Seducing Olympia Snowe: The GOP Key to Health Reform

Quiz time: Which of the following provisions has been tucked into the most closely watched health-care bill on Capitol Hill thanks to Senator Olympia Snowe of Maine? Is it a) an annual checkup for every Medicare beneficiary, b) a special health-insurance marketplace in every state that would cater to the needs of small businesses or c) new tax credits to help modest-size firms buy coverage for their workers?

The answer is all of the above. As the only Republican on the Finance Committee still in talks with Democrats on a final bill, Snowe now finds herself with extraordinary leverage as crunch time hits for health reform. Snowe could provide the 60th vote that may be needed for Democrats to overcome a GOP filibuster on the Senate floor. All of which means that pretty much anything Snowe wants, she is going to get — and any bill that emerges from this excruciating process will bear her stamp. (See the top 10 players in health-care reform.)

So what does she want to see achieved under health-care reform? In a word: affordability. With her tailored suits and her refined manner, Snowe gives off a sort of wellborn Northeast Establishment vibe. But her background is solidly working class. She was orphaned at 9 when her father, a Greek immigrant and cook, died of a heart attack a year after her mother succumbed to cancer. What drives her as much as anything else is the perspective that comes from representing a small, relatively poor state where the principal effect of well-intentioned, piecemeal efforts at health reform has been to ignite an explosion in medical costs. Maine, whose insurance market is dominated by one large firm, pays some of the highest premiums in the country, and they are rising nearly four times as fast as wages are. Much of that is falling on the small businesses that are the heart of the state's economy. Left to fend for themselves, they do not have the clout it takes to negotiate lower rates.

For many of those businesspeople, Snowe says, health insurance has become a "luxury, because the costs are astronomical. They essentially get catastrophic coverage at best." During her last re-election campaign, in 2006, an angry storekeeper in the town of Holden shoved his bill from Blue Cross Blue Shield at Snowe and demanded, "What are you going to do about this?" (See pictures of Republican memorabilia.)

Snowe tried to tackle the problem during her stint as chairwoman of the Senate's Small Business Committee, but she got nowhere. "We had a debate for a week on the floor back in 2006 for small-business health-insurance legislation," she says. "We never could reach a consensus and move beyond the barriers that had developed on both sides of the political aisle." Snowe now says that effort was a "formative event" in her approach to health-care policy — which no doubt explains why Finance Committee chairman Max Baucus made sure that what she wanted back then has been resurrected and transplanted virtually intact in his bill.

Standing Apart
I caught up with Snowe in the chandeliered reception room adjacent to the Senate chamber as she was racing from the Finance Committee's first drafting session for its health-care bill to a vote on the Senate floor and then to a luncheon with her Republican colleagues. She sounded almost rueful as she discussed a political environment in which her brand of bipartisan dealmaking sets her apart. "I understand politics plays a role in this process, but it should not be to the exclusion of our foremost obligation to the American people, which is to govern," she said. "You can't allow your differences to overtake your ability to solve problems. In a lot of ways, it's stunning that we're at a point in America, a time when our elected officials and our political institutions should be rising to the occasion to grapple with the monumental issues of our time, and we can't muster the political capacity to get it done."

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