Votes for sale

This special deal for Nebraska raises an immediate question: Why doesn’t every Democratic senator demand the same treatment for his or her state? Eventually, they will. After the Nelson deal was announced, Sen. Tom Harkin of Iowa enthused, “When you look at it, I thought well, God, good, it is going to be the impetus for all the states to stay at 100 percent (coverage by the federal government). So he might have done all of us a favor.” In a single concession, Reid undermined the theory of Medicaid — designed as a shared burden between states and the federal government — and added to future federal deficits.

Unless this little sweetener is stripped from the final bill by a House-Senate conference committee in January, which would leave Nelson with a choice. He could enrage his party by blocking health reform for the sake of $100 million — making the narrowness of his interests clear to everyone. Or he could give in — looking not only venal but also foolish…

In a single evening, Nelson managed to undermine the logic of Medicaid, abandon three decades of protections under the Hyde Amendment and increase the public stock of cynicism. For what? For the sake of legislation that greatly expands a health entitlement without reforming the health system; that siphons hundreds of billions of dollars out of Medicare instead of using that money to reform Medicare; that imposes seven taxes on Americans making less than $250,000 a year, in direct violation of a presidential pledge; that employs Enron-style accounting methods to inflate future cost savings; that pretends to tame the insurance companies while making insurance companies the largest beneficiaries of reform.