Dead center 

Sen. Max Baucus, health care reform and the future of compromise

On the morning of Thurs., June 28, Montana Sen. Max Baucus was in his Washington, D.C., office when the U.S. Supreme Court ruled on the Patient Protection and Affordable Care Act. Baucus, the law's architect, had been too busy to walk the couple of blocks and hear the decision in person, so an aide popped in and told him the news: the law stood.

Baucus, who is 70 and has been in the Senate for 33 years, had worked for years on health care reform, Democrats for decades. Yet he didn't pump his fist or high-five anyone. He says he's learned to temper excitement and disappointment, referring to a passage in Ecclesiastes that he paraphrases this way: "It's never as good as it seems, and it's never as bad as it seems."

That's an apt credo for a man who's made a career of deftly walking the line between liberalism and conservatism, maddening and delighting the left and right, often at the same time—including, especially, on health care reform.

Baucus has been called "a corporate shill" by the left for taking money from the health insurance industry, "a socialist" by the right for ushering through Congress near-universal, government-mandated health coverage. He's neither. Rather, he's a centrist dealmaker—which makes him an endangered species in D.C. these days.

It's Aug. 7, and Baucus is paraphrasing that scripture at a table in a restaurant at the Muralt's truck stop just west of Missoula. His brow below his messy gray hair still shines after spending a hot morning wielding a nail gun at a low-income homebuilding project, one of the first stops on his tour through Montana during the Senate's August recess. He's wearing jeans and a short-sleeve, button-down Patagonia shirt, and holds a lemon-lime Gatorade he just bought from the adjacent convenience store, where the clerk didn't appear to recognize him.

In fact, Baucus looks like he could be a convenience store manager, or some variety of mid-level bureaucrat, belying that he's the chair of the Senate Finance Committee, one of the most powerful posts in the federal government. He's unassuming, in stark contrast to, say, Montana Gov. Brian Schweitzer, who is sometimes excessively folksy.

Sitting in the truck stop restaurant, I ask Baucus, who has a law degree from Stanford, about the Supreme Court's ruling on ACA.

click to enlarge PHOTO BY CHAD HARDER

When he listened to the oral arguments before the court in March, he says, Solicitor General Donald Verrilli mentioned him by name, telling the justices that on the Senate floor, Baucus had defended the penalty assessed on Americans who forgo health insurance as an "exercise of the taxing power."

He perked up when he heard that, he says, thinking, "Oh, that's me!"—just as though he wasn't a key figure in the debate over the law.

As it turned out, Verrilli and Baucus were onto something, if unintentionally. The Obama administration wasn't arguing that the Supreme Court should uphold the Affordable Care Act because of Congress's taxing power. Instead, it was all about the commerce clause, the constitutional power to regulate commerce among the states. Baucus "fully expected the commerce clause to be the rationale," he says. Instead, Chief Justice John Roberts wrote that penalizing those who choose to go without health insurance "is within Congress's power to tax."

"I frankly think of it as a little convoluted," Baucus says of the reasoning. "But we'll take it. In our form of government, the Constitution is what the court says it is."

Now, four years after Baucus introduced the foundation of "Obamacare," an 89-page white paper outlining how the country could cover 45 million uninsured citizens and try to rein in soaring health care costs, he's eager to move past the partisan battle that the legislation stoked.

"Congress has enacted health care reform," he says. "The president signed the bill. And the Supreme Court's upheld it. It's here. It's not going to be overturned."

The prescription

Baucus can talk at great length about ACA. At the truck stop, he doesn't pause once to sip his Gatorade over the span of 30 minutes.

A week earlier there'd been a milestone in the law's implementation. On Aug. 1, it began requiring insurance companies to cover preventative services for women at no additional cost, including annual well-woman visits, domestic violence screening and contraceptive education and counseling.

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