Is Maria Cantwell a Puppet for the Senate Finance Committee?

It’s hard to get much closer to the center of power on health-care
reform than the U.S. Senate Finance Committee. It’s currently drafting
a bill that could reshape, for years to come, the way that every single American enters the world, stays healthy,
receives medical care for the vulnerabilities of his or her body, and
dies.

Senator Maria Cantwell landed a seat on this prestigious committee
in 2006—making her the first representative from Washington State
in 75 years to hold such a post (and only the second ever). You’d know
this if you read Cantwell’s press releases, because she bragged about
her appointment to Finance at length at the time and promised that
“this key committee assignment gives the Northwest a vital seat at the
table.” She vowed to use this opportunity to “fight” for health-care
reform.

So what is Cantwell doing now that the Finance Committee is driving
toward a compromise on health-care reform that alarms her constituents
and, according to experts, won’t be able to deliver real relief to a
nation struggling under the weight of a broken health-care system?

She’s going along with it.

Deferring to more-senior members of her committee—who are in a
position to reward her in the future—Cantwell has been
deliberately vague about exactly what type of health-care reform she
supports. At the same time, she is talking up the committee’s current
proposal, which would try to fix what’s wrong with American health care
by creating a bunch of small health-care cooperatives around the
country—the so-called “co-op compromise.”

“Co-ops cannot drive down costs,” said one furious Cantwell
constituent, Jody Hall, owner of Seattle’s Cupcake Royale and yet
another employer who’s desperate for better (and cheaper) health-care
solutions to offer her employees. “There’s no national bargaining
power… they’re going to basically be a nice gift to the insurance
companies.”

This is indeed what experts say about co-ops: nice idea, but not a
big enough force to wade into the insurance market and compete against
the big, established players to drive down costs. That’s what the
“public plan”—which Hall supports—aims to do: create a
government-­backed insurance plan massive enough to do battle with
Big Insurance on the brutal terrain of the free market. Most Americans
support the idea, as does President Obama.

“It feels like Cantwell is afraid to step up and represent,” Hall
said. Which is an amazing statement coming from a person who is pretty
much the likeliest of potential Cantwell supporters: a liberal, a
female, an entrepreneur—just like Cantwell was before becoming a
politician.

Molly Moon, owner of the popular Seattle ice-cream stores that bear
her name, has the same frustration with Cantwell: “It’s unfortunate
that a woman coming out of the business world isn’t really representing
a lot of us progressive, female business owners on this issue,” she
said. In late May, Washington’s other senator, Patty Murray, came to
Moon’s store on Capitol Hill to hold a press event and express support
for the public option. Cantwell, on the other hand, “seems to not
really be taking the lead,” Moon said.

It’s natural that small-business owners would be at the front of the
fight for better health-care options. Nationwide, their employees
account for about 40 percent of the U.S. workforce, and perhaps as many
as half the uninsured people in America work at small businesses where
the owner has looked at the numbers and decided that offering health
benefits is just not affordable.

Hall is so fed up with the financial pinch that businesspeople like
herself are feeling that she’s willing to take the unusual step of
throwing open her books in order to offer an object lesson. Since the
first Cupcake Royale opened in Madrona in 2003, Hall’s company has
grown to include stores in Ballard, West Seattle, and (opening this
month) Capitol Hill. After the new store opens, she’ll be employing
about 75 people. Her policy is that any employee who works more than 25
hours a week is eligible for coverage through Blue Cross Blue Shield.
“Which I’m really proud of,” she said.

Last year, Hall had revenue of several million dollars—but
after operating expenses, her take-home profit was far less than that.
“You’ve got payroll, rents, cost of materials, and then health
insurance,” she said. “Those are our four biggest line items. We will
soon be paying in health insurance what we pay in rent for all of our
locations.”

In 2008, the overall tab for Cupcake Royale’s health-insurance
program, which covers 75 percent of its employees’ medical expenses,
came in at about $120,000. The cost is sure to go up again this year as
Hall adds employees and as she shops for a dental plan to offer them,
too. Two years ago, the cost of providing health insurance to her
employees jumped by 40 percent. In a normal year, it climbs by at least
20 percent.

“I feel like I’m a hostage to private insurance,” she said. “It’s
not sustainable for me to charge a 20 percent to 40 percent increase
per year on my products. What is happening across the board is that
small businesses are cutting their deductibles to get a better rate, or
they’re decreasing coverage, or they’re dropping coverage
altogether.”

Hall, 42, didn’t get into the cupcake business to become a
health-care-reform advocate. But in April she traveled to the White
House to tell one of President Obama’s top health-care policy advisers
that a public option is needed “so the big insurance companies don’t
have a corner on the market.” She’s testified before the Washington
State Legislature. She’s joined a local business group advocating
reform. She’s turned Cupcake Royale’s blog into a platform for rallying
the public on the issue.

She’s considering stamping every cup of coffee she sells at Cupcake
Royale with the phone number for Cantwell’s office. She figures maybe
that’s the way to reach the senator, since it turns out that going to
D.C. didn’t accomplish much. The same day Hall was at the White House
getting an audience with one of Obama’s top aides, she also arranged to
attend a meeting with Cantwell’s staff to lobby them for real
health-care reform. Cantwell sent a junior aide who wasn’t a
health-policy expert.

“She said that Cantwell understands the needs of small businesses,”
Hall recounted, still frustrated. “She basically made it sound like
Cantwell supports a public option. But it turns out she hasn’t.”