A good article on how "inside politics" works
For House GOP, 1 Vote Came With Hefty Price
Medicare Bill Pledge Led To Drug Import Struggle
By Juliet Eilperin
Washington Post Staff Writer
Thursday, July 24, 2003; Page A19
House GOP leaders could have avoided one of the summer's most contentious votes -- a proposal to reimport lower-priced pharmaceuticals from abroad -- if they hadn't needed Rep. Jo Ann Emerson's support for a crucial Medicare bill last month.
One vote shy of passing a Republican-backed $400 billion measure to give elderly and disabled Americans prescription drug coverage, Speaker J. Dennis Hastert (R-Ill.) negotiated on the House floor with Emerson (R-Mo.) as time ticked down on the crucial roll call in late June. Well past 2 a.m., the two Republicans reached an accord. Emerson would vote aye, so long as Hastert's leadership team agreed to allow a floor vote this month on whether to legalize the reimportation of U.S.-made prescription drugs that sell more cheaply in Canada and elsewhere -- a move the White House and Hastert oppose.
Just to make sure, Emerson later put the agreement in writing and sent it to Hastert and his deputies.
Countless administrations and congressional leaders have made last-minute concessions to win a reluctant lawmaker's support for an important bill. But rarely have such promises triggered the type of battle that has led to today's expected vote.
House leaders, who initially pledged to stay neutral on the reimportation proposal, are now working to defeat it. So is the drug industry, which has angered many conservative lawmakers by enlisting the aid of a Christian activist group that has bitterly attacked the bill's backers.
Working with a relatively thin majority to begin with (229 Republicans to 205 Democrats and one Independent), House leaders sometimes complicate their goals by pushing conservative versions of bills that lose the support of party moderates. That puts swing voters in an ideal spot to negotiate.
Still, Emerson's legislative coup has amazed several of her colleagues. "She went in there, she played hardball with the big guys and she won," said Rep. Tom Cole (R-Okla.). "What's not to admire about that?"
House leaders say they don't regret the agreement, despite the headaches they now face.
"I absolutely think this is what we needed to do to bring that [Medicare prescription drug] bill along," said Majority Whip Roy Blunt (R-Mo). Another GOP leader, who asked for anonymity, said giving Emerson the vote she wanted was "a very high price, but it's the one we're stuck with and we'll deal with it . . . It's a tough one."
For more than two weeks, Emerson had told Blunt and his deputies she could not accept a Medicare prescription drug bill unless it made it easier to bring back medicines from abroad, many of which are sold more cheaply than are their U.S. counterparts. Administration officials, along with several GOP leaders and drug industry officials, say insufficient safeguards are in place to ensure the safety of such drugs. Pharmaceutical executives also say that reimporting cheap drugs will cut into their profits, leaving them less money to research and develop new drugs.
In the June showdown over the Medicare bill, House leaders at first declined to yield to Emerson. Instead, they gathered support from other Republican lawmakers with vows to contain the drug program's costs and to steer more money to rural health care. When they realized they remained one vote short, however, they were ready to deal. A few hours later, Emerson drafted a memo outlining what the leadership had promised her.
"It is agreed," she wrote, that House negotiators would remove language from the Medicare bill that requires the health and human services secretary to demonstrate that U.S.-made drugs headed back into the country are safe. Moreover, the House would vote in July on a reimportation bill. And if that bill passed, she wrote, its language would remain in any final Medicare bill negotiated with the Senate, whose version differs from the House legislation.
"I greatly appreciate your agreement to proceed in this manner and trust that we shall be successful in conference with the Senate," Emerson's memo said.
The reimportation issue has divided the GOP. Many conservatives back reimportation as a way to lower drug costs for seniors. Others see it as anathema to free-market principles.
Several antiabortion Republicans became angry this month when the Traditional Values Coalition, aided by drug lobbyists, blitzed more than two dozen GOP House districts with mailers implying a vote for reimportation would make it easier for women to obtain the RU-486 "abortion pill," a charge Emerson and others deny.
Now House GOP leaders are in the awkward position of working to kill a Republican-sponsored bill they've agreed to bring to a vote. Blunt is remaining neutral, but House Majority Leader Tom DeLay (R-Tex.) opposes it. "We're working as hard as we can to get the votes to defeat it," DeLay said Tuesday. Making last-minute concessions to wavering lawmakers "is as old as the Republic," said Rep. John D. Dingell (D-Mich.), the House's longest-serving member.
Blunt, the GOP whip, said such deals sometimes are essential to pass big bills such as the Medicare measure -- especially when House leaders virtually write off all the Democrats from the start. "Occasionally we have to be helpful on unrelated legislation," he said. "It's a lot easier to do this job if you have 350 people for a bill."
He added, however: "We've passed some very challenging legislation without a single Democratic vote."
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