Key figures: Barack Obama, Ted Kennedy (deceased), Nancy Pelosi, Harry Reid, Max Baucus, Charles Grassley, Paul Kirk, Scott Brown, Deval Patrick
Summary
Senator Edward “Ted” Kennedy died on August 25, 2009, from glioblastoma multiforme — a malignant brain tumor diagnosed in May 2008 — at his home in Hyannis Port, Massachusetts. He was 77 years old. Kennedy had served as U.S. Senator from Massachusetts since November 1962, representing the longest tenure in the state’s history, and had chaired the Senate Health, Education, Labor, and Pensions (HELP) Committee, which he used as the primary vehicle for a healthcare reform push during the Obama administration’s first year. His death occurred at a pivotal moment in that legislative effort, transforming him into a symbol that both energized and complicated the path to passage.
Kennedy’s Healthcare Legacy: Decades of Advocacy
Kennedy’s investment in universal healthcare spanned four decades. He introduced his first national health insurance bill in 1970 and came close to a bipartisan compromise with the Nixon administration in 1974 before Watergate derailed it. He opposed President Carter’s incremental approach in the late 1970s and ultimately split with Carter over the issue — a rift that contributed to Ted’s 1980 presidential primary challenge.
During the Clinton administration’s 1993–1994 healthcare reform effort, Kennedy was a key figure in attempting to broker a compromise. When that effort collapsed, he pivoted to targeted expansions: he co-authored the State Children’s Health Insurance Program (SCHIP) in 1997 with Senator Orrin Hatch (R-UT), extending coverage to approximately 8 million children, and championed the Health Insurance Portability and Accountability Act (HIPAA) in 1996. These were Kennedy’s most lasting legislative achievements in health policy before the ACA.
The 2009 HELP Committee Bill
The HELP Committee, chaired by Kennedy, moved first among Senate committees. Despite Kennedy’s declining health — he appeared publicly only rarely after his diagnosis — the committee marked up and passed the Affordable Health Choices Act on July 15, 2009, by a vote of 13–10. The bill included a public health insurance option, insurance market reforms (prohibiting denial of coverage for pre-existing conditions), and an individual mandate. Kennedy was absent from most committee sessions due to his illness, with Senator Christopher Dodd (D-CT) presiding over key deliberations.
Kennedy submitted written statements supporting the process and, in a letter to President Obama and Massachusetts Governor Deval Patrick dated May 2009 (released publicly after his death), asked that Patrick be empowered to appoint an interim successor to maintain the 60-vote supermajority in the Senate should he die before the November special election. Massachusetts law had previously prohibited such interim appointments at Kennedy’s own insistence in 2004, when he had sought to prevent a Republican governor from appointing a Republican successor to John Kerry had Kerry won the presidency.
Kennedy’s Death and Its Immediate Political Impact
Kennedy died at 11:39 p.m. EDT on August 25, 2009, surrounded by his family. His state funeral was held on August 29, 2009, at the Basilica of Our Lady of Perpetual Help in Boston; he was eulogized by President Obama and interred at Arlington National Cemetery near his brothers John and Robert Kennedy.
On September 24, 2009, Governor Deval Patrick appointed Paul Kirk — a former Democratic National Committee chairman and close Kennedy ally — as interim U.S. Senator, restoring the Democrats’ 60-seat supermajority. The Senate subsequently passed the Patient Protection and Affordable Care Act on December 24, 2009, by a vote of exactly 60–39, with every Democrat and two independents voting in favor and every Republican opposed. Democratic leaders publicly dedicated the vote to Kennedy’s memory.
The Scott Brown Special Election and Legislative Crisis
A special election to fill Kennedy’s seat permanently was scheduled for January 19, 2010. Republican candidate Scott Brown, a state senator largely unknown outside Massachusetts, ran a disciplined campaign centered on opposition to the Senate healthcare bill. Democratic candidate Martha Coakley, the state’s attorney general, was widely considered the prohibitive favorite given Massachusetts’s overwhelming Democratic lean (Kennedy had won his last election with 69% of the vote).
Brown won the January 19 special election 52%–47%, becoming the first Republican senator from Massachusetts since 1972. His victory ended the Democrats’ 60-vote supermajority and created an immediate crisis: the House and Senate had passed different versions of the healthcare bill, and a reconciled conference bill would require another 60-vote Senate vote — which Brown’s arrival made impossible.
Path to Final Passage
Democratic congressional leaders and the Obama White House settled on a strategy: the House would pass the Senate’s December 24 bill unchanged (requiring no further Senate vote), and both chambers would simultaneously pass a reconciliation sidecar — a smaller budget-related bill containing the modifications Democrats wanted — requiring only a simple majority in each chamber under Senate budget reconciliation rules.
The House passed the Senate’s Affordable Care Act on March 21, 2010, by a vote of 219–212. No Republicans voted in favor; 34 Democrats voted against. The Senate passed the reconciliation sidecar (the Health Care and Education Reconciliation Act of 2010) on March 25, 2010, by 56–43. President Obama signed the ACA into law on March 23, 2010 — before the reconciliation bill cleared the Senate — at a ceremony at which Vice President Biden, captured by an open microphone, remarked that it was “a big f—ing deal.”
Significance
Kennedy’s death and the subsequent special-election loss became defining moments in the 2009–2010 healthcare reform debate, illustrating the precarious legislative mathematics of the Obama presidency. Kennedy’s four-decade advocacy and his political skill had been essential to building reform consensus; his absence during the crucial final phases and the loss of his Massachusetts seat to a Republican created an immediate crisis of momentum that forced Democratic leaders to adopt the procedural workaround of budget reconciliation.
For the broader Republican opposition, Brown’s victory validated attacks on the reform agenda and energized the Tea Party movement that was coalescing in early 2010. Kennedy’s symbolic importance — as the “Lion of the Senate” and champion of vulnerable Americans — meant that healthcare reform itself became inseparable from his legacy. When the ACA survived multiple repeal attempts and Supreme Court challenges in the following decade, commentators regularly invoked Kennedy as the figure who had made it possible.
Sources
- Wikipedia — Edward Kennedy
- Wikipedia — Affordable Care Act
- Wikipedia — Scott Brown
- U.S. Senate — HELP Committee history
- The New York Times — Kennedy Death and Senate Dynamics, August 26, 2009
- PBS NewsHour — The Road to Healthcare Reform