Trust Time: Health Care Hinges on Rare Commodity

By Rick Klein

You can get a massage or have a tickle party or wax your back or even build a settlement. We’re not going anywhere until we have a bill, anyway.

The waiting game is back. There needs to be legislation, with a price tag. Until then, what’s the point of counting? (And how have pauses in the action worked out for health care in the past?)

Your final, final, final push on health care comes down to trust: Does the House trust the Senate? Will the rank-and-file trust the leadership? Can Democrats trust the politics to the White House? And can the public put its trust in the party in power one last time?

President Obama, in Missouri, talking: “The time for talk is over. It’s time to vote. ... I’m tired of talking about it.”

House Speaker Nancy Pelosi, D-Calif., after late-night health care talks broke up Wednesday night: “We’re going to get started.”

The talk starts to wind down with a number -- and this is another one of those moments where it’s all about the Congressional Budget Office.

And then it will be all about the legwork: “It will come down to a phenomenal effort by congressional leaders and the White House to win over skittish lawmakers after a year of incendiary debate, even as Obama keeps up campaign-style appearances designed to fire up public support,” the AP’s Erica Werner reports . “A closed-door meeting in House Speaker Nancy Pelosi's office Wednesday evening moved congressional leaders and administration officials close to agreement on such issues as additional subsidies to help lower-income families purchase health insurance and more aid for states under the Medicaid program for low-income Americans.”

Not done cutting and pasting: “The president wants to eliminate more than just Sen. Ben Nelson’s ‘Cornhusker Kickback’ and Sen. Bill Nelson’s agreement to shield 800,000 Florida seniors from Medicare Advantage cuts,” Politico’s Carrie Budoff Brown reports . “Obama has asked Reid to strike provisions requested by senators from at least five other states, in an unusual move that accentuates the culture clash between the president’s rhetoric on changing the ways of Washington and the Senate leader’s needs to exercise the old-fashioned tools of Congress to pass laws.”

ABC’s Jake Tapper, on “Good Morning America” Thursday: “He wants them all out, for a clean up-or-down vote. ... The White House says they’re going to keep pushing that [March 18] deadline, because that’s the only way to get Congress to act.”

What might still hold things up: “House Democrats can't be sure when they vote for the Senate bill that its problems will be fixed before the president signs health reform into law,” Karl Rove writes in his Wall Street Journal column. “House Democrats are being asked to cast a potential career-ending vote based on their faith that the Senate, with Mr. Obama's blessing, will undo all the disastrous elements of this bill. A year ago that trust might have existed. Today, after all the ugliness this process has created and all the intra-party acrimony it has caused, that trust appears to have disappeared.”

“Further complicating the hunt for votes, congressional rules will probably force the president to sign the Senate bill into law before House and Senate lawmakers can vote on the package of changes, another unsavory prospect for House Democrats worried about being on record backing the Senate legislation,” the Los Angeles Times’ Noam N. Levey reports .

What the White House hopes gets things moving again: “Among the rewards Obama is ready to offer [to House Democrats], White House officials said, are election-year visits to competitive congressional districts, where a presidential appearance can bring in hundreds of thousands of dollars in campaign funds,” The Washington Post’s Scott Wilson reports .

White House communications director Dan Pfeiffer: “The president has breathed some new life into this effort.”

White House Chief of Staff Rahm Emanuel: “We will continue this momentum, as you've seen in the last few weeks. ... And we must keep people focused on the price of failure.”

Prices of success? Not here: “I don’t think there are any districts in the country where the outcome of this great debate on health care reform is going to cost someone their seats,” Rep. Chris Van Hollen, chairman of the Democratic Congressional Campaign Committee, said on ABC’s “Top Line” Wednesday .

Or you could put a price tag on this -- new from the NRCC: “The national GOP is planning to expand its health care offensive with a new batch of targeted TV ads warning House Dems who voted for the health plan last time -- and are mulling doing so again -- that their career is on ‘life support,’ ” Greg Sargent reports at The Plum Line blog.

What’s making momentum hard to hold onto: “For Dems, the problem has become clear: They need legislation before they can sell it to their members. Every day that goes by without a bill gives the GOP more time to pressure wavering Dems,” Reid Wilson writes for Hotline on Call.

While we’re talking trust: “Senate Democratic leaders are concerned about the amount of mischief their own Members could create if or when a health care reconciliation bill comes up for debate,” Roll Call’s Emily Pierce and David M. Drucker report . “And sources said some supporters of creating a public insurance option are privately worried that they will be asked to vote against the idea during debate on the bill, which could occur before March 26.”

Help reconcile this: “All 41 Republican Senators vowed in a letter today to do everything in their power to kill Democrats' health care legislation and vote en bloc against procedural motions Democrats want to use to fix the health reform bill passed Christmas Eve by the Senate,” ABC’s Z. Byron Wolf reports . “This would include a scenario where the Republican Senators oppose language championed by anti-abortion rights Democrats in the House and side instead with abortion rights defenders.”

Another complication ... The student loan overhaul isn’t flying, not here, not now: “I think it threatens the health-care bill,” Senate Budget Committee Chairman Kent Conrad, D-N.D., said . “It would threaten to sink them both.”

When is an up-or-down vote not really even a vote? “One method for accommodating the situation (first reported in CongressDaily) would allow the House to vote on the Bill B and, after doing so, simply consider the Senate health care bill (Bill A) as passed,” Slate’s John Dickerson writes . “There would be no actual up-or-down vote on the underlying bill. This would be the legislative equivalent of the economist's old trick of assuming a can opener.”

Memories of Massa -- and keeping the pressure on for more to get done. (Look for Republicans to push a resolution that would keep House investigations alive.)

“House Speaker Nancy Pelosi's office was notified in October by then-Rep. Eric Massa's top aide of concerns about the New York Democrat's behavior, two congressional sources familiar with the matter said Wednesday night,” Carol D. Leonnig reports in The Washington Post. “The revelation about warnings to Pelosi's office comes as the House ethics committee closed its short-lived investigation of allegations that Massa groped and sexually harassed several young, male staffers in his office, according to two sources familiar with the decision. ... The decision set up a political battle with House Republicans, who are already targeting congressional Democrats with campaign ads saying they have failed to look deeply enough into the ethical transgressions of their party members.”

“A Pelosi aide told POLITICO on Wednesday evening that Massa’s chief of staff, Joe Racalto, informed a member of Pelosi’s ‘member services’ operation in October that Massa was living with several aides, had hired too many staff members and used foul language around his staff,” Jonathan Allen and John Bresnahan report . “Racalto also raised concerns about “the way Massa ran his office” and informed Pelosi’s member-services staffer that he had asked Massa to move out of the group house on Capitol Hill, the Pelosi aide said.”

Next move belongs to Republicans: “House Republicans are considering whether to ask Thursday for the Ethics Committee to investigate House Speaker Nancy Pelosi and Majority Leader Steny Hoyer for their handling of information about misbehavior by former Rep. Eric Massa, who resigned Monday for sexually harassing male staffers,” Jon Ward and Mike Riggs report in The Daily Caller.

Swamp stuff: “Small defense companies, energy firms, and other technology start-ups throughout New England could lose tens of millions of dollars a year because of a decision by House Democrats yesterday to abruptly halt budget earmarks for companies,” Matt Viser reports in The Boston Globe. “The decision follows a House ethics probe into an alleged pay-to-play system in which investigators followed a trail of campaign contributions and linked them to earmarks — a provision added to a bill that directs money to a specific project, in this case, a private company. Although the House Ethics Committee cleared members of specific wrongdoing, House leaders remained sensitive to the appearance of a rampant quid-pro-quo system that has stoked outrage around the country.”

Of scandals (not) past: “Previously undisclosed e-mail messages turned over to the F.B.I. and Senate ethics investigators provide new evidence about Senator John Ensign’s efforts to steer lobbying work to the embittered husband of his former mistress and could deepen his legal and political troubles,” Eric Lichtblau and Eric Lipton report in The New York Times.

“Mr. Ensign, Republican of Nevada, suggested that a Las Vegas development firm hire the husband, Douglas Hampton, after it had sought the senator’s help on several energy projects in 2008, according to e-mail messages and interviews with company executives. The messages are the first written records from Mr. Ensign documenting his efforts to find clients for Mr. Hampton, a top aide and close friend, after the senator had an affair with his wife, Cynthia Hampton.”

In New York -- looking for real: “Encouraged by state and national Republican Party leaders, Dan Senor, an author, private equity executive and Defense Department adviser in the last Bush administration, is seriously considering a political challenge against Senator Kirsten E. Gillibrand, according to three people told of the discussions,” The New York Times’ Michael Barbaro reports . “In recent weeks, as Democratic political prospects have soured, a number of big-name Republicans — including Rudolph W. Giuliani, the former mayor and presidential candidate — have urged Mr. Senor to consider running.”

Time’s Karen Tumulty checks in on the Pennsylvania Senate race. Sen. Arlen Specter, D-Pa., says Republicans’ “sole calculation is defeating Obama in 2012.” Says Rep. Joe Sestak, D-Pa., of Specter: “He’s a flight risk after May 18th.”

Sarah who? “Mitt Romney's new book, ‘No Apology: The Case for American Greatness,’ will debut on top of the New York Times bestseller list due out March 21, a source tells me,” Politico’s Ben Smith reports .

Making the vice president’s trip interesting: “Vice President Joe Biden once again condemned Israel's plans for new settlements in the occupied territory of East Jerusalem and said that the move threatens to damage the fragile trust between the two sides at this critical juncture,” ABC’s Karen Travers and Simon McGregor-Wood report .

Biden, in Ramallah: “The decision by the Israeli government to advance planning for new housing units in east Jerusalem undermined that very trust, the trust that we need right now in order to begin as well as produce -- have profitable negotiations.”

Biden, speaking at Tel Aviv University Thursday: “Ladies and gentlemen, the status quo is not sustainable.”

Fired up: Rep. Patrick Kennedy, D-R.I., in the Afghanistan resolution debate. “If anyone wants to know where the cynicism is, there's two press people in this gallery,” Kennedy said on the House floor, per ABC’s Jonathan Karl . (With maybe a dozen House members milling around at the time.)

Keep America Safe, keeping up the fight: “The American people have a right to know who in the Department of Justice is setting policy regarding detention of terrorists and related national security issues,” Aaron Harison, executive director of Keep America Safe, told ABC’s Devin Dwyer . “Lawyers in private practice have the right to volunteer 'pro bono' to defend terrorists. However, membership in the legal profession does not immunize a person from questions or criticism of their prior actions.”

Turning the tables, on Citizens United, as two branches of government clash: “The central ruling of Citizens United v. FEC allows corporations to engage in independent advocacy during elections. This applies equally to labor unions,” Steven J. Law of the US Chamber of Commerce writes in a Wall Street Journal op-ed. “And unlike corporations, unions are far better positioned to take advantage of the ruling because they have virtually no other restraints on their capacity to engage in political action.”

The Kicker:

“Next Congress, we’re going to take a look at it.” -- Senate Majority Leader Harry Reid , D-Nev., on filibuster reform -- next year.

“We don't ever have to pay attention to this man ever again.” -- Glenn Beck, on Eric Massa .

For up-to-the-minute political updates check out The Note’s blog ... all day every day:

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