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The Health-Care Tipping Point

It is an irony worthy of a Greek drama that the moment ObamaCare appeared to overcome one of the final hurdles to passage may have been the one that sealed its rejection a few days later in Massachusetts. That moment occurred on the Thursday before the Massachusetts vote, as union leaders emerged from two days of secret discussions in the White House to announce that they had gotten a five-year $60 billion exemption from the “Cadillac tax” on their health-care plans. That may have been the tipping point.

The exemption — call it the Union-Label Insurance Exemption (U-LIE) — marked the culmination of a process that violated multiple Obama promises about the changes he would bring to Washington: it was not transparent, it was not post-partisan, and it did not eliminate the Blue State/Red State dichotomy. On the contrary, it followed a parade of buy-offs, kickbacks, and exemptions given to Blue State senators to garner their participation in the “historic” process: Mary Landrieu (D-La.) got her Louisiana Purchase; Ben Nelson (D-Neb.) got his Cornhusker Kickback; Bill Nelson (D-Fla.) got his Gator Aid; Sen. Jeff Merkley (D-Ore.) got his Longshoreman Carve-Out, etc. Then unions got a massive exemption not accorded nonunion workers, with the cost to be shifted to unknown others.

The process had previously featured bills placed in print only hours before votes were called, their text shielded not only from the public but also from those responsible for voting. The unpopularity of what was known about the pending legislation was said to be soluble by learning about it later: David Axelrod asserted Sunday that “people will never know what’s in that bill until we pass it,” but they will like it after that.

What made U-LIE the likely tipping point was that it was a quantum leap in an already corrupt process — not simply quantitatively, as a buy-off in the tens of billions on top of the hundreds of millions offered seriatim to individual senators, but qualitatively as well: this time it was not an individual buy-off in some legislative backroom over which Obama could argue (although implausibly) he had no control, but a secret conference committee in the White House, in an eight-hour meeting with Obama in attendance much of the day, ending with a massive transfer to a favored constituency, with no hearings at all, much less ones on C-SPAN. It was then simply announced to the public, including the portion residing in Massachusetts.

Coming on top of a process already appalling, U-LIE may have been the final straw, cementing a perception of Obama as a president committed to a nontransparent, partisan push of unpopular legislation, loaded with kickbacks and buy-offs and complete with assurances that people would appreciate it all later. It is not clear what tone or tack Obama will take in his State of the Union address tomorrow evening about the process over which he presided. As of yesterday, the speech was reportedly still being written. But the problem he now confronts may be one that can no longer be solved with a speech.


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