Michael Gerson

WASHINGTON -- Sometimes there is a fine ethical line between legislative maneuvering and bribery. At other times, that line is crossed by a speeding, honking tractor-trailer, with outlines of shapely women on mud flaps bouncing as it rumbles past.

Such was the case in the final hours of Senate Majority Leader Harry Reid's successful attempt to get cloture on health care reform. Sen. Ben Nelson of Nebraska, the last Democratic holdout, was offered and accepted a permanent exemption from his state's share of Medicaid expansion, amounting to $100 million over 10 years.

Afterward, Reid was unapologetic. "You'll find," he said, "a number of states that are treated differently than other states. That's what legislating is all about."

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But legislating, presumably, is also about giving public reasons for the expenditure of public funds. Are Cornhuskers particularly sickly and fragile? Is there a malaria outbreak in Grand Island? Ebola detected in Lincoln?

Reid didn't even attempt to offer a reason why Medicaid in Nebraska should be treated differently from, say, Medicaid across the Missouri River in Iowa. The majority leader bought a vote with someone else's money. Does this conclusion sound harsh? Listen to Sen. Lindsey Graham of South Carolina, who accused the Senate leadership and the administration of "backroom deals that amount to bribes," and "seedy Chicago politics" that "personifies the worst of Washington."

This special deal for Nebraska raises an immediate question: Why doesn't every Democratic senator demand the same treatment for their state? Eventually, they will. After the Nelson deal was announced, Sen. Tom Harkin of Iowa enthused, "When you look at it, I thought well, God, good, it is going to be the impetus for all the states to stay at 100 percent (coverage by the federal government). So he might have done all of us a favor." In a single concession, Reid undermined the theory of Medicaid -- designed as a shared burden between states and the federal government -- and added to future federal deficits.

Unless this little sweetener is stripped from the final bill by a House-Senate conference committee in January, leaving Nelson with a choice. He could enrage his party by blocking health reform for the sake of $100 million -- making the narrowness of his interests clear to everyone. Or he could give in -- looking not only venal but foolish.


Michael Gerson

Michael Gerson writes a twice-weekly column for The Post on issues that include politics, global health, development, religion and foreign policy. Michael Gerson is the author of the book "Heroic Conservatism" and a contributor to Newsweek magazine.
 
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