Reid’s health reform dilemma

Health care reform has been a front-burner issue in Washington for several months now, and everybody on Capitol Hill seems to be sick of the debate. Nobody could be more feverish about it than Senate Majority Leader Harry Reid.

Reid, D-Nev., is aging before our eyes as he tries every which way to get a health bill passed in the upper chamber. With Republicans determined to thwart his efforts, Reid must secure 60 votes in order to bypass the Senate’s procedural gauntlet.

It’s been a rough road for Reid, who at various times has appeared to be on the verge of success, only to encounter a new roadblock. The latest obstacle is Connecticut Sen. Joe Lieberman, an independent who used to be a Democrat.

Not so long ago, Reid was championing a bill that included a so-called public option — a government health insurance plan to compete with private plans. When the political tide seemed to be turning against this idea, Reid came up with a compromise that dropped the public option and expanded Medicare instead.

But Lieberman, the crucial 60th vote, piped up this week, saying he couldn’t support the Medicare expansion. He dropped this little bombshell despite the fact that he publicly supported a Medicare expansion plan just a few months ago.

You gotta believe Reid, a boxer in his youth, would like to put those skills back into practice during a dark-alley meeting with Lieberman.

Anyway, now Reid is left with a 2,000-page bill that still has some good things in it but contains a disconcerting flaw: It requires most Americans to buy health insurance but does little to reduce or control the costs of that insurance.

So Reid finally may be able to garner 60 votes for a health bill. Maybe, just maybe his long, tortured journey will bear fruit before Christmas. But two important questions must weigh on his mind:

First, is the final Senate bill truly as historic as some advocates contend? With no public option, no Medicare expansion and no controls on insurance costs, will this bill take a leap forward in addressing the nation’s health care crisis? A smaller measure may be worth doing in any case, but the bill as it stands is a far cry from the ambitious goals set forth at the outset of this effort.

Second, how will this final Senate bill be viewed in the context of Reid’s bid for another term? While some argue that passage of health reform would hurt Reid’s re-election chances, I disagree. Reid, I believe, would benefit from being known as a leader responsible for reforms in this critical area of American life.

This bill, as watered down as it is, contains provisions to improve the lives of thousands of Nevadans. Among other things, it would prevent insurance companies from denying coverage or increasing premiums because of pre-existing conditions or because of age. It also would expand the number of low-income people eligible for Medicaid coverage.

Of course, the progressive wing of the Democratic Party is apoplectic over how health care reform has been decimated on Reid’s watch. Although Lieberman is their “most hated man in Washington” right now, Reid seems to be running a close second.

But does this matter? It would if there was a real possibility that liberal Democrats would vote against the compromise bill. For all their grumbling, they ultimately will support the bill as a step in the right direction.

And for all their criticism of Reid, most progressives aren’t likely to vote against him either. For one thing, there aren’t enough principle-first progressives in Nevada to be a factor in the election. As a sometime-associate of that passionate group, I can assure you it has a modest membership across the Silver State.

For another thing, the fact that a senator from Nevada is the most powerful lawmaker in the free world still carries a lot of weight. Even if Reid is not particularly liberal on some issues, the prospect of a Republican taking his seat is unthinkable for most Nevada Democrats.

Health care reform is not Reid’s most pressing election challenge. A much bigger factor is how much time he will be able to spend in Nevada over the next 10 months.

A successful campaign requires time and money. Reid has a huge war chest, so money is not an issue. But as the Senate majority leader, Reid spends most of his time in Washington, appearing almost daily on the evening news and subjecting himself to relentless conservative attacks on radio and TV talk shows.

For Reid to win in 2010, he must be able to campaign extensively across Nevada, reminding voters that he’s a flesh-and-blood person, not a national cartoon image. And that doesn’t mean a TV ad blitz and a handful of dress-up fundraisers in Las Vegas and Reno. It means face-time with regular people, shaking hands and discussing the issues facing Nevadans.

Although Congress must deal with other pressing issues in the new year, moving health care reform off the front burner soon will allow Reid to come home and get the most vital part of his re-election campaign started.

Geoff Schumacher (gschumacher@reviewjournal.com) is the Review-Journal’s director of community publications. His column appears Friday.

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