The talks ran for five days straight.

“We bonded,” said Rockefeller, who always made sure to sit next to Sen. Sherrod Brown, a sometimes fiery liberal from Ohio. Rockefeller took to calling Brown “Charlie” after Brown’s brother, a West Virginia resident. Brown in turn called Rockefeller “Nelson.” On the evening of Dec. 8, the group emerged with a tentative deal to scrap the public option that Reid had put in the bill, but to allow some Americans between 55 and 64 to buy into Medicare. Reid and his leadership team believed they had broken the impasse.

Their hopes were short-lived. That Sunday, Lieberman publicly announced that he would not support a bill with the Medicare buy-in provision.

Reid, who prided himself on understanding his members, was stunned. He and others had assumed that Lieberman would back the compromise because he had endorsed a Medicare buy-in a few months before.

At an emergency meeting in Reid’s office that afternoon, Schumer despaired that there was no time to fix the bill. In a hallmark of his leadership, Reid said simply that they needed to talk to Lieberman. “Reid just kept the process going,” said one participant.


When Lieberman joined the meeting at 2:30 that afternoon, he said he still wanted to support the bill.

Reid did not commit to a deal but said that he understood Lieberman’s concerns and would work on them.

That set in motion a series of calls and meetings as Reid and his lieutenants scrambled to persuade liberals to accept a bill without a Medicare buy-in.

Reid knew that he had to keep Lieberman in the tent. And the next night, when Democrats gathered for a special caucus meeting, Reid did not call out the Connecticut senator, focusing instead on the need to unite and move forward.

Without the Medicare buy-in, Lieberman would be the 59th vote. And Reid turned to Nelson, who had a long list of demands, including more restrictions on funding abortions and full federal funding to expand Nebraska’s Medicaid program. (Most other states would be forced to pick up some of the cost.)

Reid was closing in on a deal.

Then, less than 48 hours before the necessary motions had to be filed to ensure a final vote by Christmas, another crisis erupted.


Republicans were in a full-court press to extend debate, even if it meant filibustering the defense appropriations bill as a way to postpone consideration of the healthcare legislation.

Democrats found themselves one vote short of quashing the GOP filibuster threat because Feingold, an ardent war critic, had pledged to oppose the defense funding.

Reid was unwilling to challenge Feingold on a vote of conscience. And when Democrats gathered for yet another special caucus meeting last Thursday, Reid was ready to concede defeat.

But as dejected senators began to leave, Feingold arose: He would put aside his convictions on the war, he said, and vote with his party. “I don’t think there was a dry eye in the caucus room,” said Sen. Benjamin L. Cardin (D-Md.).

The next night, Reid shook hands with Nelson after a marathon 13-hour day of negotiating that produced an abortion deal. And at 11 p.m., Reid finally got his congratulatory telephone call from the president.