by John Kerry
Health care had been the cause of Ted Kennedy’s career, but it was also a personal passion of mine. I had cared about health care as a policy issue for decades. When I ran for president, health care was one of the first proposals I put in front of the country because I believed it was the right thing to do for moral reasons and also the smart thing to do for the economy. Skyrocketing health care costs were hurting the competitiveness of our businesses. But it had become personal to me and my family. My daughter Vanessa was practicing medicine in Boston. She saw a system that was separate and unequal in every way. There had been so many times through my cancer diagnosis and surgery when I had to remind myself how blessed I was that I had the best insurance in the world and money out of pocket if I wanted to create new options. I’d been able to put my care first, not the bills. Forty-four million Americans weren’t so lucky. They had no insurance. Millions upon millions more had lousy insurance or had health risks that drove up the costs of their policies so much that they were choosing between their insurance and paying for their kids’ college. That shouldn’t happen in the richest country on the planet.
One of the reasons I had been so personally invested supporting Barack Obama’s campaign and worked so hard to help elect big majorities in Congress was that I thought we could finally pass health reform in the new president’s first term.
My seat on the Senate Finance Committee put me in the center of the debate. Ted Kennedy, Chris Dodd and Tom Harkin were the stalwart liberal champions on the Health, Education, Labor and Pensions Committee (HELP), but the Finance Committee had jurisdiction over tax revenue, Medicare and Medicaid. Our role would be critical to passing a bill. We had the job of finding the money and the savings to pay for reform, and we could shape its contours.
I started out with optimism about the process. The chairman, Max Baucus of Montana, had been smart to hold the first public listening sessions on health care in 2008, a year in advance of the legislative process. He wanted senators to start going on record with proposals. He wanted to build the public record. He wanted everyone on both sides of the aisle to feel they had been given time to have input.
The Finance Committee has usually been a collegial place. In past years, Republicans like Orrin Hatch had worked closely with the Democrats on health care. There was ample reason to believe the policies could be bipartisan. After all, Republicans for years had supported measures like the individual mandate, the idea that every American had a responsibility to buy health insurance the same way every driver has to buy car insurance. It was the basis of the reform Mitt Romney supported as governor in Massachusetts. We were willing to move toward that proposal. Suddenly, Romney himself disavowed it, disavowed his own bill! He was gearing up to run for president in 2012, and he wouldn’t stand a chance if he looked “too bipartisan.”
There were warning signs inside the Senate from the start. Max Baucus reached out and met repeatedly with Republican senator Mike Enzi of Wyoming, a key vote on the committee. Max wanted to partner with him on a bipartisan agreement. Enzi committed to work with him but wanted to keep their meetings private. There’s nothing wrong with that as long as you’re working in good faith. But not only did the process drag on and on with nothing to show for it, but Republicans began attacking health reform with an effective talking point: It was being done “behind closed doors.” It was a “backroom deal,” they said. We had essentially created a news blackout at their request, but now they were filling the vacuum with lies about the process. Worse, they took the public vacuum of not having a bill and began making wild allegations about what might be in Democratic health reform. The very Republicans who for years had tried to cut money out of Medicare began filling the airwaves with accusations that we were cutting Medicare to pay for socialized medicine. The irony, of course, was that we were spending time trying to persuade Republicans to join us on health reforms they had once championed, only to have them excoriate us for advocating to do something about those policies. They attacked from every direction.
We knew Teddy didn’t have much time left. He was no longer as present in the Senate. When there was a critical vote on health care, however, Ted made a superhuman effort to be there. I remember coordinating with Vicki to make sure we could get him in and out as easily as possible. Just the trip down from Hyannis was dangerous because of his weakened immune system and the threat of infection, not to mention fatigue.
I will never forget that day in April 2009, when the familiar van pulled up to the ramp on the east side of the Senate building. The door slid open and I was greeted by this great, warm Kennedy smile. As difficult as the journey was, it was evident Ted was thrilled to return to the Senate. I wheeled him up the ramp with Vicki and a coterie of Senate police. We came in the back door, took the elevator up to the rear hallway of the Senate chamber, then wheeled him to the door. Once at the door, Ted wanted to get out of the chair and walk onto the Senate floor under his own power. When he appeared, the Senate erupted in prolonged, emotional applause. Many of us had tears in our eyes. Except for a few of us, no one had expected him to be there for the vote on this particular day. In fact, the minute the Republicans saw him enter the chamber, they knew they were going to lose the vote. Those senators who did not want a recorded vote against Medicare immediately switched their votes now that the victory was predetermined. We on the Democratic side of the aisle knew that Ted’s difficult trip was worth the effort. Senators crowded around to shake his hand and welcome him back.
Chris Dodd and I sat in the back row beside his desk and listened to Teddy regale us with an imitation of his efforts to practice throwing out the ball at the Red Sox season opener on April 7, ninety-seven years after his grandfather Boston mayor John “Honey Fitz” Fitzgerald had done it in 1912, at the first major league game played at Fenway. Ted laughed and poked fun at how reluctant his hand and muscles were to obey his commands. I was in awe of this moment of humility and self-deprecating humor in the face of a frustrating reality. As Teddy so often said over the years, we have to take issues seriously but never take ourselves too seriously. He was a master of that too.
Because I had been in regular contact with Vicki over the weeks and months since Ted had taken a turn for the worse, I knew that he had only a limited amount of time left. At the end of July or early August, I arranged with her that I would come for a visit at their house in Hyannis. As I drove by the famous dock where hundreds of pictures must have been taken of Teddy walking toward the sea for an afternoon sail, surrounded by grandkids and nephews and nieces, the Pied Piper of an afternoon on Nantucket Sound on his beloved schooner, Maya, a sweep of memories overwhelmed me as I approached the compound.
I walked up to the porch of the house he grew up in, the famous house of his parents, Joe and Rose, where so many extraordinary moments of history had played out. I knew this was most likely a goodbye visit, and since I hate goodbyes, I wasn’t sure how to get through this one. We sat on the porch looking out at the stunning view of the sound, at the waters that Teddy and Jack and Bobby had sailed on all their lives. We talked about the good times sailing, about the Senate, about what was happening in politics. Ted seemed incredibly peaceful. I wondered if there was some Dylan Thomas inside him to “rage against the dying of the light,” but he gave no hint of anger or rebellion against his fate. I could feel the closeness of his relationship with Vicki, who had been heroic in managing Ted’s life from the moment of his diagnosis and before.
When I felt I had stayed long enough and run the limits of his stamina, I said I thought I should get back to Boston. We got up. I went over to Teddy and hugged him. In all the years I had known Ted Kennedy, I had never hugged him, not even after my election victories or his. Our partings had always ended with a boisterous celebration, a hearty handshake, a great thump on the back. This time I hugged him close and held on for a moment, as did he.
Knowing how much Ted lived life to the fullest, I had earlier wondered whether he had gone through a stage of anger or even bitterness
about his condition. Vicki had told me that he never felt any bitterness, not only because he had lived through the loss of all his brothers and two sisters, but particularly because two of his children had fought cancer. He felt lucky looking back on his life.
Ted thought that perhaps his treatment and journey could help other people, maybe even save some lives. He consciously came to a spiritual, peaceful place believing it was important for him to help show people how to die. He did that by living to the end. He sailed until just two weeks before he died, when he couldn’t pursue this particular passion any longer. Until the very last night, he sat at the dinner table as head of the family. Vicki later said he didn’t go quietly. On the contrary, from the day of his diagnosis, Teddy and Vicki shared a concentrated time of purpose, one that they both came to describe as joyous. Certainly it was filled with challenges—pulling off a speech at Obama’s convention in Denver, preparing to receive an honorary degree from Harvard, finishing his inspirational memoir, True Compass (although he didn’t live to see it published the month after he died), continuing to fight for health care, attending sessions of the Senate until May 2009—all the while being treated for the tumor that was eating away at his life. He passed away on the evening of August 26. I looked out at the ocean, where gray sky met gray water, with no evident horizon. The sky almost seemed to be in mourning. It was not a time for sailing. The next afternoon, however, as I sat at his home, I looked out at a perfect Nantucket Sound and thought with certainty that he was on a schooner now, smiling and sailing. At Ted’s memorial service in Boston, when I was introduced to speak by Paul Kirk, the man who would be appointed to temporarily fill the Senate seat, the introduction left me speechless for a moment: “the senior senator from Massachusetts, John Kerry.” I’d never thought about those words referring to me because I’d never imagined the Senate or Massachusetts without Ted. But when I heard them, I felt a weight that was different from before. There was an immediacy to what I had to do as a senator at this moment: we had to finish the job on health care.
• • •
WHEN I HEADED back to the Senate after Ted’s burial, I remembered one of the conversations we had had as spring turned to summer. I had told Ted that I feared we were getting stuck on health care, that the Republicans were playing rope-a-dope. Ted was following the process closely through his staff in Washington and through Vicki, herself a health care expert. I told him that Majority Leader Harry Reid thought that in the end we might need to pass a bill just with Democratic votes. Teddy’s eyes lit up. He had been down this road so many times. He knew these historic opportunities were in short supply.
In our Democratic caucus meeting, I argued that we needed to pass a bill, period. What we were trying to do was not easy. It wasn’t easy for Franklin Roosevelt when he tried, it wasn’t easy for Harry Truman when he tried, it wasn’t easy for Bill Clinton when he tried. But you don’t sound the retreat, and you don’t make the perfect the enemy of the good. I told the story I thought Ted would have told if he were there. Ted Kennedy always said his biggest political mistake was turning down a health care deal with Richard Nixon in 1971 that would have required all companies to provide a health plan for their employees, with federal subsidies for low-income workers. Teddy backed away from it under heavy pressure from Democrats who wanted to hold out for a single-payer system once the party recaptured the White House. Thirty-eight years had passed and single-payer still wasn’t a reality. Here we were in 2009, fighting to get less than what we could have had in 1971! The lesson Teddy taught me, I said to the caucus, was that when it comes to historic breakthroughs in America, you make the best deal you can, then immediately start pushing for ways to improve it. We wouldn’t have sixty Democratic votes forever. We wouldn’t always have a Democratic president. Now was the time. We couldn’t allow ourselves to get bogged down in internecine fights. Those who wanted what was called a “public option” were right. It should be law. I supported it. It deserved a vote. I’d support it as I always had. But I wasn’t going to lose the chance to pass reform just because I couldn’t get everything I wanted.
We began a public process in the Finance Committee to move legislation to the Senate floor. We weren’t waiting for the Republicans any longer. I came up with a plan to raise significant revenue to pay for reform: an excise tax on the so-called Cadillac health plans provided by some companies. It was not a tax on individuals, but on big corporations that could afford it. My colleagues embraced it. I also convinced the committee to adopt a central plank of the health plan I had proposed as a presidential candidate: lowering health care costs for people with catastrophic medical expenses by creating a pool of money to pay for those costs. It was called “reinsurance.” I thought of the people I’d met on those rope lines in 2004, people with rare cancers, or kids with chronic diseases that required lifelong care. They should be able to get insurance that was affordable. I also managed to include in our committee’s legislation a package of tax cuts to make health insurance affordable for small businesses. These were not minor things. These were things we had been striving for for decades, certainly in the twenty-five years I had been in the Senate.
That fall, health care became personal again, unexpectedly. In our family, we endearingly call Teresa “Dr. T.” Her father was a doctor in Mozambique. As a young girl, she had followed him into the bush to watch him care for the indigenous population. She was always fascinated by medicine and, later in life, almost certainly knew more about it than most senators and even some doctors. I would frequently hear her on the phone giving advice to friends who inevitably called her to get “second opinions” about one thing or another. She was uncanny in her ability to sense or interpret one symptom or another. That fall, she forced an exam that resulted in a diagnosis of breast cancer. She had surgery to have the cancer removed and then went through radiation to get a clean bill of health. Exhausted and a little scared, but in the hands of great doctors and nurses, she was doing all this at the same time that Congress was dithering and delaying. More time was being spent on television talking about Sarah Palin’s made-up “death panels” than about a real-life lifesaving medical system that was denied to millions of women. While Congress delayed, how many women weren’t getting the mammograms that had saved Teresa’s life?
Teddy’s death had left a void in the Senate that in many ways is still felt today. But it also left a void in the votes needed to pass reform. Ted would have loved to stand in the well of the Senate one last time and be the sixtieth vote for the reform for which he’d fought since age thirty. But his passing triggered a special election in Massachusetts that jeopardized the prospects for its passage at all. Massachusetts is not immune to the national mood. Republicans had spent a year blocking progress and then blaming President Obama for lack of progress. It was disgraceful. But it was effective. The Tea Party was at its peak. In January 2010, a little-known Republican state senator from Wrentham, Scott Brown, was elected to replace Ted. Scott was a good campaigner riding a big red wave. Health reform was in jeopardy.
I thought we needed to put health care to a vote, and soon. I was proud of what we were doing. But more important, we were putting Republicans on record: They had a chance to propose amendments. They had a chance to be constructive. If they just wanted to say no, the country would see them do it.
No one could credibly claim that he or she did not get a chance to have input on this bill. The Finance and Health Committees of the Senate spent months negotiating and passed bills including more than one hundred amendments by the minority. The Republicans still wouldn’t vote for them.
The question was whether we would fold—or fight. There were people in the White House urging President Obama to back down. They knew the risks to his presidency if he lost a legislative fight after the midterm shellacking. He made the courageous decision to demand a vote. And vote we did: using the budget reconciliation process, we passed health care reform without a single Republican vote in support of ideas they had to campaign on
for decades. The Tea Party had taken over the Republican Party, but more Americans were getting health care.
I had once wanted to name the bill after Teddy, but it took on a name of its own: Obamacare. I knew Ted Kennedy would’ve liked that just as much. Ted was up there smiling that big Irish smile.
• • •
THE ENVIRONMENT WAS both a passion and a fascination since I was a kid, and particularly since I became involved in that first Earth Day in 1970, after my return home from the service.
Maybe it was the lessons my mom taught me—as her community’s first recycling pioneer, or in the nature walks she took us on as little kids trailing behind her in the woods. Perhaps it was also that early excitement of watching the first Earth Day channel grassroots energy into a political movement that could actually defeat members of Congress who voted against the environment; at a time when so much was going wrong in Richard Nixon’s America, average citizens had done something powerfully right in making the environment a voting issue.
But whatever the reason, with the exception of issues of war and peace, I’d probably worked on the environment more steadily than any other issue my entire career, as a citizen, as lieutenant governor, and through the Senate years, including as a candidate for president in 2004.
My commitment had certainly been tested. Some even on my own political staff tried to convince me it wasn’t a winning issue—a “political landmine,” they argued. They were furious when, in the run-up to the presidential campaign, I teamed up with John McCain to try to pass legislation to increase vehicle emissions standards: “It can’t pass, why introduce a bill and screw yourself with every Democrat who votes in the Michigan primary?” I understood their concern for my politics, but I was not going to give up who I was and what I believed in. I don’t think you win that way. You win by fighting for something—the test Ron Rosenblith used to call the “stand-up guy test.” Sometimes the national headquarters would cut climate change remarks out of my speeches; I’d add them right back in. I believed there were a lot of Democrats in Michigan—veterans, environmentalists, union workers—who thought it was a pretty great idea to build fuel-efficient cars so no one’s son or daughter had to go die in the Middle East for oil. That’s exactly how we went out and won Michigan twice—in the primary season and again in the general election. I made my case face-to-face with voters, persuaded almost 2.5 million Michiganders we cared about their jobs and their clean air, and denied Karl Rove his high hope of turning Michigan red.
