How Transparent Was The Health Reform Process?

During yesterday’s interview with ABC News, President Obama admitted that the process of passing health care reform had not been as transparent as he would have liked. “Part of what I had campaigned on was changing how Washington works, opening up transparency and I think it is — I think the health care debate as it unfolded legitimately raised concerns not just among my opponents, but also amongst supporters that we just don’t know what’s going on,” Obama said. “And it’s an ugly process and it looks like there are a bunch of back room deals”:

OBAMA: Now I think it’s my responsibility and I’ll be speaking to this at the State of the Union, to own up to the fact that the process didn’t run the way I ideally would like it to and that we have to move forward in a way that recaptures that sense of opening things up more. SAWYER: A lot of people think you must say at the end of the day, this is not who I was in 2008, these deals with Nebraska, with Florida… OBAMA: Let’s hold on a second, Diane. I mean, I think that this gets into a big mush. So let’s just clarify. I didn’t make a bunch of deals. There is a legislative process that is taking place in Congress and I am happy to own up to the fact that I have not changed Congress and how it operates the way I would have liked. So that’s point number one.

Obama is right to recognize that the process of forcing 60 Democrats to support something as ambitious as comprehensive health care reform required some serious arm twisting. But Washington deal-making isn’t the only factor behind the popular dissatisfaction with the “process”; Republican obstructionism and repeated Democratic concessions deserve at least some of the credit.

In the Senate, Democrats wasted a lot of time reaching out to the GOP and conservative Democrats. They watered down their legislation — removed the most popular elements of reform — and when Republican support still failed to materialize, they found themselves at the mercy of the Democratic hold-outs. Members like Ben Nelson, could not be convinced to vote for reform for reform’s sake and were brought on board with extra Medicaid funding. This drawn out process of missed deadlines and back room negotiations in the majority leader’s office tugged on the public’s patience and did more to dilute reform than improve it.


The process wasn’t pretty, but it was a far cry from the kind of arm twisting the GOP engaged in during their push to pass Medicare Part D in 2003. Democrats held months of committee mark-ups and debate. They provided Republicans with ample opportunity to contribute to the legislation, allowed Max Baucus to hold nine months of bipartisan negotiations and included Republicanfriendly provisions in their bills. But Republicans undermined this process. House Republicans shouted down Democrats as they tried to introduce the measure for debate, Republican Senators tried to prevent health care reform from reaching the Senate floor, forced the clerk to read thousands of pages of legislative language, routinely lied about the bills, and introduced a stream of message amendments designed to derail reform.

On the whole, the process produced a fairly conservative piece of legislation in a moderately transparent manner. The GOP’s success in painting the bill and the debate as a left-wing power grab while they got away with talking about ‘death panels’ and successfully obstructing “the legislative process” every step of the way, says more about the GOP’s communication efforts than it does about Ben Nelson’s Cornhusker kickback.