Reveals the hidden web of influence that links George W. Bush, Dick Cheney, and the Texas Republicans to the 2000 recount in Florida; the national tort-reform movement, the controversial late-hour, one vote passage of the Medicare Reform Act; Congressional Redistricting schemes; scandals in the energy sector; the destruction of basic constitutional protections; the financial machinery of the Christian right; the manipulation of American-Indian tribe casinos; the Iraq War torture scandals; crooked management of the Department of the Interior; the composition of the Supreme court; and the 2007 purges of seasoned prosecutors in the Justice Department.

Some of the actors are in federal prison, others are on their way there, and many more have successfully eluded a day of reckoning.

An Excerpt - From Chapter 12 - Master of the House

Nothing, though, so well illustrated the power of DeLay the congressional boss than the vote over the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The vote would also demonstrate what could happen when Texan Bush and Texan DeLay combined their considerable might. Passage of the "MMA" legislation would show off every skill possessed by Tom DeLay. Like "tort reform," or like the Senate's vote on the Iraq War, the Medicare Drug, Improvement and Modernization Act was a Trojan horse—designed to marginalize the opposition. Some, like the AARP—so desperate for any kind of prescription relief that it would accept the proverbial half a loaf rather than no loaf—would be forced into bed with DeLay and Big Pharma. Others, almost all of them Democrats, would then find themselves painted as having "gone against AARP" or of "trying to deny drug benefits to our seniors." And like a vote against the war, a vote against the AARP was seen to be a career-killer. Only in this case the battleground was not the Senate but the House.

The root of the problem lay in the spiraling cost of prescription drugs, something no one expected at the time of the passage of the act creating Medicare in 1965. Medicare had, of course, been the capstone of Lyndon Johnson's domestic agenda, the Great Society. First envisioned by Harry Truman in the late 1940s, federal-sponsored medical coverage for seniors had floundered for years, opposed as it was by the American Medical Association (the AMA) and Republican legislators in Congress.

Only with the overwhelmingly Democratic Congress elected alongside him in 1964 was even legislative genius Johnson able to pull that rabbit out of the hat. But now he had, and over time Medicare had become, like Social Security, an entitlement that not even the most right-wing Republicans dared bad-mouth for long.

That did not mean, however, that conservative Republicans wished to extend the benefits of Medicare—though AARP, with its enormous demographic base of seniors, certainly did. The genius of the Medicare Prescription Drug Act was that it gave AARP—and the seniors—just enough to push them on board, while giving billions to Big Pharma.
On the one hand, MMA provided a subsidy for large employers to discourage them from eliminating private prescription coverage to retired workers. That was a key AARP goal—and one that pleased traditionally Democratic labor unions even more. But the encouragement took the form of huge subsidies to the corporations affected by the bill. IBM, for example, was estimated to benefit to the tune of $400 million over six years, beginning in 2006.

On the other hand, MMA prohibited the federal government from negotiating discounts with drug companies. Big Pharma would be getting paid full freight.

And MMA prohibited the federal government from establishing a formulary, a list of accepted medications, while allowing private providers, such as HMDs, to do just that, thus restricting drug choices.

The act also provided that care could be restricted to networks of providers; prescription coverage could be deferred; and care, other than emergency care, could be restricted by region. The act also funded a six-city trial of partly privatized Medicare (by 2010), gave an extra $25 billion to rural hospitals, and mandated means testing for Medicare B patients beginning in 2007, meaning that the next generation of Medicare recipients would have to pay virtually full price for Medicare B benefits beginning at retirement, thus in effect eliminating Medicare B over time. That was the genie in the bottle—and the worst aspect of the bill if you were a boomer rather than a current senior.

From the point of view of current seniors, the worst part of the act was that it provided for a "doughnut hole" in the middle of coverage, meaning that enrollees were 100 percent responsible for costs between $2,250 and $5,100 (a gap of $2,850). Clearly, this bill was no AARP dream.

But it was the reality Tom DeLay and the administration presented AARP with. It was also, as was almost everything else pending before Congress in the Age of DeLay, written in large measure by industry lobbyists.

And who better to write such legislation than one of DeLay's closest colleagues on the Hill along with a former DeLay chief of staff? For such were the chief strategist and the chief tactician of MMA. After representing south Louisiana's Third Congressional District, the famed Cajun country, for twenty-five years (1980-2005), former-Democrat-turned-Republican Tauzin would retire only tot up the reins at Big Pharma's trade association. The very day he left Congress, January 3,2005, Tauzin took over as president of the Pharmaceutical Research and Manufacturers of America (PhRMA). It was wide! reported at the time that his asking fee had been $2 million—and that the former congressman had gotten it. Big Pharma knew the value of tale

But in the summer of 2003, Billy Tauzin was still chairman of the House Energy and Commerce Committee, and thus the man chosen to shepherd MMA through the House.

The day-to-day legislative tactics were left to Susan Hirschmann, the former DeLay chief of staff. Hirschmann's conservative, even right-wing credentials were impeccable. She had been a big shot both in her native Alabama and later in D.C. with the College Republicans. One of her closest female friends in Washington was said to be right-wing think-tank executive Amy Ridenour, Jack Abramoff's former friend and money-mover. And her husband, David, was a vice president of the U.S. Chamber of Commerce.

So sought-after had Hirschmann been when she made it known that she was ready to leave DeLay's office and cash in on her contacts that an auction was held for her services. Williams & Jensen won that battle. The fees from her client list there soon mounted into the millions. Of these, Big Pharma and its various individual members were the ne plus ultra.

What a cast of characters had lined up behind MMA: the Bush White House and Karl Rove, Big Pharma, the AARP, Boss DeLay, his Energy and Commerce chairman Tauzin, DeLay and Tauzin's right hand man on the committee, Joe Barton of Dallas, and, making the trains run on time, Susan Hirschmann.

Considering the brains and brawn lined up behind the thing, it's astonishing that the vote was even close. But it was—very, very close.

And when the time came, in the early hours of June 27, 2003, the vote stood 214 in favor—and 218 against. But the DeLay train was not done, not by a long shot. In the next few minutes, one Republican House member was made to change his vote to "present," while two others switched their votes from no to aye.

After the Senate voted 76-21 to pass its own version of the bill, a joint House-Senate conference committee was called to "unify" the two measures. The critical, final House vote on the Medicare Prescription Drug Act came on November 22, 2003, at 3 a.m. After forty-five minutes, the bill seemed lost, with the vote at 219-215 against. Once again, contrary to House precedent, the vote was held open. This time it was for all the marbles. DeLay, Blunt, and even Speaker Hastert could be seen on the floor of the House, buttonholing and cajoling, promising this member rewards and threatening to wreak vengeance on that member.

Even Republicans were appalled. One senior Republican remembered it as "the ugliest night I have seen in twenty-two years in politics." Representative Walter Jones of North Carolina recalled that night, "It was horrible. I saw a woman—a member of the House—a lady—crying."

At 5:50 a.m., all the threats and all the promises, the sweet nothings of pure power politics, had done their charm. When Republican John Culberson of Texas reversed his vote, the deed was done. The Medicare Prescription Drug, Improvement and Modernization Act of 2003 had passed.

It was soon revealed that the true cost of the MMA had been hidden. Medicare's nonpartisan chief actuary admitted that he had been ordered not to reveal the cost. While Bush administration spokespeople—and their legislative lackeys—pronounced the cost a mere $395 billion, the real number was in excess of $500 billion.

The lead negotiator from the Department of Health and Human Services joined the ranks of K Street lobbyists ten days after the passage of the act. At least fifteen congressional staffers involved went the same way.

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