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A Project of The Annenberg Public Policy Center

SEIU Misleads on Lincoln’s Health Vote

In the final days of a hotly contested Senate Democratic primary in Arkansas, the Service Employees International Union is running a misleading attack ad against Sen. Blanche Lincoln.

In the ad, titled “Nancy,” an Arkansas resident by the name of Nancy Shaw talks about her daughter, who suffers from Down syndrome. Shaw says she is upset that Lincoln “voted to allow health insurance companies to deny coverage to people with preexisting conditions.” Shaw speculates that Lincoln “sided with the big insurance companies because they could afford big campaign contributions.”

In fact, Lincoln is one of a few moderate Democrats who can legitimately claim that she cast the deciding vote to make the health care bill a reality — a bill that forces new group and individual health plans to cover people with preexisting medical conditions. In defense of its ad, the SEIU points to a second Senate vote taken after the health care bill became law that expanded the ban on preexisting condition exclusions to protect more people. Yes, Lincoln voted against that second bill — known as the reconciliation bill — which made some changes to the health care legislation. But there’s no evidence that her opposition had anything to do with the provisions on preexisting conditions, and it was moot anyway, because President Obama and Democratic leaders knew that they could pass the reconciliation bill without her support and did not press her to vote for it.

Lincoln was a key player in the convoluted legislative process that led to the passage of the health care bill. She and other moderate senators, including Ben Nelson of Nebraska, had been wavering on whether to support the controversial bill. Expecting a tough reelection, Lincoln was being targeted by Republicans and their allies to vote against it. The Democratic leaders needed all 58 Democrats and two independents to break the GOP filibuster and bring the health care bill to the floor for a debate. She announced on the Senate floor on Nov. 21, 2009, that she would vote to end the filibuster and that day the Senate voted to do so. On Christmas Eve, the Senate passed the health care bill. Once again, the bill got 60 votes, including Lincoln’s.

That bill, among many other things, prohibits new individual and group health plans from denying coverage to children who have preexisting conditions within six months of passage and to everyone else by January 2014. It was opposed by America’s Health Insurance Plans, an industry trade group.

On the day of Senate passage, Lincoln issued a press release that included this statement from the very same Nancy Shaw who is featured in the SEIU ad:

Shaw, in Lincoln’s release, Dec. 24: "I have a daughter with Down syndrome and I’m self employed. I can’t get her health insurance, so I think health care reform will help us,” said Nancy Shaw of Hot Springs. “[Lincoln’s vote] really says she’s paying attention to the people that voted for her. The fact that she voted for it really says it does matter."

The Senate votes to end the filibuster and approve the bill turned out to be the most important votes in the process. The Senate bill was approved by the House on March 21 and signed by Obama on March 23.

On the day the House passed the Senate bill, Lincoln put out a statement commending the House vote and singled out the provision on preexisting conditions for particular praise:

Lincoln, March 21: I am pleased that we will now force insurance companies to cover pre-existing conditions, preserve Medicare for future generations and reduce the deficit by more than one trillion dollars over the next 20 years. I now look forward to ensuring that Arkansans benefit the most from health insurance reform.

That statement also made clear that she would vote against the reconciliation bill that would revise the new law. A reconciliation bill — which could not, by definition, be filibustered — was needed mainly to address concerns that the House had with the Senate health care bill; the Democrats no longer had a 60-vote filibuster-proof majority thanks to the results of a special Senate election in Massachusetts.

Why did Lincoln vote against the reconciliation bill? At the time, she said she opposed the bill because it went beyond health care and addressed unrelated issues, such as the administration of student loans. Her March 21 statement offered this explanation:

Lincoln, March 21: The Reconciliation package devised by the House includes matters unrelated to health care and employs a legislative process that wasn’t subject to the same transparency and thorough debate that we used in the Senate. I cannot support this process.

On the day she voted against reconciliation, Lincoln put out a statement once again explaining why she voted against the bill and once again clearly expressing her support for forcing companies to cover those with preexisting conditions.

SEIU spokeswoman Lori Lodes says Lincoln “can’t have it both ways,” adding that her vote against the reconciliation bill was a vote against expanding the ban on preexisting condition exclusions to protect more people from the practice. Jennifer Tolbert, a health care policy expert at the Kaiser Family Foundation, said the reconciliation bill widened the ban to include existing individual and group plans, not just new plans created after enactment of the law on March 23. "That’s a pretty large group," Tolbert said.

Even so, the fact is that Lincoln’s position on denying health care coverage based on preexisting conditions is clear in an extensive public record. There is no support that we’re aware of for the contention that Lincoln’s vote on reconciliation had anything to do with this issue.