WASHINGTON -- Democratic Sen. John Breaux of Louisiana is a self-described centrist who long has frustrated Republicans by first embracing a conservative position, then retreating from it under pressure by his own party. Thus, it was significant last weekend when he came down hard in favor of a health care initiative that drives liberal Democrats crazy.
"I think most Democrats are opposed to it," Breaux admitted on CNN when I asked about the provision in the stalled economic stimulus bill. Nevertheless, he continued, a tax credit enabling unemployed workers to purchase health insurance is "a good idea, and we're going to try and push it." Breaux called the plan "a good way of going about giving people the ability to choose what's best for them."
This is an unusually clear break with Democratic dogma for the wily Breaux, Louisiana's most popular politician and a sure bet for governor if he had not last Thursday declined to make the race. Breaux is part of a developing center-right coalition on health care that breaks the liberal Democratic momentum.
In the wake of the Sept. 11 terrorist attacks, the economic stimulus package became a grab bag for pet schemes of both parties. The evolving measure had little to do with bringing back prosperity -- especially the Democratic insistence on subsidizing people who had lost their jobs. The Democratic health care provision would extend Medicaid welfare to unemployed workers who had earned as much as $36,000 a year. The excitement of a rare new government entitlement eclipsed considerations of economic revival.
At that point, the usually sluggish Republicans struck back. Dr. Mark McClellan, a member of the President's Council of Economic Advisers, drafted a health insurance tax credit for displaced workers. Chairman Bill Thomas collaborated with McClellan, slipped it into his stimulus bill and pushed it through his House Ways and Means Committee. The tax credit would cover 60 percent of premiums, up to $294 a month for family coverage. It would be "advanceable" (in advance of tax payments) and "refundable" (above the amount of actual taxes paid).
Conservative tax reformers gnashed their teeth over another messy complication in the Internal Revenue Code, but conservative health reformers were jubilant. "For the first time in more than decade," wrote Grace-Marie Arnett of the Galen Institute, "supporters of free markets embraced a health reform idea that is gaining strength as the decade continues and has actually put them on the offensive."
Arnett and other free-market health care advocates long have pressed for insurance separated from a person's job. Robert Moffit of the Heritage Foundation sees the stimulus bill's provision "for the first time" providing "consumer choice -- a momentous development."
Breaux and two other Democratic senators signed on to the stimulus package, providing a Senate majority for a bill that passed the House on a party-line vote. But the Democratic establishment mobilized against the bill when the health tax credit was added. According to Senate sources, Sen. Jay Rockefeller of West Virginia told colleagues he had spent his career fighting this kind of proposal and he was not going to stop now.
Why should Rockefeller, the Democratic leader in health care, oppose a plan raising the government contribution to displaced workers to 60 percent from today's zero share? Why would Senate Majority Leader Tom Daschle keep it from coming to a vote?
Because much more is at stake politically than workers who lost their jobs because of the terrorist crisis. The idea of using tax credits to provide health care was spawned in 1993 during the battle over Hillary Clinton's ill-fated national health care plan. The conservative alternative is viewed as the ultimate evil by the many Democrats who are attempting, piece by piece, to reconstruct a collectivized health plan in the image of Hillarycare. The stimulus bill's tax credit could doom a future government-controlled national plan.
When Sen. Breaux announced in Baton Rouge Thursday that he would stay in the Senate, he urged Republicans to cooperate on an economic stimulus with Tom Daschle. However, Breaux's affirmation of the tax credit means the cagey Cajun is not bailing out on the Republicans, and he will not sacrifice the breakthrough market-oriented health care provision to adopt an otherwise pedestrian proposal.