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Barack Obama's presidency

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On Health Care, Dems Lack GOP Grit

By Bruce P. Cameron
February 15, 2010

Over the past quarter century when the Republicans had a priority – from funding the Nicaraguan contras to passing massive tax cuts for the wealthy – they would use whatever legislative means necessary, including bending congressional rules to get their way, a marked contrast to how today’s Democrats are handling health-care reform.

In one of the GOP’s unorthodox maneuvers – regarding aid to the Nicaraguan contra rebels in the mid-1980s – I was a participant and watched the process first-hand. A procedure for making technical changes to a bill, like fixing typos or other inadvertent mistakes, was stretched to create a major loophole for third-country support for the contras. [See below for details.]

A similar example of the GOP’s do-what-you-must approach to legislative gamesmanship came in 2001 and 2003 when President George W. Bush and congressional Republicans turned the budget reconciliation process on its head to enable the enactment of trillions of dollars in tax cuts by a simple majority vote in the Senate.

What Bush and the Republicans did was to use reconciliation – a process adopted in 1980 to allow the government to make the difficult decisions necessary for eliminating the federal deficit – for the opposite goal: blowing a giant hole in the budget and thus creating deficits as far as the eye could see.

In doing so, Bush and the GOP leaders bent the congressional rules, which bar use of reconciliation for any purpose that expands the deficit. The Republicans viewed the tax cuts as Bush’s top legislative priority so they simply muscled the bill through.

By contrast, President Barack Obama and Senate Democratic leaders, such as Budget Committee Chairman Kent Conrad of North Dakota, have rebuffed calls from rank-and-file Democrats to invoke reconciliation to pass a strong health-reform bill.

Cutting the Deficit

The justification for using reconciliation here is that health care represents a major drain on the federal budget, growing worse in future years. Cost-saving changes are needed in health care to rein in government spending and thus cut the deficit.

Indeed, as the Center for Budget and Policy Priorities notes, “because rising health care costs represent the single largest cause of the federal government’s long-term budget problems, fundamental health care reform must be part of any budget solution. …

“If health reform is pursued through the reconciliation process this year, the resulting legislation – unlike the tax cuts of 2001 and 2003 – will need to be designed so it does not add to the deficit,” which is how the Democratic legislation has been structured. [For a detailed history of reconciliation and its uses, see the Center’s Jan. 27 report.]

Ironically, it has been Democratic resistance to using reconciliation that has undercut various strategies for further reducing the nation’s health-care costs.

Because the Republicans were unified in blocking legislation with the filibuster, the Democrats had to muster all their 60 Senate votes to move the bill forward. That required concessions to conservative Democrats, like Sen. Ben Nelson of Nebraska who wanted to protect his state from higher Medicaid costs, and neoconservative Independent Joe Lieberman of Connecticut, who insisted that a cost-saving “public option” be dropped as well as a Medicare buy-in for people 55 to 64 (which Lieberman had previously favored).

Since the “public option” and expanded Medicare represented the most effective way to cut costs – by putting competitive pressure on the private insurance industry – the elimination of those features meant the reform legislation could promise fewer savings.

Meanwhile, the legislative sausage-making needed to round up the 60 votes to break a Senate filibuster  – as well as the demoralization of the Democratic “base” over the sacrifice of a meaningful “public option” – contributed to the Democrats’ stunning defeat in the special Senate election in Massachusetts in January, costing them the 60th vote and putting health reform in jeopardy.

Now, rather than turning to reconciliation to pass a strong health-care bill that would save both American citizens and their government money, Obama and the Democrats appear more interested in continuing their quixotic quest for Republican bipartisanship.

The Contra Case

As I witnessed in the mid-1980s, the Republicans had no similar regard for the niceties of congressional comity when one of their prized policies was at risk.

In the 1970s, I had been a lobbyist for liberal efforts to cut aid to right-wing dictatorships in places like Uruguay, Chile, Gen. Suharto’s Indonesia for its massive violation of human rights in East Timor, and Anastasio Somoza’s Nicaragua.

However, in the 1980s, after leftist Sandinista rebels overthrew Somoza, I grew concerned about reports of human rights violations attributed to the Sandinista regime. I was persuaded to throw my support behind the Reagan administration’s efforts to support a contra movement aimed at defeating the Sandinistas.

For that reason, I found myself in a meeting with White House aide Oliver North, who was President Ronald Reagan’s point man on Nicaragua. We were discussing a little known part of the 1986 Foreign Aid Authorization Bill called the Pell amendment, after its author Sen. Claiborne Pell, D-Rhode Island.

The Pell amendment would bar the United States from giving aid to any country that provided support to the contras. North told me that the provision would have a chilling effect on U.S. allies who might be thinking of aiding the contras. (The world would learn later that Reagan and North were already arranging millions of dollars in third-country aid from Saudi Arabia and other countries.)

At the time of our meeting, the Senate-approved authorization bill, containing the Pell amendment, was in a House-Senate conference that was ironing out differences in the two versions of the bill before the two chambers would give final approval to the legislation.

To help North remove the obstacle of the Pell amendment, I scheduled a meeting with Rep. Dante Fascell, D-Florida, chairman of the House Foreign Affairs Committee who would lead the House conferees. Unlike the other House Democratic conferees, Fascell supported aid to the contras. But my meeting was canceled.

When I finally encountered Fascell, the chairman’s mind was so filled with minutia about the bill's other issues that he couldn't focus on Pell’s contra language.

Later at the conference committee, I ran into Rep. Henry Hyde, a conservative Republican from Illinois who knew me from my days working with liberals to stop U.S. support for brutal right-wing dictatorships.

Hyde quipped, “Which of America’s allies are you trying to do in today?”

I had to convince a skeptical Hyde that I was indeed trying in earnest to help the contras, though beyond that I remained opposed to Reagan’s agenda.

“I only support the Contras,” I said. “Otherwise, I am a liberal Democrat in trouble with his soul and soon dead with his funders, you supporter of fascism.” Hyde laughed.

Despite my efforts, congressional Republican leaders didn’t seem to appreciate the urgency of North’s worries about Pell’s prohibition on third-country aid to the contras. That was because the contra-aid compromise had been done out of channels, with people like moderate Democrat Dave McCurdy who worked directly with North.

Last-Minute Maneuvers

Finally, in despair over my inability to force a change in the Pell language, I arranged a phone conference with North and a senior State Department official, explaining the situation. Within minutes, every Reagan administration lobbyist on Capitol Hill had his copy of the conference notes open to the section on the Pell amendment.

But it was too late. The elected officials who needed to be briefed on the amendment’s importance were the Republican senators who supported the contras and they didn’t get the message.

Though Hyde gave a spirited speech against the Pell amendment, Republican senators didn’t picked up on it. Fascell simply said his fellow Democratic conferees “will accept no change.”

The battle was over in minutes. Hyde looked my way and shrugged.

However, North and the White House didn’t just fold their tents. They went to work figuring out another way to gut the Pell amendment.

The next morning, White House lobbyists informed the conferees that Reagan would veto the bill if the Pell amendment were included. But Fascell refused to reopen the conference. So North came up with another solution.

The White House got Pell, the ranking Democrat on the Senate Foreign Relations Committee, to agree to a “technical modification” which was incorporated into the bill as it was reported by the conferees to both the House and Senate for final passage.

Though technical changes are not supposed to be substantive, this one was.

In its new form, the Pell amendment prohibited using foreign aid as leverage to induce other governments to aid the contras but allowed U.S. officials to explain the goals of Reagan’s policy in Central America and permitted those governments to provide military material from their own reserves to the contras if they so wished.

The “technical modification” created a loophole that the Reagan administration could drive a small war through. With the Pell amendment reduced to a bunch of empty words, Reagan signed the authorization bill into law.

A Scandal Erupts

Shortly after that, North told me privately that he would have to raise $1.5 million per month in contra military aid from foreign sources to supplement the $3 million per month in economic aid authorized by Congress.

I heard this with a mixture of unease and pride in the work I had done. My timely information on the conference had allowed North to mobilize forces in the White House to generate a veto threat and ensure that the third-country military aid was legal.

Still, I had no idea that North would use the revised Pell amendment to build his so-called “enterprise,” a quasi-government entity that merged funds from third countries with profits from the secret sale of U.S. military hardware to Iran to pay for a supply network in Honduras and El Salvador that hired pilots and other personnel to deliver weapons to contra forces inside Nicaragua.

North used the Pell loophole to wage a secret war. But his elaborate scheme finally erupted into a public scandal in the fall of 1986 as the Iran-Contra Affair.

But how the Pell amendment was essentially made meaningless was an important example of how the Republicans demonstrated toughness and creativity in circumventing traditional congressional rules to achieve their most important goals.

Obama and the Democrats might want to draw a lesson from these past events – the contra case in the mid-1980s and the tax cuts during the Bush-43 administration – that leadership requires using the legislative tools available to get a President’s agenda enacted.

Obviously, a key difference between then and now is that the Democrats in the 1980s, especially Sen. Pell, were willing to bend to White House pressure, while today’s GOP shows no inclination to compromise with Obama.

Still, if Democrats truly believe their rhetoric that improved health care is a life-or-death issue for millions of Americans, they should look at all possibilities for getting around the legislative obstacles.

They might try something similar to using technical modifications to the existing Senate bill, removing some problematic language and allowing it to be passed by the House and be sent to the President.

Or the Democrats could go the reconciliation route, repackaging health reform – including a cost-saving public option and a Medicare buy-in – and pass the bill on majority vote in both chambers, and then send it to the President.

Instead, the Democrats are looking like whiny supplicants begging the Republicans to let them pass something, while the Republicans perceive that their obstructionist tactics are working. They are looking forward to a Democratic rout in November, so they have no political incentive to give Obama even a partial victory.

But the lack of a Democratic fighting spirit may be the biggest obstacle of all to getting meaningful health reform passed in the United States.

Bruce P. Cameron has served as a Washington lobbyist for various governments over the past several decades, including Nicaragua, Mozambique, Portugal and East Timor. He is the author of My Life in the Time of the Contras.

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