Morning Must Reads — Winning ugly

America is closer to a national health program than ever before, but we still don’t know what kind.

In a party-line vote at 1 am, the Senate agreed to move to final passage on a plan worked over like a truck stop cube steak. That means Congress is almost certain to pass something.

But what?

As we knew would be the case when this process began, the House bill is much more liberal than the Senate bill and the two must now be mashed up into one plan that can then get 60 votes again in the Senate. The Senate negotiators will take the position that their bill, with huge giveaways to holdouts and the elimination of a government insurance program, represents the best possible offer from the upper chamber. Nancy Pelosi, though, only cleared the 218-vote threshold she needed in the House by two votes. Since that vote almost seven weeks ago, liberals (Howard Dean et al) have militated against the Senate plan, saying it is worse than nothing and moderate House members from swing districts have come to realize just how toxic the environment for their reelection efforts have become.

So yes, a bill will likely be approved next month. But what will be in it and what it will take to get there are still up in the air.

Writers Shailagh Murray and Lori Montgomery explain that liberals are smarting, but doing their best to think of the rest of the camel still outside the tent.

“Liberal Democratic senators vowed that where the legislation falls short, Congress would answer with modifications and additions. ‘This is not the end of health-care reform. It is the beginning,’ Senate health Chairman Tom Harkin (Iowa) said on the floor early Monday. Harkin, who is serving his fifth Senate term, described the procedural motion as ‘the defining vote of my career.’”

New York Times — Deep in Health Bill, Very Specific Beneficiaries

The size and complexity of the Senate Democrats’ health bill is owed in part to the big number of little giveaways and sweetners given to wavering members and those powerful enough just to demand them.

My column today
looks at the most notorious deal cut to get the bill passed, but writer Robert Pear helpfully looks at all of the small favors doled out in the process of crafting the definitive Harry Reid bill.

“Another provision would give $100 million to an unnamed “health care facility” affiliated with an academic health center at a public research university in a state where there is only one public medical and dental school.

Senators and their aides said on Sunday that they were not sure who would qualify for this money or who had requested it.

Dr. Atul Grover, the chief lobbyist for the Association of American Medical Colleges, said he believed that Commonwealth Medical College, a new school in Scranton, Pa., was a likely candidate.

Los Angeles Times — Familiar faces among health industry lobbyists

Writer Andrew Zajac and a team from the graduate journalism school at Northwestern used the data compiled by the Center for Responsive Politics to figure out how many former Hill staffers have been lobbying on health care. It’s been quite a hogwaller.

“At least 166 former aides from the nine congressional leadership offices and five committees involved in shaping healthcare overhaul legislation, along with at least 13 former lawmakers, registered to represent at least 338 healthcare clients since the beginning of last year, the analysis found.

Their healthcare clients spent $635 million on lobbying over the last two years, the study showed.

The total of insider lobbyists jumps to 278 when non-healthcare firms that reported lobbying on health issues are added in.”

USA Today — Climate summit a let-down to some delegates

The Euros are fuming over the climate meltdown in Copenhagen. While the White House was talking about a “great step forward” (Did they bring Anita Dunn back?), the rest of the warming-believing world was in a snit.

But the White House says at the next summit, set for one year from now in Mexico City, the promises about an international carbon regulatory authority, firm commitments to fund green initiatives in the Third World, and binding targets for emissions reductions.

Writers Eric Lyman and Brian Winter were part of the horde of journos who went to Copenhagen to watch the snow fall.

‘Everyone is tired,’ said [Anders] Turreson, the co-chair of Sweden’s delegation to the Copenhagen talks. ‘In many ways, this was an ideal moment to strike an agreement, and it could not be done.’”

Robert Samuelson — Passing health reform could be a nightmare for Obama

Republicans believe that Democrats have inflicted a deep wound on themselves for the 2010 elections by riding their health-care bill downhill like a toboggan. Democrats believe that the plan will pay medium-term political dividends once Americans see that they are a party of progress and action.

Samuelson, though, goes beyond the symbolism to look at how what the bill actually does will come back to bite President Obama where it hurts him the most – right in the legacy.

“The remaining uninsured may also exceed estimates. Under the Senate bill, they would total 24 million in 2019, reckons Richard Foster, chief actuary of the Centers for Medicare & Medicaid Services. But a wild card is immigration. From 1999 to 2008, about 60 percent of the increase in the uninsured occurred among Hispanics. That was related to immigrants and their children (many American-born). Most illegal immigrants aren’t covered by Obama’s proposal. If we don’t curb immigration of the poor and unskilled — people who can’t afford insurance — Obama’s program will be less effective and more expensive than estimated. Hardly anyone mentions immigrants’ impact, because it seems insensitive.”