After nearly a year of debate, months of negotiations and major lobbying blitzes, the U.S. Senate on Christmas Eve passed their version of the major health insurance reform legislation. The final vote was 60-39. All 60 members of the Democratic caucus voted in favor of the plan, while no Republican senators backed the bill.
Sen. Jim Bunning (R-Ky.), who opposed the Democrats' legislation, was absent and did not vote. In a rare move, Vice President Joe Biden, in his role as president of the Senate, presided over the chamber. Many observers watched the senators cast their votes, including Rep. John Dingell (D-Mich.), the sponsor of the health insurance reform bill passed by the House.
Senators who opposed the bill received an average of nearly 30 percent more political donations from political action committees and individual employees of health and health insurance-related groups and companies since 1989, a Center for Responsive Politics analysis has found.
Since 1989, Republican senators who voted against the bill received an average of $1.67 million from PACs and individual employees associated with health insurers and health-related organizations, groups and trade associations, CRP found. Democratic senators who supported the bill, meanwhile, received an average of $1.29 million from these interests since 1989.
Republican lawmakers, on average, collected significantly more cash from medical professionals, health insurers and pharmaceutical manufacturers -- groups that often fought proposed reforms during the past year (as well as reform proposals during previous Congresses), as Capital Eye outlined in its "Diagnosis: Reform" series this summer.
The Center for Responsive Politics found that Republican senators who opposed the bill collected an average of 41 percent more from medical professionals, an average of 41 percent more from pharmaceutical and health product companies and an average of 28 percent more from health and accident insurers than their Democratic counterparts.
Additionally, the Center for Responsive Politics found that Democratic lawmakers who backed the health care reform plan received an average of 1,000 percent more campaign cash from PACs and individual employees of labor unions, which have vocally lobbied in favor of reforming health care.
Since 1989, Democratic senators who supported the measure received an average of $893,200 from PACs and individual employees of labor unions, CRP found. Republican senators who opposed the legislation, meanwhile, received an average of just $79,250 from labor interest over the same time.
| Labor:Health | Labor | Health/Health Insurance | Health Insurance | Pharma | Health Pros | |
|---|---|---|---|---|---|---|
| All Yes | 0.69 | $53,592,095 | $77,448,350 | $9,786,184 | $13,677,935 | $34,923,203 |
| Yes Average | $893,202 | $1,290,806 | $163,103 | $227,966 | $582,053 | |
| All No | 0.05 | $3,090,753 | $65,148,437 | $8,111,107 | $12,530,086 | $31,933,027 |
| No Average | $79,250 | $1,670,473 | $207,977 | $321,284 | $818,796 | |
| % Diff | 1027.1% | 29.4% | 27.5% | 40.9% | 40.7% |
(Download the full list for yourself here. If you use these data, please be sure to credit CRP: SenateHealthVoteData.xls)
The Center found that the average ratio of money from labor interests versus health-related interests for Democratic senators was 0.69-to-1. The ratio for Republican senators was approximately 0.05-to-1.
That is, Democrats have received an average of 70 cents from labor interests for every dollar they have collected from health-related interests, while Republicans, on average, have raised about a nickel from labor for every dollar they raise from employees and PACs affiliated with health insurers and health-related companies, trade associations and groups.
At the high end of this spectrum, Sen. Bernie Sanders (I-Vt.), a self-identified socialist who caucuses with the Democrats, has received nearly nine times as much money from labor interests compared to health care and health insurance interests: about $1.3 million compared to $146,400, CRP has found. Sanders is a long-time supporter of a single-payer health care system and raised concerns during recent weeks that the Senate bill might not adequately protect consumers. He ultimately voted in favor of the proposal.
Some of the lowest ratios of money from labor versus money from health-related interests are associated with several of the Democratic caucus' conservative members, including Sen. Joe Lieberman (I-Conn.), who was among the last senators to sign onto the compromise deal worked out in the Senate. Lieberman has received roughly $5 from health-related interests for every $1 he has received from labor interests, CRP found.
Other Democratic senators near Lieberman's labor-to-health ratio included: Senate Agriculture Committee Chairwoman Blanche Lincoln (D-Ark.) and Senate Finance Committee Chairman Max Baucus (D-Mont.) at 0.27-to-1; Republican-turned-Democratic Sen. Arlen Specter (D-Pa.) at 0.22-to-1; and freshman Michael Bennet (D-Colo.), who was appointed by the governor last January when incumbent Ken Salazar was tapped to serve in the president's Cabinet, at 0.18-to-1.
Among Republicans, Sens. Lisa Murkowski (R-Alaska), Olympia Snowe (R-Maine) and Richard Shelby (R-Ala.) had the highest ratio of money from labor interests compared to health interests at roughly a quarter from labor interests for every dollar from health interests over their careers, CRP found. Nevertheless, none of these Republicans supported the labor-backed plan -- although Snowe had voted to pass an earlier version of the legislation out of the Senate Finance Committee.
CRP also found that many influential senators in the health care debate have been among the top recipients of campaign contributions from health insurance and health-related companies, trade associations and groups.
Between January and September, Senate Majority Leader Harry Reid (D-Nev.), who is facing a tough reelection battle and has brought his caucus together around this contentious issue, collected the most from these interests via his campaign committee and leadership PAC, with $718,575. During the same time, he also raised $252,350 from labor interests.
Specter, who is also in a tough reelection bid, ranks second, with $562,000 in contributions from health and health insurance-related interests during the first three quarters of 2009. During the same time, he also collected $28,500 from labor interests.
Lincoln, who is similarly in a tough reelection fight ranks third, with $561,550 in such contributions between January and September. She's raised $35,600 from labor interests during the same period. Her home state of Arkansas was one of the most targeted places for TV advertisements from both supporters and opponents of the legislation as well.
Sen. Chuck Schumer (D-N.Y.), one of the leading liberal voices in the Senate's health insurance reform debate, has collected $509,500 from health and health insurance-related interests between January and September. In that time, he's also collected $205,000 from labor.
Sen. Chuck Grassley (R-Iowa), the ranking member of the Senate Finance Committee and a key negotiator during meetings on this issue earlier this year, rounds out the top five top Senate recipients of health care campaign cash. Grassley has collected $458,500 from health and health insurance-related interests during the first three quarters of the year and has not collected any money from labor. (In fact, he refunded one $1,000 labor-related contribution.)
Additionally, during the first three quarters of the year, these senators, and others, were among the top recipients of money from health insurers and drug companies, including their PACs and individual employees.
Below is a table detailing the top 10 senators to receive contributions to their campaign committees and leadership PACs between January and September from HMOs and health services interests, as well as health and accident insurers.
| Member | Total From Health Insurers |
|---|---|
| Sen. Chuck Grassley (R-Iowa) | $80,650 |
| Sen. Richard Burr (R-N.C.) | $67,150 |
| Sen. Harry Reid (D-Nev.) | $65,600 |
| Sen. Patty Murray (D-Wash.) | $60,650 |
| Sen. Blanche Lincoln (D-Ark.) | $58,500 |
| Sen. Charles Schumer (D-N.Y.) | $54,250 |
| Sen. Chris Dodd (D-Conn.) | $52,750 |
| Sen. Ben Nelson (D-Neb.) | $43,500 |
| Sen. Richard Shelby (R-Ala.) | $39,550 |
| Sen. Orrin Hatch (R-Utah) | $38,500 |
Below is a table detailing the top 10 senators to receive contributions to their campaign committees and leadership PACs between January and September from the pharmaceutical and health products industry.
| Member | Total From Pharma |
|---|---|
| Sen. Richard Burr (R-N.C.) | $168,719 |
| Sen. Arlen Specter (D-Pa.) | $130,850 |
| Sen. Orrin Hatch (R-Utah) | $126,585 |
| Sen. Harry Reid (D-Nev.) | $118,100 |
| Sen. Chris Dodd (D-Conn.) | $92,350 |
| Sen. Patty Murray (D-Wash.) | $92,050 |
| Sen. Blanche Lincoln (D-Ark.) | $87,050 |
| Sen. Barbara A. Mikulski (D-Md.) | $75,374 |
| Sen. Evan Bayh (D-Ind.) | $61,837 |
| Sen. Chuck Grassley (R-Iowa) | $60,100 |
Among the highlights of the legislation passed by Senate Democrats: It seeks to prohibit health insurance companies from denying coverage based on pre-existing conditions, and it would require insurers to spend less on administrative costs and more on clinical services. It would also extend federal subsidies for low-income Americans to buy health insurance and expand the roles of Medicare, Medicaid and the Children's Health Insurance Program (CHIP) -- insuring millions of previously uninsured Americans. The Congressional Budget Office projects the plan will reduce the federal deficit by $132 billion over 10 years and that it will cost $871 billion -- lower than the $900 billion threshold set by President Barack Obama.
Unlike the version passed by the House of Representatives, the legislation passed by the Senate does not call for the creation of a government-administered public health insurance option. Lieberman, who became in independent after he lost a Democratic primary in 2006 but still caucuses with the Democrats, along with other conservative Democratic senators, said they would join Republicans to filibuster any proposal that retained this new program.
Many Democrats argued this public insurance plan would bring down consumer costs and offer additional options to consumers. Most Republicans, however, disagreed and said such a plan was unnecessary and would be tantamount to a "government takeover" of health care.
The differences between the Senate and House versions must be resolved before President Barack Obama can sign the bill into law.
CRP Senior Researcher Douglas Weber contributed to this report.
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