Monday, December 21, 2009

The Chicago Way

Thanks to Daniel Foster at National Review Online's Doctor! Doctor! here's how the politics of the "Chicago Way" worked for a few of the senators who played hard to get.

Sen. Ben Nelson (D., Neb.):

—$1.2 billion over ten years for a permanent exemption from Nebraska's share of the Medicaid expansion. The only state so exempted under the bill.

—Exemption for Nebraska from an excise tax on non-profit insurers.

Sen. Carl Levin (D., Mich.), Sen. Debbie Stabenow (D., Mich.)

—Exemption from the non-profit excise tax for Michigan insurers. Michigan and Nebraska were the only two states so exempted.

Sen. Bernie Sanders (I., Vt.), Sen. Patrick Leahy (D., Vt.)

—$10 billion for "community health centers".

—Protections from cuts to Medicare Advantage beneficiaries in Vermont.

—$250 million over six years in expanded federal Medicaid funding.

Sen. Mary Landrieu (D., La.)

—$300 million increase in Medicaid funding in Louisiana.

Sen. John Kerry (D., Mass.), Sen. Paul Kirk (D., Mass).

—Three years of expanded federal Medicaid funding.

Sen. Chuck Schumer (D., N.Y.), Sen. Kirsten Gillibrand (D., N.Y.), Sen. Bob Casey (D., Pa.), Sen. Arlen Specter (D., Pa.), Sen. Bill Nelson (D., Fla.)

—Special treatment for Medicare Advantage beneficiaries in New York, Pennsylvania, and Florida.

Sen. Daniel Inouye (D., Hawaii), Sen. Daniel Akaka (D., Hawaii)

—billions in new funding for something called “Disproportionate Share Hospital” (DSH) payments (financed, in large part, by $18.5 billion in cuts to DSH payments in other states).

Sen. Max Baucus (D., Mont.), Sen. Jon Tester (D., Mont.), Sen. Kent Conrad (D., N.D.), Sen. Byron Dorgan (D., N.D.), Sen. Tim Johnson (D., S.D.)

—Higher federal Medicare reimbursement rates for low-population “frontier” states (also qualifying under the bill’s definition of frontier states are Utah and Wyoming, represented in the Senate by Republicans).

Even those familiar with the less savory aspects of the legislative process are amazed by the shameless venality of the administration and its congressional allies.


Athos said...

My motto, regardless of what party has the majority, has always been, "Follow the money."

The health care reform, that is to say, the federal government taking over 1/6 of the economy, will see to it that literally hundreds of millions of dollars will be going out in every direction, making it impossible to follow it.

That is power; and, a remarkably apt way to keep oneself in power. It is a new level of believing in the ways and means of social engineering and the power of Mammon.

Can't wait for the DMV-ization of doctors visits!

Robert Mooney said...

The 300 million Louisiana got for their Medicare funding was due to a 400 million or so shortfall due to an anomaly in the federal formula caused by demographic distortions from Hurricane Katrina. This is not a good way for Louisiana to prevent the kind of cuts that would harm many of our poor people, but it is sorely needed. The consequences that would result from this shortfall we are facing without these funds are not fair to the poor of our state. We have tried to get these funds otherwise for over a year, but without success. Again, I don't like this method, but am glad for our poor if it works.