Health Care Reform, Earmark Edition

It’s the first rule of congressional lawmaking: Never miss an opportunity to grab everything you can for your constituents, even if it comes at the expense of everyone else.

That’s certainly been the case in the Senate’s health care reform bill, where it wasn’t just the moderate holdouts who successfully secured enormous earmarks for their states. Here’s the emerging list:

(1) Ben Nelson (D-Neb.): Making a joke of the earlier claim that his vote is “not for sale,” the Nebraska Democrat won three huge concessions for his state in the Senate bill: $100 million in extra Medicaid funds; an annual fee exemption for some Nebraska-based insurance companies; and another carve-out exempting some physician-owned hospitals in the state from new restrictions.

(2) Mary Landrieu (D-La.): Senate leaders secured her support with $300 million in new Medicaid funding for Louisiana.

(3) Max Baucus (D-Mont.): The Finance Committee chairman has long fought for federal funding surrounding an asbestos mine in Libby, Mont., The New York Times pointed out over the weekend. The health reform bill, most of which Baucus and his staff wrote, fulfilled his wish, including a provision to expand Medicare coverage to victims living near the mine.

(4) Bill Nelson (D-Fla.): Representing a state chock-full of seniors, the Florida Democrat has been concerned about the proposed cuts to the Medicare Advantage program, under which the government pays private insurers to cover Medicare beneficiaries. The result? Three counties in south Florida are exempt from the cuts.

(5) Chris Dodd (D-Conn.): Many senators have been scratching their heads in recent days trying to figure out who would benefit from a $100 million provision to build a new university-affiliated hospital. Turns out that Dodd, who ushered the health reform bill through the Senate HELP Committee in the absence of the late Sen. Edward Kennedy (D-Mass.), is eyeing the funding for UConn.

(6) Bernie Sanders (D-Vt.) : The Vermont Independent had threatened to oppose the bill if it lacked a strong public insurance option. Instead, Senate leaders agreed to Sanders’ request for additional money for community health centers ($10 billion more, to be exact). Vermont was also among the handful of states to win extra federal Medicaid funding.

This, of course, is nothing new. As David Axlerod told CNN’s “State of the Union” over the weekend, “Every senator uses whatever leverage they have to help their states. That’s the way it has been. That’s the way it will always be.”