Kennedy Biographer Adam Clymer: Kennedy Shaped Obama’s Health Agenda

Adam Clymer covered Congress as a Washington correspondent for the New York Times and the Baltimore Sun, beginning in 1963, the year after Edward Kennedy was elected to the Senate. He is the author of a remarkable biography, “Edward M. Kennedy,” which captures the sweep and breadth of Kennedy’s remarkable half century of public service in the Senate. KHN’s Eric Pianin talked with Clymer.

Q: Senator Kennedy was such a dominant figure in politics and public life for so long, that it seems a herculean challenge to try to sum up his legacy. He became the patriarch of one of the most famous political families in American history, he ran unsuccessfully for president, and ultimately he became a man of the Senate, and the embodiment of the Kennedy family’s commitment to public service. His interests and causes ranged far and wide, from civil rights to foreign policy to health care reform. Adam, what do you see as his greatest achievements as a legislator?

A: Well, it’s ironic to talk about this today, Eric, because he refers to universal health insurance as “the great cause of my life,” and now he won’t be around when the country is, perhaps, on the verge of achieving some form of it. You wouldn’t call getting national health insurance his greatest success, because he didn’t get it.

But millions and millions of Americans have better health care because of his efforts; whether it’s from the Children’s Health Insurance Program that he worked through with Sen. Orrin Hatch, R-Utah, or community health centers. He put in the first legislation for them back in 1966, when he was a very junior member of the Senate. He legislated the war on cancer and the creation of the National Cancer Institute in 1971. Probably his greatest single legislative achievement is the Americans with Disabilities Act, which obviously has some relation to health care. But I put it more in the category of his other great cause, which was civil rights – the great unfinished business of America, as he so often called it.

Q: You mention that he first got started in this drive to reform health care back in 1966. That was when he made a visit to a Boston housing project, Columbia Point, which had a unique health care clinic there. Can you tell me a little bit about that?

A: That was one of the first community health centers. There were a couple of them (another in Mound Bayou, Mississippi) and because it was Boston and his turf, he went, and he was fascinated and greatly taken with it. His brother-in-law, Sargent Shriver, was head of the War on Poverty at that point, and he worked with him and then worked in Congress to put in a rider for a few hundred thousand dollars to create some more health centers. Something that was probably more easily done in those days; create a new program just because it’s a senator’s whim. But he remained a staunch defender of that system. The Reagan Administration wanted to cut them back or eliminate them, and now I think there about 1300 of them around the country providing cheap health care for people who need it.

Q: How did he use his celebrity and political skills to advance his agenda and cause in the Senate?

A: I’m not sure that he used his celebrity; he couldn’t avoid it. It was with him, it would attract attention. His political skills really were coming from an era in the Senate where the staffs were much smaller. There was no C-SPAN. Senators spent a lot more time on the floor; they knew each other better. And they managed to rely on each other on issues – nobody had a staff big enough so that he could offer an opinion on every subject that came down the pike. Kennedy told me, for example, he would rely on George McGovern’s advice when there was an agricultural bill on the floor, and other senators had people they relied on that way. But it was these personal relationships that helped make him a success in the Senate. 

Q:  He was very good at working across the aisle, with Republicans such as Orrin Hatch.

A: Of course. He had an early instinct. He came to the Senate before filibusters were common. You didn’t necessarily need 67 votes, which was what the filibuster rule was before he got there, to pass anything at all. They were reserved for issues like civil rights or things of great importance. But there were enough conservative Southern Democrats there so that getting things done, even in those days, invited working across the aisle. He had a knack for finding people who might differ with him on most issues but would be sympathetic on an issue –  health care, for example. Orrin Hatch and others in his Mormon faith treat health care issues as very important. Kennedy and he worked together very effectively on that.

Q: Kennedy and his niece, Caroline Kennedy, provided an important boost to Barack Obama’s presidential campaign, in part because of Obama’s commitment to passing universal health care reform legislation early in his administration. The presumption was always that Kennedy was going to be at the center of that debate. Until the world heard the news that he was battling brain cancer, the assumption was that he would be a major player in all of that.

A: Even after he was diagnosed and operated on, he expected to come back and be centrally involved, early this year. His health didn’t bounce back as much as he had hoped and so he wasn’t able to. I think Obama’s commitment to health care in the Kennedy style – some of it is owed to Kennedy’s support and insistence on it. Obama, after all, was not an advocate of mandatory coverage of everyone. That was Hillary Clinton’s position. He wanted to cover all children and hoped to cover more adults. By now, he’s an advocate, thanks in part to Kennedy’s pressure. Every time Kennedy introduced him, he said “With Barack Obama as president, we’ll have universal health care.” So I think he pushed him.

Q: It’s highly speculative, of course, but do you think the health care debate would be playing out differently if Kennedy hadn’t been sidelined by his illness?

A: I don’t know that it would be very different at this point. He might well have gotten a bill through his committee with no Republican support. But I think there’s no question that it will be harder to get it done in the long run without him. Simply because he had the ability to find Republicans to work with. And even more important, perhaps, whatever bill comes out of the workings of the Senate Health, Education, Labor and Pensions Committee, and the Finance Committee, will undoubtedly not be as liberal as he might have hoped, or as many of his colleagues from the more liberal wing of the Democratic Party might have hoped.

But he would be the one who could say, “Look, fellas, I don’t like everything in this but it’s the best we can get and it’s worth doing.” And that sort of voice in the caucus has swung Democratic support for compromise legislation in things like the Medicare prescription drug benefit and No Child Left Behind legislation. So there, as a voice in the House-Senate conference, are the places where he’ll most be missed.