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Healthcare reform backlash: Americans angry over earmarks

Healthcare reform legislation often means cutting 'deals,' but public anger over earmarks may further gridlock healthcare reform.

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"People are tired of political manipulation, regardless of the dollar amount," says David Williams, vice president of policy at Citizens Against Government Waste, which produces an annual "Pig Book" to track earmarks. "People see the Nebraska, Louisiana, Florida deals and say, 'They're doing the same exact thing they've been doing for years: They're buying votes and trying to manipulate the system.' "

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When it came down to it, Senate Democrats were working against a tight deadline to complete their bill in 2009. Senator Reid met with holdout senators, including centrists facing opposition to healthcare reform at home. Those last off the fence often drove tough bargains.

In what may have been a fateful move, some touted what they had won for their states. For example, Sen. Mary Landrieu (D) of Louisiana announced that reports that she had won $100 million for her state in exchange for a healthcare vote were inaccurate. "It's not a $100 million fix. It's a $300 million fix," she said on Nov. 21.

Pressed to respond to mounting public criticism of these deals, Reid defended the practice of senators looking after their states' interests.

"There are a hundred senators here, and I don't know if there is a senator that doesn't have something in this bill that was important to them," he said in a Dec. 21 press briefing. "And if they don't have something in it important to them, then it ... doesn't speak well of them. That's what legislation is all about: It's the art of compromise."

That comment went viral, too.

Sen. Ben Nelson (D) of Nebraska held out the longest before promising his vote. He negotiated a deal that exempted his state from paying the costs of expanding access to Medicaid. A new federal mandate involving Medicaid would cost Nebraskan taxpayers $450 million over 10 years, state officials said.

But Nebraskans reacted sharply to the news that their state had been singled out for special treatment. "We don't like special deals," Gov. Dave Heineman (R) told Fox News. The governor's office reports that it was overwhelmed with phone calls on the issue, mainly opposing the deal.

In an unusual move for a lawmaker not up for reelection, Senator Nelson ran television ads explaining his vote in favor of the bill. Now back in Washington, Nelson says he is discussing with Senate leaders and others how to change the bill to make sure all states are treated equally.