'Gang Of Six's' Sen. Conrad May Be Health Care Key

Democratic Sen. Kent Conrad of North Dakota is perhaps the most ardent deficit hawk in his party, which makes him a pivotal figure in the Senate Finance Committee's "Gang of Six." The gang of three Democrats and three Republicans is working on a bipartisan health care bill, even as town halls erupt and compromise recedes.

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One of the so-called Gang of Six senators negotiating a health care bill is Kent Conrad, a North Dakota Democrat. He's chairman of the Senate Budget Committee, and perhaps his party's most ardent deficit hawk.

Conrad's focus on the deficits and debt makes him a pivotal figure in the health care debate, as NPR's Andrea Seabrook reports.

ANDREA SEABROOK: He's known in Congress as the budget guy. Everything, all $3 trillion of the federal budget runs through Senator Kent Conrad and his committee, so he's keenly aware of the long-term problems the United States faces when it comes to government spending and the national debt. And when it comes to health care? Conrad sees big, new problems with the idea of big, new government programs. Perhaps, that is why he was the first Democrat to say this.

Senator KENT CONRAD (Democrat, North Dakota; Chairman, Senate Budget Committee): The fact of the matter is there are not the votes in the United States Senate for the public option. There never have been. So to continue to chase that rabbit I think is just a wasted effort.

SEABROOK: That was on Fox News Sunday last week. The clip ran on dozens of blogs under the headline: Conrad Declares Public Option Dead, though he doesn't go quite that far.

Democratic leaders could ram a health care bill through the Senate. They'd have to use a special set of rules known as reconciliation. Conrad knows this: he just thinks it's a terrible idea. The rules were built to help senators ratchet down budget deficits, and that's a problem, says Conrad. He warns that if Democratic leaders use reconciliation rules to pass health care, it will force the Senate to gut the bill like a fish: cutting out the new insurance company regulations, changes for doctors and hospitals, anything that doesn't have to do with the budget. Now, because Conrad is at the nexus of budget expertise and political centrism, Senate Democratic leaders and committee chairs asked him to device a plan that could pass the Senate and get some Republican votes.

Enter the health care co-op.

Sen. CONRAD: This cooperative model would be very competitive, would get 12 million members in very short order, would become the third largest insurer in the country, would provide meaningful competition in the states that now have virtually none…

SEABROOK: That's Conrad stumping for the co-op idea on Fox Business Network. Health care co-ops would be to private insurance companies what credit unions are to private banks. The co-op would provide health insurance, but it would be a nonprofit business owned by its members. A big plus, says Conrad, they'd be a lot cheaper in the long-term. The idea already has support from centrists of both parties. But it's not gaining Conrad any fans in the more liberal parts of the Democratic Party.

Mr. CHARLES CHAMBERLAIN (Political Director, Democracy for America): There are a lot of things that can be said about him that are excellent.

SEABROOK: This is Charles Chamberlain of the liberal progressive group, Democracy for America.

Mr. CHAMBERLAIN: But the co-op proposal is a political compromise. This isn't an actual policy compromise that makes any sense.

SEABROOK: Democracy for America is trying to wrangle the votes in the Senate to pass health care with the public option intact. And Chamberlain says Conrad's co-op plan could water down real reform for the sake of a word: bipartisanship.

Mr. CHAMBERLAIN: Bipartisanship for the sake of bipartisanship is not worth of that bill. America needs real change when it comes to our health care reform. And we absolutely need to have the choice of a public option if we want to achieve that kind of change.

SEABROOK: So the pressure continues and the summer is waning. Conrad's co-op idea is trickling out in the news, making some Democrats wonder if it's enough change and others start counting new Republican votes. Conrad's personal stake in this? He could end up being the guy who represented the rational middle or the guy who killed real reform.

Andrea Seabrook, NPR News, the Capitol.

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What The 'Gang Of Six' Wants From Health Care Bill

A small group of key senators known as the Gang of Six was once looked at as the key to passing a bipartisan health care bill in the Senate.

But the group of Senate Finance Committee members has, instead, proved a time-sucking bust, with no compromise after months of negotiations and plenty of Senate Democrats peeved at the influence ceded to the gang's GOP members.

Committee Chairman Sen. Max Baucus, a Montana Democrat, who headed the group, said Wednesday that his committee will start voting on a bill in two weeks — whether or not the gang's three Republican members are with him or against him.

"The time has come for action, and we will act," Baucus says, regardless of whether Republican Sens. Chuck Grassley of Iowa, Mike Enzi of Wyoming or Olympia Snowe of Maine are on board with a compromise plan.

Baucus this week released what he called a "framework" for health reform that does not include a public insurance option, and he will propose legislation next week.

Though some in the group of senators have a history of collaborating with their colleagues across the aisle to craft legislation, only Snowe in recent weeks appeared to remain in serious compromise discussions with Democrats and the White House.— Liz Halloran

Here's a look at the concerns that each member of the Gang of Six brought to the negotiating table.

REPUBLICANS:

Sen. Mike Enzi, Wyoming i i

hide captionSen. Mike Enzi (R-WY) moves towering copies of the Senate health care bill and its amendments before a markup hearing on Capitol Hill in June.

Charles Dharapak/AP
Sen. Mike Enzi, Wyoming

Sen. Mike Enzi (R-WY) moves towering copies of the Senate health care bill and its amendments before a markup hearing on Capitol Hill in June.

Charles Dharapak/AP

Sen. Mike Enzi, Wyoming

Enzi is one of the top-rated senators with the American Conservative Union. But as a member of the Senate Committee on Health, Education, Labor and Pensions, he is also known for working on bipartisan bills with its late chairman, Massachusetts Sen. Edward Kennedy. While Enzi has rejected the health care overhaul bill produced by that committee, he is using his position on the Senate Finance Committee and in the Gang of Six to have more influence on the legislation.

Enzi has said that he opposes paying for universal coverage through tax increases or by squeezing savings from Medicare. He wants a bill that will get the support of at least 75 senators. He has rejected the Sept. 15 deadline set by Senate Finance Committee Chairman Max Baucus to have a deal.

But Enzi has also long been known to care deeply about health care issues. In the past, he pitched his own reform bill, titled "10 Steps to Transform Health Care in America," which encouraged revamping the current system in small steps.

Liberals complain that Enzi's demands will only water down the health care overhaul bill, but his conservative bona fides increase the potential for Republican support. — Audie Cornish

 

Sen. Chuck Grassley, Iowa i i

hide captionSen. Chuck Grassley (R-IA) speaks with reporters after a town hall meeting in Adel, Iowa. Grassley has faced mounting scrutiny from conservative constituents and commentators.

Steve Pope/AP
Sen. Chuck Grassley, Iowa

Sen. Chuck Grassley (R-IA) speaks with reporters after a town hall meeting in Adel, Iowa. Grassley has faced mounting scrutiny from conservative constituents and commentators.

Steve Pope/AP

Sen. Chuck Grassley, Iowa

Grassley is the lead Republican negotiator on the Senate Finance Committee and in the Gang of Six, and is good friends with committee Chairman Baucus; Grassley has boasted in the past of their bipartisan work.

However, of the six senators on this list, Grassley has had the toughest time dealing with constituents and rowdy town halls during the congressional recess.

As a result, Grassley says he won't vote for the bill the group is working on if it can't get more than three or four Senate Republicans on board. He says he represents their concerns at the negotiating table.

"No public option. No play-or-pay. No things that are going to lead to any rationing of health care. No interference with the doctor-patient relationship," says Grassley. "About the only place we haven't made progress along the lines of what Republicans are wanting on the bill is in tort reform."

Still, Grassley insists that he believes in the work of the bipartisan group. "I've always said I'm not going to walk away from the table," he says. "If I get away from the table, it's because I am pushed from the table."

Grassley told his hometown newspaper that Baucus would have a difficult time winning GOP support for his plan. — Audie Cornish

 

Sen. Olympia Snowe, Maine i i

hide captionSen. Olympia Snowe (R-ME) is the only senator in the Gang of Six from a state that has attempted universal health care.

Alex Wong/Getty Images
Sen. Olympia Snowe, Maine

Sen. Olympia Snowe (R-ME) is the only senator in the Gang of Six from a state that has attempted universal health care.

Alex Wong/Getty Images

Sen. Olympia Snowe, Maine

Snowe is a moderate who has sided with Democrats on key votes, such as the economic stimulus package earlier this year. She has been courted assiduously on health care by Senate Democrats, and the White House.

This past spring, she compared the life of a moderate in the GOP to that of a cast member of the reality television show Survivor.

"You are presented with multiple challenges, and you often get the distinct feeling that you're no longer welcome in the tribe," she wrote in an April op-ed in The New York Times.

Snowe is the only senator in the Gang of Six from a state that has attempted universal health care. Maine's program was signed into law in 2003 and has had limited success, falling well short of its original goal of insuring nearly 130,000 residents by 2009. Snowe says the program has failed to grow large enough to wield the clout it needs to keep costs and premiums low.

Now, as she sits at the negotiating table for a national health care overhaul, Snowe tells NPR that controlling costs is her primary focus: "What we have to do is develop a plan that's going to be available to people on an affordable basis ... containing costs, both for the American consumer and the American taxpayer." She has said flatly that there is no GOP support for a public insurance option, and has urged the White House and Democrats to consider a public option that would be triggered only if insurance coverage failed to meet a basic threshold.

Audie Cornish

 

DEMOCRATS:

Sen. Max Baucus, Montana i i

hide captionSenate Finance Committee Chairman Max Baucus (D-MT), pictured at the microphone, is leading the Gang of Six in crafting the definitive Senate health care bill.

J. Scott Applewhite/AP
Sen. Max Baucus, Montana

Senate Finance Committee Chairman Max Baucus (D-MT), pictured at the microphone, is leading the Gang of Six in crafting the definitive Senate health care bill.

J. Scott Applewhite/AP

Sen. Max Baucus, Montana

Nobody is more central to the success or failure of a health care overhaul than Baucus. Elected last fall to his sixth term, he chairs the Senate Finance Committee, where he leads the Gang of Six in crafting the definitive Senate health care bill.

He unsuccessfully pushed the gang this week to come up with a compromise plan in advance of President Obama's Wednesday's address to Congress, and has announced that his committee will move forward with a bill whether or not Republicans support terms on the table.

A moderate, Baucus carefully guards his bargaining power. He's vague about what he wants in a bill — he is inclined not to favor new taxes, and he would like to see a public option. But his ultimate goal, as he said on July 30, is "meaningful, bipartisan legislation that can pass the Senate and become law this year."

Such pragmatism can make more liberal Democrats nervous, and he has drawn the ire of fellow Democrats including fellow committee member Sen. Jay Rockefeller of West Virginia. Baucus has a history of cooperating with the Senate Finance Committee's ranking minority member, Grassley, who is seen as the tougher negotiator.

Baucus' Washington connections have also come under scrutiny. An NPR Dollar Politics story examined his ties to industry lobbyists and noted that in his last campaign, 47 percent of his funds came from political action committees, compared to 5 percent from Montanans. — Peter Overby

 

Sen. Jeff Bingaman, New Mexico i i

hide captionSen. Jeff Bingaman (D-NM) is the most liberal of the Gang of Six and a firm supporter of the public option.

Mark Wilson/Getty Images
Sen. Jeff Bingaman, New Mexico

Sen. Jeff Bingaman (D-NM) is the most liberal of the Gang of Six and a firm supporter of the public option.

Mark Wilson/Getty Images

Sen. Jeff Bingaman, New Mexico

Bingaman is easily the most liberal of the Gang of Six. A soft-spoken Westerner, he has made his mark in health care in the areas of Medicaid and health care for Native Americans.

Now serving his fifth term in the Senate, Bingaman, like Enzi, sits on both the Finance and Health, Education, Labor and Pensions committees.

Bingaman supports the concept of a public option to compete with private health insurance plans. But, as one might expect from a longtime senator, he has also said that he is open to compromise.

"Obviously, we wouldn't be spending all these hours in all these meetings if we didn't think there was a good chance of getting an agreement," he told New Mexico Public Television earlier this month.

But he said he was prepared for the possibility of Democrats having to move a bill without Republican support if the negotiations ultimately fail to produce a deal. "It's possible we would be forced to do that," he said. — Julie Rovner

 

Sen. Kent Conrad, North Dakota i i

hide captionSen. Kent Conrad (D-ND) has kept a close eye on the cost of the health care proposals and was one of the first Democrats to come out against the public option.

Harry Hamburg/AP
Sen. Kent Conrad, North Dakota

Sen. Kent Conrad (D-ND) has kept a close eye on the cost of the health care proposals and was one of the first Democrats to come out against the public option.

Harry Hamburg/AP

Sen. Kent Conrad, North Dakota

A moderate Democrat, Conrad is a deficit hawk and chairman of the Senate Budget Committee.

Conrad pays close attention to the Congressional Budget Office's cost estimates for remaking health care.

According to a preliminary CBO analysis, enacting the leading health care bill in the House would cost more than $1 trillion over the next decade. That estimate is not based on a complete picture of the bill, but Conrad says that the negotiating group in the Senate Finance Committee is focused on proposing something that costs far less.

Conrad was one of the first Democrats to come out against the public option. "Those of us who have to count votes know that the public option does not have the votes," he says.

Instead, the North Dakota senator has angered liberal supporters of a health care overhaul by pushing for health care cooperatives. Conrad says they would be nonprofit, member-owned groups that could theoretically negotiate better payment rates by pulling together a network of health care providers. — Audie Cornish

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