Nelson on healthcare: Make me an offer I can't refuse

The Nebraska Democrat thinks you've got an awfully nice reform package here, and it'd be a shame if something were to happen to it.

Published April 23, 2009 6:15PM (EDT)

It’s been said before that running a government and running the Mafia are somewhat similar activities. But Sen. Ben Nelson, D-Neb., might be taking the analogy a little too far.

Just to be clear, that’s not a suggestion that Nelson stands to gain personally from his Senate activities or that he's burying anyone at the Meadowlands. He's strong-arming his party politically, exploiting the good luck of being the most conservative senator in a 59-member party that needs 60 votes to pass its agenda. Virtually anything that’s going to happen in the Senate has to go through Nelson. That means, essentially, that he can force Democrats to write whatever he wants in to law. Plus, he’s threatened to kill President Obama’s  proposal to cut the middlemen out of student lending (not coincidentally, a big lending company is based in Nebraska), and he managed to hold the stimulus bill hostage until Democrats acquiesced and stripped out an arbitrary couple hundred billion dollars.

Next on Nelson’s shakedown list, apparently, is healthcare. The New Republic’s Jonathan Cohn has a report of a Nelson staffer boasting, “Democrats will have to earn [Nelson’s] vote,” and threatening that the senator is “fully prepared to vote against” a Democratic bill. (Cohn got an on-the-record statement from a Nelson staffer that was far less definitive: Nelson is “concerned about the overall cost of health legislation, but he’s definitely working with Senator Baucus to make improvements to it.”)

Cohn adds that 90 percent of Nebraskans favor “an affordable health plan for all -- regardless of health status.” Granted, of course, that’s an extremely easy proposition to agree with. But Nelson may well end up responsible for preventing a bill that would achieve that goal from reaching the supermajority needed to pass.

What will it take to “earn his vote?" It’s not clear; the anonymous staffer Cohn quotes suggests that the senator is likely to object to anything too ambitious or comprehensive. That could mean, for example, that he’ll insist liberals give up on a government-offered insurance plan to compete with the private sector. Democrats and health reformers, after all, have to outbid a pretty fierce competitor for the Nebraskan’s vote: From 2003-2008, of the five sectors that gave the most campaign cash to Nelson, insurance came in at number one (with $608,709), and health professionals at number five (with $233,426). Like Sal Tessio tells Tom Hagen in The Godfather -- it’s just business.

By Gabriel Winant

Gabriel Winant is a graduate student in American history at Yale.

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