States of Personal Privilege
Senators aren't counting on reform savings when it comes to their constituents.
By Kimberley A. Strassel
WSJ.com
How good is Sen. Max Baucus's health reform bill? So good that Democrats have made sure some of the most costly provisions don't apply to their own states.
The Senate Finance Committee is gearing up for a final vote next week, and Chairman Baucus now appears to have the Democratic votes to pass his bill. Getting this far has of course meant cutting deals, and those deals, it turns out, are illuminating. The senators are all for imposing "reform" on the nation, so long as it doesn't disadvantage their constituents.
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Sens. Harry Reid (Nevada) and Charles Schumer (New York) are among
those inserting goodies for their states.
A central feature of the Baucus bill is the vast expansion of state Medicaid programs. This is necessary, we are told, to cover more of the nation's uninsured. The provision has angered governors, since the federal government will cover only part of the expansion and stick fiscally strapped states with an additional $37 billion in costs. The "states, with our financial challenges right now, are not in a position to accept additional Medicaid responsibilities," griped Democratic Ohio Gov. Ted Strickland.
Poor Mr. Strickland. If only he lived in . . . Nevada! Senate Majority Leader Harry Reid, who is worried about losing his seat next year, worked out a deal by which the federal government will pay all of his home state's additional Medicaid expenses for the next five years. Under the majority leader's very special formula, only three other states—Oregon, Rhode Island and Michigan—qualify for this perk, on the grounds, as Mr. Reid put it recently on the Senate floor, that they "are suffering more than most."
Tell that to Mr. Strickland, who is still trying to figure out how to close an $850 million budget hole, in a state with near 11% unemployment. And tell it to Republican Sen. Lamar Alexander, who quipped: "I wonder how citizens in Wyoming, in California and Florida and other states will feel if they pay more taxes so that Nevadans can pay less taxes."
To pay the bill for his version of ObamaCare, Mr. Baucus's legislation would tax high-value insurance plans—a 40% tax on plans that cost more than $21,000 a year. Democrats argue it is reform to make those who can afford "luxury" health care chip in for those who can't afford any at all.
That is, unless you live in a state such as New York. That state, along with some others, has many high-value plans—in part because it boasts a lot of union members with "Cadillac" plans, in part because the state has imposed so many insurance regulations that even skimpy plans are expensive. Sen. Chuck Schumer didn't want a lot of angry overtaxed New Yorkers on his hands, so he and other similarly situated Democrats carved out a deal by which the threshold for this tax will be higher in their states. If you live in Kentucky, you get taxed at $21,000. If you live in Massachusetts you don't get taxed until $25,000. This carve-out is at least more sweeping, applying to 17 (largely blue) states, though that's cold comfort if you live in Louisville.
Mr. Baucus will also pay for his bill by socking it to pharmaceutical companies, on the principle that drug companies are filthy rich and should have to contribute to health care. The view is a bit different in New Jersey. The state's Web site boasts it is the "global epicenter" of the drug industry, where "15 of the world's 20 largest pharmaceutical companies have major facilities." And Sen. Bob Menendez, of the Garden State, seems concerned that his home-state employers are going to struggle to both pay their federal liabilities and to continue to grow and innovate. Thus Mr. Menendez's quiet deal for a $1 billion tax credit for companies investing in drug R&D.
The Baucus bill, we are assured by many Dems, will successfully "bend down" the health-care cost curve. Michigan Sen. Debbie Stabenow isn't counting on it when it comes to her constituents. She and Massachusetts Sen. John Kerry included $5 billion in the bill for a reinsurance program designed to defray the medical costs of union members.
"This will help our employers, whether it's the auto industry or whether it's other industries, be able to lower their costs for early retirees," said Ms. Stabenow. She is apparently unaware that this is what the broader bill is supposed to do, even without $5 billion in union slush money.
So, health-care "reform" is good, smart and necessary, so long as it isn't fully applied to the states of the senators who are pushing it. The Democrats' growing problem is that somebody is ultimately going to have to pay, and Mr. Reid's bad example has given every one the same idea. "If Colorado has a fair claim on being treated the same way Nevada has been, of course we're going to ask to have that kind of treatment," promised Sen. Mark Udall, upon news of the Reid deal.
Most senators are saving up their special state demands for when the bill hits the Senate floor. At that point, we'll get an even better idea of how much health-care change Democrats truly believe in.
Write to kim@wsj.com