Is Grassley Abandoning Bipartisan Health Bill?

Sen. Grassley responds to a question at a town meeting in Adel, Iowa. i i

Sen. Chuck Grassley (R-IA) responds to a question from Sheryl Prather at a town meeting in Adel, Iowa. Facing heat from conservative constituents, the senator has backed away from bipartisan health care negotiations. Steve Pope/AP hide caption

itoggle caption Steve Pope/AP
Sen. Grassley responds to a question at a town meeting in Adel, Iowa.

Sen. Chuck Grassley (R-IA) responds to a question from Sheryl Prather at a town meeting in Adel, Iowa. Facing heat from conservative constituents, the senator has backed away from bipartisan health care negotiations.

Steve Pope/AP

A few months ago, Republican Sen. Chuck Grassley of Iowa positioned himself to be the key GOP player in negotiations to advance President Obama's top domestic priority — overhauling the nation's health care system.

As ranking minority member on the Senate Finance Committee, Grassley has been a leading voice in the committee's bipartisan "Gang of Six" that had been struggling to hammer out a bill before Congress recessed for August.

But Grassley's evolution — from legislator once complimented by Obama for his willingness to work across the aisle to one of the president's chief critics on health care — is a sign that the chances for passing a bipartisan health care bill have all but disintegrated. And as Grassley has pivoted from defending bipartisan work on a Senate bill to criticizing a competing House bill, he has increasingly sown confusion over just where he stands in negotiations to overhaul health care.

In the process, the five-term senator criticized the president as "intellectually dishonest" and prompted some Democratic leaders to say efforts at a bipartisan deal are dead. He has also drawn sharp criticism himself for echoing in recent days the questionable argument that a Democratic plan would ration health care for seniors.

In an interview on Wednesday, Grassley insisted he is still interested in working toward a bill with broad-based appeal, though his assertion this week that he would vote against any bill — even one he supports — if it fails to attract wide GOP support has raised questions about his commitment to bipartisan negotiations.

What happened to Grassley the compromiser, who less than four months ago hailed the momentum Obama created for a health care overhaul and touted the promise of "bipartisan health reform proposal"?

Brett Wian poses a question to Sen. Grassley. i i

Brett Wian poses a question to Grassley at the town meeting in Adel. The senator, who is up for re-election next year, has been sharply criticized by conservative constituents and pundits for his efforts to reach across the aisle. Steve Pope/AP hide caption

itoggle caption Steve Pope/AP
Brett Wian poses a question to Sen. Grassley.

Brett Wian poses a question to Grassley at the town meeting in Adel. The senator, who is up for re-election next year, has been sharply criticized by conservative constituents and pundits for his efforts to reach across the aisle.

Steve Pope/AP

Those questions make Grassley bristle.

"I'm sitting down talking with the idea that we come out with a product," he told NPR Wednesday. "I've said that we've got to have a bipartisan bill, and bipartisanship is not three Republicans and 58 Democrats."

"You asked me why I said lately that I would not be going with a bill that got a few votes," Grassley said. "I've been saying that all year. You're asking me a question like I just said it..."

"I'm not going to walk away from the table," he said. "If I get away from the table, it's because I'm pushed away from the table."

But in recent days, Grassley's comments suggest that he's doing some of the pushing. During town hall meetings in Iowa, he alluded to government programs that would "pull the plug on Grandma." He recently engaged in a tit-for-tat Twitter argument over health care "death boards" with Sen. Arlen Specter, a Pennsylvania Democrat. And he invoked gravely ill Sen. Edward Kennedy when inaccurately suggesting that under a British-style, state-run health plan, the Massachusetts Democrat would have been denied treatment for cancer because of his advanced age.

"I regret using Sen. Kennedy's name," Grassley told NPR. But he said he has no regrets about comments he made about British-style health systems, or addressing concerns — real or imagined — about end-of-life issues under a government plan.

Pressure And Pushback

Partisan and ideological pressure pushed Grassley back from working too closely with Democrats on a health care bill, says political analyst Charlie Cook, along with an altered political world where the public's appetite for systemic change has receded dramatically over the past year.

"The pressure has been really intense to hold ranks and not give Obama a victory," says Cook, the publisher of The Cook Political Report. "And, ideologically, this health care overhaul has been tough for conservatives to swallow."

When Grassley said that he would not back a bill that didn't attract wide GOP support, he was simply engaging in an unusual moment of political candor, Cook says.

"If he can't bring along the Dick Lugars, the George Voinoviches and other Senate Republicans who might be open to something," Cook says, "he's wasting his time."

Says Grassley: "We're restructuring 16 percent of the gross national product. Health care is a life-or-death issue for every person in America, and my principle has been the same as [Montana Democratic] Sen. [Max] Baucus's during this whole year of discussion of health care — that it ought to be done on a broad, consensus basis, which we've always signaled is 70 to 80 votes."

From The Senator

NPR caught up by phone with Grassley on Wednesday, while the senator was on a bus tour of his home state. Here are some excerpts from that interview, about the ongoing health care overhaul negotiations:

On the circumstances in which he would stop negotiating with the other members of the Senate Finance Committee's bipartisan "Gang of Six":

"I'm at the table to represent the interests of my party in overall reform. ... I'm also at the table because Iowa ... has high quality and low reimbursement under Medicare. I've got to be at the table to represent Iowa's interests to see that we don't continue to get screwed by Medicare. And so I'm at the table for those reasons. And I've always said I'm not going to walk away from the table. If I get away from the table, it's because I'm pushed away from the table."

On whether the public insurance option is dead, given Health and Human Services Secretary Kathleen Sebelius' suggestion Sunday that the public option is "not the essential element" of a health care overhaul:

"I believe it is. There again, you send up a trial balloon like [Sebelius] did last Sunday on talk shows and you think, yeah, well, maybe the president is taking my advice when I gave it to him a week ago. ... I said something like, 'Can you make a public statement that you would sign a bill without a public option?' He didn't answer me, but I saw [Sebelius' comments] as a trial balloon. And then the next day I saw him backpedaling."

On whether, absent a public option, he could bring any more Republicans onboard:

"I can't really answer that question until you have a product to show them. Don't forget, there's no point in my talking to Democrats if I can't get Republican support — because that's my goal."

A Target For Upset Conservatives

Back home in Iowa, long before the boisterous town hall meetings of summer, Grassley was kicked around by conservatives after he attended the president's spring health care forum at the White House. Though he argued that it was better for his party to have a seat at the table than not, critical letters to the editor began appearing in local newspapers, and conservative pundits on cable television made Grassley, up for re-election next year, a favorite target.

"He's an example of a leader who is genuinely trying to make something happen and winds up getting hit from both sides," says David Yepsen, the former Des Moines Register political reporter who followed Grassley for decades.

"But he understands his state and has a very tough chasm to bridge back there," says Yepsen, now director of the Paul Simon Public Policy Institute at Southern Illinois University, Carbondale.

Though Iowa went for Obama over GOP nominee John McCain in the presidential election last fall, the state's Republicans earlier made former Arkansas Gov. Mike Huckabee — who stressed his Christian conservative credentials — their top choice in the statewide caucuses. And last year, they ousted their longtime national party committee members and replaced them with more conservative picks.

Iowa remains a largely conservative place, says Diane Bystrom, director of the Catt Center for Women and Politics at Iowa State University. Grassley increasingly felt the heat, she says, as opposition to health care became entrenched on the right, and more false rumors and innuendo spread about plans being considered in the House and Senate.

"Sen. Grassley's conservative credentials were being questioned at town meetings, and his pushback was to make sure his meetings were crowd pleasers," Bystrom said.

No Peril At Home

Though part of Grassley's strategy may be electoral self-preservation, there are no indications that he'll face any serious challenge next year if he runs for a sixth term, as he has said he will.

"Charles Grassley isn't in danger in this state," says Bystrom, noting that the senator has been elected with more than 65 percent of the vote since his second term and pulled in 70 percent in 2004.

So, just what will Grassley do when Congress reconvenes in September and will again take up health care negotiations?

"The short answer is, we just don't know," Cook says.

With the president's proposal for a public insurance option withering on the vine, Grassley says he is among Republican senators more amenable to the alternative of yet-to-be-defined health care co-ops, owned and managed by members. The concept is familiar in rural states, where agriculture and utility co-ops have been around for decades.

"I can support co-ops if they want to do it as we've known co-ops in America for 150 years — where they serve the purposes of the consuming public, whether it's health care or whether it's co-ops as we know them in the Midwest, providing electricity or to sell supplies to farmers," Grassley said.

He opposes suggestions by Democrats like New York Sen. Chuck Schumer to create a national co-op, characterizing it as moving "right back to a public option."

The Future Of Bipartisan Progress

Grassley's commitment to bipartisan negotiations may become clearer Thursday evening when Baucus, chairman of the Senate Finance Committee, has scheduled a teleconference with his fellow Gang of Six members. Baucus said the group will meet again before Congress reconvenes.

Grassley says any deal will have to reflect the position of the GOP caucus: "No public option, no pay-or-play, no things that are going to lead to any rationing of health care, no interference with doctor-patient relationships, and tort reform." A pay-or-play mandate would require employers to either provide employee health coverage or pay a tax to a national fund that would provide coverage.

The ball, as Grassley sees it, is in the Democrats' court.

"Have you ever stopped to think that maybe 40-45 percent of the Democrats are so liberal they think that Baucus shouldn't be talking to any Republican?" Grassley said. "So it seems to that [Baucus] has some problems. It seems to me that [House Speaker Nancy] Pelosi has signaled problems."

"And I see a lot of stuff coming out of the White House this week that is very defensive," Grassley said.

In a statement released Wednesday, Baucus asserted that "bipartisan progress continues."

"The Finance Committee," he said, "is on track to reach a bipartisan agreement on comprehensive health care reform that can pass the Senate."

Whether Grassley will be part of that deal is anybody's guess, but the odds, this week any way, appear long.

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