Health care battle tests longtime bipartisan Senate team

WASHINGTON — For nearly a decade, Democrat Max Baucus of Montana and Republican Charles Grassley of Iowa have worked together on the Senate Finance Committee to shape tax cuts, trade measures and health bills.

As Congress returns to work next week, however, their partnership has frayed over President Barack Obama's push to overhaul the nation's health care system.

Grassley made a stream of caustic and pessimistic remarks as he toured Iowa during the Senate's August recess. He initially made no attempt to challenge unfounded charges that the House of Representatives Democrats' health care legislation included "death panels" and called Obama and House Speaker Nancy Pelosi of California "intellectually dishonest" in using the controversy to divert attention from problems with the Democrats' approach.

Now the question is: Can this marriage be saved? Don't bet on it, at least when it comes to a health care overhaul.

"Would either Baucus or Grassley arrive at a compromise just because we're friends?" Grassley said in a recent interview with Kaiser Health News. "No. Product is what we're working on, and bipartisanship doesn't result just because we have a good working relationship. It works because we're able to work things out." He insisted that his relationship with Baucus was still intact, however, and that bipartisan talks on the issue would continue.

Baucus agreed, telling KHN: "We have a long history of working across party lines, and while we may not always agree on every issue, we always try to find a way to work together."

Grassley's problem, said David Yepsen, the former chief political reporter for the Des Moines Register, is that he's caught "between different forces crushing in on him," with Senate GOP leaders and conservatives back home adamantly opposed to a deal, and large numbers of Obama voters in Iowa who support health care action.

Grassley, a five-term lawmaker who's up for reelection next year, also said he wasn't sure that bipartisan talks could produce a Finance Committee deal in September. He also said that the soaring budget deficit — now projected to total $9 trillion in the coming decade — "puts a stake in the heart" of many reform ideas.

Baucus, the chairman of the Finance Committee, said he still thinks that a health care overhaul is "inevitable" this year.

"I remain committed to getting health care reform done — done right and done this year — and a bipartisan bill is my first, second and third choice," he said. "As always, I'm going to work with anyone who shares that goal."

However, with Grassley, the ranking Republican, inching away from the bargaining table, Baucus may be left with two bad choices:

_ Drastically scaling back the committee's $900 billion draft plan in an effort to satisfy a few Republicans, a move certain to alienate large numbers of liberal Democrats

_ Standing aside as Senate and House Democratic leaders use special budget rules to try to push through a major bill, which likely would include a controversial public insurance plan, with virtually no Republican support.

"I think as Democrats talk about, 'Let's do it ourselves,' that makes it easier for Grassley to say, 'Okay, I'm out of here,'" said Yepsen, now the director of the Paul Simon Public Policy Institute at Southern Illinois University in Carbondale, Ill.

With the death of Massachusetts Sen. Edward Kennedy, the Democrats' majority in the Senate shrank to 59 votes, including two independents who generally vote with the Democrats. In all likelihood, the Democrats will need 60 votes to overcome a Republican filibuster to pass virtually any health care legislation this year.

Besides Grassley and Baucus, the Finance Committee negotiators are Republicans Mike Enzi of Wyoming and Olympia Snowe of Maine and Democrats Kent Conrad of North Dakota and Jeff Bingaman of New Mexico. If Grassley and Enzi bail out of the so-called "Gang of Six" talks, the Democrats' only hope is to hold on to Snowe, a moderate Republican.

Even if Snowe remains on board, however, the Democrats could have trouble preventing defections by a handful of moderate-to-conservative Democrats who're facing strong opposition to health care legislation from their constituents.

When they shook hands and returned home for the August recess last month, Baucus and Grassley thought a health care deal was within their grasp and that the final details could be wrapped up by a Sept. 15 deadline.

Baucus aides, however, became alarmed by some of Grassley's town hall comments, particularly by the way he waded into a controversy sparked by former Alaska governor Sarah Palin's warning that a Democratic end-of-life counseling provision in the House bill could lead to "pulling the plug on grandma."

Aides to Baucus conferred with Grassley's staff to try to determine whether there'd been a sudden rupture in their relationship. Baucus conferred with Grassley several times by phone during the August break, gently sounding him out about how his town meetings were going and his impressions of public sentiment — but not confronting him about any of his statements.

With so much uncertainty about the fate of health care legislation this fall, about the only thing that can be said with certainty is that the Baucus-Grassley relationship will soon be put to its ultimate test.

Baucus, 67, a reticent Montana rancher, and Grassley, 75, a folksy Iowa farmer, share many of the same economic and social values. Both are political mavericks who've angered their party leaders in the past by cutting deals with the other side that conflicted with their parties' agendas.

The two first teamed up in 2001, when Grassley took the helm of the Finance Committee, and they've swapped roles as chairman three times since then. Bipartisan deals worked out by them smoothed the way for President George W. Bush's major tax cuts, the 2002 fast-track trade agreement, and the 2003 Medicare prescription drug benefit.

While sensitive to their parties' political imperatives, Baucus and Grassley frequently have charted a middle course, such as when Baucus enraged Senate and House Democratic leaders by privately negotiating a compromise with Republicans to pass the Bush administration's Medicare prescription drug benefit plan.

Grassley sided with the Democrats to help pass a $35 billion expansion of a health insurance program for children of low-income families, although Bush later vetoed it. When Obama and congressional Democrats revived the legislation but changed provisions of the bill regarding legal immigrant children, Grassley voted against the bill. It passed nonetheless, and Obama signed it into law.

This time, with the political stakes so high over the fate of Obama's signature health care initiative, Grassley and Baucus are finding it much harder to chart a course independent of their parties' leadership.

Senate Republican leader Mitch McConnell of Kentucky calculated last spring that defying Obama on health care reform would pose less of a risk to Republicans than Obama's landslide election results suggested it would.

Beginning in May, McConnell began declaring publicly that his party was ready to work with the president to overhaul the health care system, while stressing that "it's important to get it right" and avoid creation of a government-run health care system that "could soon lead to government bureaucrats denying and delaying care."

Democrats pushed their own versions of health care legislation through the Senate Health, Education, Labor and Pensions Committee and three House committees — Ways and Means, Energy and Commerce, and Education and Labor.

Baucus and Grassley, however, took a different approach and created a six-member negotiating team consisting of three Democrats and three Republicans to try to draft compromise legislation that could attract large numbers of votes from both sides of the aisle.

As the "Gang of Six" seemed to be inching toward an agreement, though, Republican criticism of the effort stepped up, and Grassley came under increased pressure from GOP colleagues to slow down or sidetrack the bill.

Sen. Jim DeMint, R-S.C., boasted that if the Republicans could bring down the bill, Obama would suffer "his Waterloo." Over the August recess, Sen. Jon Kyl, R-Ariz., told reporters that the Republican leadership not only was unalterably opposed to a public option, but also wouldn't go along with a fallback proposal to create nonprofit health insurance co-operatives.

"I think it's an accurate picture to say that both parties would try to discourage us," Grassley told Kaiser Health News last week. "But we have held the position since January that we're affecting one-sixth of the economy and that we're affecting life-or-death issues with every American that it ought to be done in a broad bipartisan way and that's lots of Republicans and lots of Democrats — but not necessarily all Republicans and all Democrats."

Asked whether he's been criticized by some in the Republican leadership for persisting in search of a bipartisan deal, Grassley replied: "Not to my face, but I think to my back I have been."

(Mary Agnes Carey of Kaiser Health News contributed to this article.)

(Kaiser Health News, an editorially independent news service is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization that's not affiliated with Kaiser Permanente.)


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