Healthcare reform

Healthcare reform

Healthcare reform

Forget the old saw about the perils of knowing too much about how sausages or laws are made. Americans, it turns out, wanted to know a lot about the backroom deals that went into the healthcare bill. (Chaddock, Gail Russell, 2010)

Stung by months of criticism of a $300 million deal over Medicaid payments, dubbed "the Louisiana purchase," Sen. Mary Landrieu (D) took to the Senate floor yesterday to set the record straight. The deal - an agreement to lower Medicaid charges to the state due to per capita income figures artificially inflated by post-Katrina relief payments - was not secret, she said. Nor was it offered in exchange for her vote on healthcare reform. "I don't want to see what has been said inappropriately or erroneously to jeopardize the healthcare bill in the future," she told reporters after the speech. (Chaddock, Gail Russell, 2010)

President Obama has acknowledged that these deals helped turn the public against the legislation. "With all the lobbying and horse-trading, the process left most Americans wondering, 'What's in it for me?' " he said in his State of the Union address. For many Americans, those "sweetheart deals," tucked into the legislation for certain states or groups, became a flash point.

Terms for these deals - including the Louisiana Purchase, the Cornhusker kickback, and the Cadillac tax exemption - went viral over the Internet. Newspapers and broadcast media also picked up reports about the deals - accurate or not. The public came to see the process as corrupt and self-serving. "The volume of viral e-mails attacking healthcare has really been remarkable," says Brooks Jackson, director of the Annenberg Public Policy Center's FactCheck.org. "Ninety percent of what we see is false," he adds. (Chaddock, Gail Russell, 2010)

Of course, Congress is no stranger to making deals that benefit a state or district. The practice of targeting funds to member projects in spending bills - also known as earmarking - took off in the 1990s (see chart). But in recent years, there's been a backlash to the backroom deals of Congress. Public-interest groups set up a cottage industry in tracking and drawing attention to earmarks, and Americans have become more vocal in objecting to them. The public uproar in 2005 over a $223 million "bridge to nowhere" in Alaska stunned lawmakers: They hadn't expected people to dig into matters so arcane. (Chaddock, Gail Russell, 2010)

The response to reports of backroom deals in the healthcare legislation was even more surprising. As Senate majority leader Harry Reid began drafting a compromise bill in secret, every whisper of a deal was amplified. "People are tired of political manipulation, regardless of the dollar amount," says David Williams, vice president of policy at Citizens Against Government Waste, which produces an annual "Pig Book" to track earmarks. "People see the Nebraska, Louisiana, Florida deals and say, 'They're doing the same exact thing they've been doing for years: They're buying votes and trying to manipulate the system.' "(Chaddock, Gail Russell, 2010)

When it came down to it, ...