Grassley plots backup healthcare plan

Sen. Chuck Grassley (R-Iowa) is battling on two fronts in the war for health reform.

On one side are Democrats, eager and determined to impose their vision on the American healthcare system and unafraid of using strong-arm tactics to get what they want.

{mosads}On the other side are some of Grassley’s Republican colleagues, who see 2009 as a priceless opportunity to recreate the glory days of 1994, when they crushed President Clinton’s health reform plan and seized control of Congress.

In the middle is Grassley, the ranking member of the Finance Committee and the chief Republican negotiator on healthcare. Grassley and his close friend, Finance Committee Chairman Max Baucus (D-Mont.), have been working for months to strike what could prove an unattainable compromise.

Grassley has served in Congress since 1976, starting with three terms in the House. Next year, he will stand for reelection to his sixth term in the Senate after winning more than 70 percent of the vote in 2004. He hasn’t missed a floor vote since July 1993. He’s been Finance Committee chairman twice and has made his mark on nearly every major healthcare bill to pass Congress this decade.

Even under the weight of all that history, health reform could prove Grassley’s greatest triumph or his biggest disappointment. And with Grassley’s years on the Finance Committee coming to an end in 2011, this could be his last crack at revamping the nation’s healthcare system.

During an interview with The Hill, Grassley insisted that bipartisan health reform is possible but that the precarious balance struck among members of the Finance Committee could be disrupted at any moment by partisan maneuvering on either side of the aisle. (Watch video here)

On Wednesday, Grassley will join Baucus for a face-to-face meeting with President Obama on health reform at the White House. Grassley made it clear that he is not worried about the president.

“I think that Obama’s sincere about wanting bipartisanship. I think that his leaders on the Hill were out of power for 14 years, that they’ve been waiting around for 14 years to get things done — and they’re going to get them done, regardless of what their president wants,” Grassley said.

The Finance Committee is on schedule to mark up a health reform bill in July. That should be enough time if they’re left alone to work out a deal, Grassley said. “I believe, if we have an opportunity to negotiate as we have been doing for months and continue that for another six weeks, we can get a bipartisan agreement.”

The biggest fault lines between Democrats and Republicans on healthcare are already clearly visible and reflect a philosophical divide about the appropriate size and role of the federal government. Among them is whether to create a public plan that would provide health insurance.

“There might be something you could do, but I’m very leery of that being possible. But everything’s on the table. Baucus hasn’t taken anything off the table; I’m not going to take anything off the table,” Grassley said.

Grassley wants to stick with Baucus for as long as he can but knows that Democratic leaders such as House Speaker Nancy Pelosi (Calif.), Senate Majority Leader Harry Reid (Nev.) and White House Chief of Staff Rahm Emanuel are waiting in the wings, ready to force through a Democratic bill if a consensus fails to emerge.

“Here’s something we Republicans have to consider: We can be bargaining in good faith up to that … one, last issue — whatever that might be — and regardless of how [well-]intentioned Sen. Baucus is on reaching an agreement with me, Pelosi and Reid could decide to pull the rug out from under them at the midnight hour and not have an agreement,” Grassley said.

{mosads}Grassley is dealing with pressure from the right as well as from the left. He knows there are Republicans in Congress who see no point in trying to make deals with Democrats on healthcare and want to start fighting back now.

Budget reconciliation changed everything, Grassley said. By choosing to provide themselves a tool to enable health reform to pass the Senate with a simple majority, the Democratic leadership threatened to prevent a bipartisan alliance emerging — and undercut promises made by President Obama, Baucus and others, he said.

Baucus and other Senate Democrats, including Budget Committee Chairman Kent Conrad (N.D.), oppose reconciliation and say they would do everything they can to see it isn’t used — and Grassley believes them. But they lost that battle once already. Grassley recounted Baucus and Conrad “explaining to me the distress — and I saw it in their face[s] — that they had when they were trying to talk [to] Rahm Emanuel about forgetting about reconciliation.”

Grassley hasn’t made his task any easier by setting an extraordinarily high bar for bipartisanship: 70 to 80 votes in the Senate, a tally that might seem inconceivable to either party’s leadership.

“We’ve got to have it where there’s a few Republicans that aren’t going to be satisfied with anything we do and a few Democrats that aren’t going to be satisfied with anything we’re going to do. In other words, I’m saying we’ve got to legislate toward the middle 80 percent of the Senate,” he said.

Though intent on taking the bipartisan work as far as he can, Grassley also understands he has a responsibility to his conservative principles and to his party to hold the line.

“When I’m negotiating, you’re really trying to be negotiating in two directions,” Grassley said. “If I hadn’t had the knife of reconciliation at our back, I wouldn’t be saying that,” he said.

In his capacity as a Republican leader on healthcare, it is incumbent on Grassley to be prepared if the chance for bipartisanship dissipates, he indicated.

“In tune with our responsibility as the loyal minority and loyal opposition, with emphasis on ‘loyal,’ we have to have a constructive alternative, with emphasis on ‘constructive,’ ” Grassley said. “So we have to be developing a bipartisan package with Baucus, with that being our goal and right now our only goal, but [we] can’t wait until the midnight hour to have something that Republicans can rally behind.”

Five minutes before midnight might not be soon enough for everyone in the GOP, Grassley acknowledged. “I think some Republicans would like to have it released ahead of time, but I think that that draws a line in the sand and I wouldn’t draw a line in the sand until I know we’re going to have reconciliation.”

Grassley also doesn’t see himself taking on the role adopted by Baucus during the negotiations on the 2003 bill that created the Medicare prescription drug benefit. At the time, Baucus and then-Sen. John Breaux (La.) were the only Democrats who continued working with Grassley, other Republican lawmakers and the Bush administration on the legislation. The two Democrats, especially Baucus, took intense heat from their conference, many members of which thought they’d sold out to the GOP.

“There’s quite a bit of difference between making a slight improvement in Medicare — which is how I would classify the prescription drug bill: a slight modification of Medicare — to rewriting 16 percent of the gross national product,” Grassley said.