By Bob Cusack - 09/27/05 12:00 AM EDT
As the White House and a powerful Senate Republican clashed over a hurricane-relief bill last week, an influential lobbyist worried about getting caught in the crossfire.
The dilemma hit K Street soon after Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and ranking member Max Baucus (D-Mont.) unveiled their Emergency Health Care Relief Act of 2005 on Sept. 15. The bill seeks to provide “targeted, temporary” disaster-relief Medicaid coverage to evacuees from the hardest hit counties in Louisiana, Mississippi and Alabama.
The Bush administration opposes the measure, saying it is unnecessary because evacuees are getting the healthcare services they need.
Aware of that friction within the GOP, Vicki Hart — a lobbyist for a group representing 200,000 physicians — sent an e-mail to a Senate leadership aide asking if the doctors should endorse the legislation. The e-mail was sent on behalf of the Alliance of Specialty Medicine.
After receiving the advice of an unnamed leadership staffer, Hart updated her client in another e-mail.
The Sept. 21 e-mail, obtained by The Hill, tells members of the alliance that GOP leaders are expressing only tepid support for the bill.
“I know there has been some debate about the Alliance sending a support letter for the Grassley/Baucus bill,” Hart wrote. “I have been hearing that Senate Republican Leadership has been lukewarm on the bill.”
To underscore the point, Hart, a former staffer for Sens. Bob Dole (R-Kan.) and Trent Lott (R-Miss.) who is now president of Hart Health Strategies, copied and pasted an e-mail from the Senate leadership aide.
“The specialty docs shouldn’t feel like they have to send a letter on the Grassley/Baucus bill, but if they do it would be helpful for them to stay pretty general (i.e. good step forward, need to provide for survivors of Katrina) rather than providing explicit endorsement for the exact policy of the bill,” the aide wrote. “The House and WH are not keen on the Medicaid expansion and generality would save them heartburn from those sides. We too have a few issues with individual pieces, but are generally supportive.”
Hart, who asked alliance members not to forward her e-mail to others outside the group, told The Hill, “It is standard practice for outside interest groups to coordinate their message with the Leadership and the Finance Committee Chairman and Ranking Member. That was what we did.”
High-profile legislation can trigger tens, if not hundreds, of letters of support or disapproval from outside groups. While most of this correspondence never attracts headlines, congressional officials analyze them closely.
Lawmakers regularly compile lists of groups that support their legislation and use this backing to urge their colleagues also to support it.
A Senate Republican staffer who supports the Finance Committee bill said that failure to pass the legislation could further damage the GOP’s image in responding to the aftermath of Hurricane Katrina. The source added that some Republicans waited for the administration to propose a hurricane healthcare relief bill but were disappointed when the only healthcare policy change was a Medicaid waiver given to the state of Texas.
The waiver enables Texas to sign up evacuees for Medicaid. But, unlike Grassley’s bill, the waiver does not expand the program to include those who would not, under normal circumstances, qualify for it. Grassley’s measure would temporarily broaden Medicaid for five months and give President Bush the option of extending the plan up to an additional five months.
The administration believes the Texas waiver ensures that evacuees, many of whom are now located in that state, will receive medical attention.
The National Governors Association has sided with Grassley, praising his bill for providing 100 percent federal funding for the healthcare needs of Katrina survivors.
Grassley and Baucus considered moving the bill through a unanimous-consent request last week but opted to wait until this week after hearing that Sen. Tom Coburn (R-Okla.) would object.
In presenting his case on the Senate floor last week, Baucus argued that Congress needed to act quickly.
“We must act and act now to help those who have been harmed. This is an emergency,” he said. “This is not time for the legislative process as usual. … Senators from both sides of the aisle of the affected states have all worked with us. … I cannot speak for the House of Representatives, but I can speak for us in this body.”
The House has no plans to produce a similar bill. A spokesman for the Energy and Commerce Committee confirmed that the panel has no immediate plans to introduce or mark up legislation on this issue. The committee is analyzing the healthcare needs of Katrina survivors and held a hearing on the matter last week.
One healthcare expert said that if former Appropriations Committee Chairman Bob Livingston (R-La.) or former Energy and Commerce Committee Chairman Billy Tauzin (R-La.) were still in office, the House would likely be moving a bill.
Proponents of the Grassley legislation have tried to persuade Coburn that the bill calls for a smaller federal role than other hurricane bills that have been introduced since the disaster unfolded. If the Grassley bill does not pass by unanimous consent, amendments offering more federal assistance could be offered.
The Congressional Budget Office estimates that the bill would increase direct spending by $7.5 billion in 2006 and by $8.9 billion over the 2006-2010 and 2006-2015 period.
Of the six senators from Louisiana, Mississippi and Alabama, Sens. Mary Landrieu (D-La.), Thad Cochran (R-Miss.), and Richard Shelby (R-Ala.) are cosponsors of the Grassley bill.