The closer you look at the crisis in Washington, the more you can see how it's yet another story about money in politics. It's not just that congressional Republicans are running scared before big conservative donors who threaten to finance primary challenges, as I have written here and here.
The healthcare industry is also pressuring Republicans to take a hard line—or, more specifically, the small but ulta-wealthy slice of that industry that makes medical devices.
Repealing the medical device tax has become a major demand of House conservatives as a condition for reopening the U.S. government and letting the Treasury pay America's bills.
On the surface, this demand is pretty weird, since the device tax is a small part of Obamacare and not nearly as onerous as the Medicare surcharge the law imposes on wealthy households. Also, the tax hardly falls on the kind of heartland Americans that the Tea Party supposedly represents. Its main sting will be felt by giant multi-billion dollar corporations like Johnson & Johnson and Medtronic—companies with hefty profits.
What's more, the substantive arguments against the tax have been debunked—most notably John Boehner's wildly exaggerated claim that it's "costing us tens of thousands of jobs that are being shipped overseas."
Keep in mind that we're talking about a tax that will raise just $29 billion over the next nine years in a country that spends nearly $3 trillion a year on healthcare. It's a wonder that Republicans are fretting at all about such small change for such a wealthy industry, much less threatening armaggedon over it.
In fact, though, the medical device tax obsession makes perfect sense within the ways of Washington. The corporations that make these devices have super deep pockets and very skilled lobbyists, and their influence reaches to the very top of the House. Boehner's deputy chief of staff, Brett Loper, used to be the chief lobbyist of AdvaMed, the industry coalition leading the charge against the tax. In that role, Loper led the original fight against the device tax in 2009 and 2010.
Lee Fang recently showed in The Nation how a letter demanding a repeal of the tax and signed by 75 Tea Party Republicans was likely written by AdvaMed.
And so it goes. Yes, the battle in Washington is partly about ideology. But if you get out your magnifying glass, you'll find that the fingerprints of big money are all over this fight.