Health Care's Last Holdout

As House leaders rally the troops for a final attempt to pass health-care reform next week, Dennis Kucinich is coming under intense scrutiny among Democrats for his opposition to President Barack Obama’s plan.

Kucinich may be the last liberal holdout, now that the only other congressman who opposed the bill for drifting too far from a single-payer system, Eric Massa, has resigned his seat. For many backers of health-care reform, the prospect of a narrow vote coming down to objections from the progressive side of the spectrum is a nightmare scenario. But Kucinich has pledged to oppose the bill unless his demands are met. In an interview with The Daily Beast, Kucinich repeatedly named two provisions needed to secure his vote: a public option significantly stronger than the one that passed the House in November, and a provision that would protect states that implement their own single-payer system from legal challenges. Without these provisions, Kucinich says he believes the bill will be a giveaway to insurance companies.

“I never approach things based on whether all my friends agree with me or not,” Kucinich said when asked about the left’s broad support for the president’s plan.

“I have a special responsibility here to my constituents as someone who really understands the issue to inform people what actually is going,” Kucinich told The Daily Beast, “as opposed to yielding to the marketing of one particular piece of legislation.”

Kucinich’s threats are certainly being taken seriously by the White House: President Obama will hold a rally in his Cleveland district on Monday and Kucinich expects him to try and persuade him once again to join his side on the plane ride over.

“I’ve met with the president three times on this, I’ll be flying with him to Cleveland on Monday when he comes to my district to talk about health care, and I’m sure we'll have time to talk some more,” Kucinich said. “But he knows my concerns and at this late date, with so many deals flying through the wind like a spring snowstorm I would just like to see if we can rescue some provisions that would enable this bill to be representative of true reform.”

Long beloved by progressives as an eccentric (he once described a UFO encounter in a presidential debate), but compelling speaker (his 2008 convention speech scored a standing ovation), Kucinich risks severing his relationship with the mainstream left over this issue. Markos Moulitsas Zuniga, founder of the influential grassroots site The Daily Kos, is threatening to fund a primary challenge against Kucinich in 2012 if he votes against the bill. Eighty-three percent of MoveOn.org’s members this week voted to back the president’s legislation. Jacob Hacker, the Yale professor who conceived the public-option idea and whom Kucinich cited multiple times in this interview, favors passing the Senate bill—even without his idea in the mix. The Senate’s fiercest single-payer advocate, Bernie Sanders of Vermont, is also on board.

“I never approach things based on whether all my friends agree with me or not,” Kucinich said when asked about the left’s broad support for the president’s plan.

But Kucinich maintains he’s negotiating in good faith, pointing out that he supported the version of the health bill that passed in committee before opposing the final legislation approved last year by the House.

“I voted on a bill that represented a compromise from my well-known position as an advocate of Medicare for All,” he said. “But when the administration’s plan came forward, the plan was absent a public option and protection for states to pursue single-payer. You look at it and think: Where’s their compromise?”

Obama has put all his chips on the table with his latest push for reform, warning that if comprehensive legislation fails, the issue could be tabled for another generation. Kucinich says he doesn’t buy that logic.

“The idea it’s all or nothing is a false idea. We’re being told, ‘Don’t let the perfect be the enemy of the good.’ Well, this isn’t good,” he said. “The very thought that people are going to say that if this doesn’t pass they’ll take their ball and go home—that’s not going to happen.”

Kucinich suggested, for example, that a ban on excluding patients with pre-existing conditions could receive broad support. But numerous experts warn that without an individual mandate and generous federal subsidies for the uninsured to accompany it, neither of which are likely to get past a Republican filibuster in a new bill, that provision is unlikely to fly. Insurance companies would be forced to drastically raise rates or risk bankruptcy to make up for the high costs of financing already-sick patients. In addition, Kucinich believes that the current legislative proposals would harm future prospects for single-payer coverage, or what he calls “Medicare for All.” But the lack of support for single-payer even in the most Democratic Senate and House since Lyndon Johnson’s time raises the obvious question: When exactly would this pass?

“I think down the road, America will have Medicare for All, not because of this bill, but despite it,” Kucinich said. Kucinich says he doesn’t buy Obama’s latest argument to progressives that there will be other opportunities to improve upon the legislation once they help him pass this bill.

“Fix it later, are you kidding?” he said. “If you don’t get it in the bill up front, it’s not going to happen.”

Benjamin Sarlin is Washington correspondent for The Daily Beast. He previously covered New York City politics for The New York Sun and has worked for talkingpointsmemo.com.