Sweets for some become sweets for all

March 11, 2010|By Kathleen Parker

Skipping through the Candy Land of the health care bill, one is tempted to hum a few bars of "Let Me Call You Sweetheart."

What a deal. For deal-makers, that is. Not so much for American taxpayers, who have been misled into thinking that the sweetheart deals have been excised.

Not only are the deals still there, but they're bigger. And the health care "reform" bill is, consequently, more expensive by billions.

Yes, gone (sort of) is the so-called "Cornhusker kickback," extended to Nebraska Sen. Ben Nelson when his 60th vote needed a bit of coaxing.

Meaning, Mr. Nelson is no longer special. Instead, everyone is. All states now will get their own Cornhusker kickbacks.

Originally, Mr. Nelson had secured 100 percent federal funding for Nebraska's Medicaid expansion - in perpetuity - among other hidden prizes to benefit locally based insurance companies. When other states complained about the unfair treatment, President Barack Obama and Congress "fixed" it by increasing the federal share of Medicaid to all states through 2017, after which all amounts are supposed to decrease.

Mr. Nelson's deal might have escaped largely unnoticed, if not for his pivotal role on the Senate vote last December. The value of what he originally negotiated for Nebraska, about $100 million, wasn't that much in the trillion-dollar scheme of things, but the cost of the "fix" runs in the tens of billions, according to a health lobbyist who crunched the numbers for me.

Other sweetheart provisions that remain in the bill include special perks for Florida, Louisiana, Nevada, Montana, Wyoming, North Dakota and Utah.

There may well be others, and staffers on the Hill are sifting through the stacks of verbiage.

Wearily, one might concede that this is politics as usual. But weren't we supposed to be finished with backroom deals?

During last month's health care summit, Sen. John McCain had the audacity to raise - "with respect" - the specter of opaque and "unsavory" deal-making, whereupon Mr. Obama reminded his former presidential foe that the campaign was over. Which isn't exactly true, of course, but point taken.

The effort to push any health care bill through Congress is relentless, no matter how many Americans oppose it.

To his credit, Mr. Obama conceded Mr. McCain's point in a post-summit letter to Congress, noting that some provisions had been added to the legislation that shouldn't have been. His own proposal does not include the Medicare Advantage provision mentioned by Mr. McCain that allowed extra benefits for Florida, as well as other states. The president also mentioned that his plan eliminates the Nebraska yum-yum (not his term), "replacing it with additional federal financing to all states for the expansion of Medicaid."

More fair? Sure, but at mind-boggling cost. To correct a $100 million mistake, we'll spend tens of billions instead.

Throughout the health care process, the Democrats' modus operandi has been to offer a smarmy deal and then, when caught, to double down. The proposed tax on "Cadillac" insurance policies to help defray costs is another case in point. Pushed by the president, and initially passed by the Senate, the tax was broadly viewed as an effective way to control costs. But then labor unions came knocking, and everyone caved. The tax will be postponed until 2018.

And the cost of the union compromise? According to the Congressional Budget Office, the original Cadillac tax would have saved the Treasury $149 billion between 2013 and 2019. Under the postponed tax, the savings will likely plunge to just $65 billion. Regardless of what the CBO reports in the coming days, no one can claim the bill is as lean as it could be. A spoonful of sugar may indeed help the medicine go down, but even King Kandy and the Gingerbread People can choke on too many sweets.

Kathleen Parker's e-mail is kathleen parker@washpost.com.

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