TALKING 'BOUT MY JURISDICTION.

In the Senate, there are two committees with some claim to jurisdiction -- which is to say, control -- over health care reform. There's the Health, Education, Labor, and Pensions Committee, which is chaired by Senator Ted Kennedy. And then there's the Senate Finance Committee, chaired by Max Baucus (who I profiled yesterday). HELP has a strong argument: "Health" is right their in their title. But few buy it. Fundamentally, HELP can't construct revenue streams, and has no authority at all over Medicare and Medicaid. Since Medicare and Medicaid are a huge part of health reform, and since just about any reform you can imagine would require the construction of new funding streams (even if it saved money, the money would have to flow differently), Finance is thought to be where the action is at.

At least, that would be true if HELP weren't chaired by Ted Kennedy. But Kennedy is such a force in the Senate and such a presence in the country's national debate that he can, by virtue of sheer personal charisma and longstanding relationships and staff energy, capture a major role in issues that his committee might not naturally control. If he is healthy, he will be a major part of health reform.

The last few months have seen intense, but quiet, jockeying between HELP and Finance for lead on this issue. Kennedy staffed up by hiring John McDonough, the widely-respected advocate whose long-time agitation brought the Massachusetts health reform plan into being. Baucus staffed up by hiring Liz Fowler, a longtime congressional health staffer who's well known and well-respected in both the policy and political communities. Kennedy, along with McDonough, began running a private policy education seminar where various senators and their staffs would meet to hear presentations and begin talking through the issues. Baucus gathered the entire Senate Finance Committee in the James Madison Memorial Building for a daylong, open-to-the-press, health care event entitled "Prepare for Launch." And around this time, Kennedy got sick. Though all reports are that he remains involved in health reform efforts, his absence from Washington and the dark rumors about his health have injected much uncertainty into the role he will, or will not, be able to play.

But yesterday there was a new round of jockeying. Max Baucus penned a letter to President-Elect Barack Obama advocating quick action on health reform and warning Obama that Baucus would be releasing a set of principles and ideas into the Congress next week. In reply, Kennedy's staff director, Michael Myers, sat down at a Families USA conference and explained that Kennedy would take his "cues from the Obama White House." According to Myers, Kennedy has "articulated a strategy that he calls the one bill strategy. We've learned from the lessons of the past.'' And Kennedy, of course, plans for HELP to write the final bill.

These sorts of jurisdictional battles can be damaging. And they have real effects. HELP is a liberal committee that could pass a fairly pure bill that might have problems on the floor. Finance has a moderate, bipartisan history and would probably pass a heavy, consensus-oriented bill that will be built to smoothly pass once brought to the floor. I've heard talk, in the past, of setting up a special Committee of some sort that would include members of HELP and Finance (and probably Clinton and some others) to build health reform, but so far as I know, that's not gone anywhere. Then there's the wild card of Kennedy's health. WIthout Kennedy, HELP has nothing. Then there's the question of who Obama will side with. He's close to Kennedy, and owes him. But he also is close to some former Baucus staffers, including James Messina, Baucus's chief of staff who got loaned out to the Obama campaign to serve as the campaign's chief of staff. So it's a bit unclear.