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When the majority doesn't rule

Stem cell bill supporters had pulled off a miracle: victory in the conservative House. The Senate was supposed to be easy, but its leader was conflicted. Then there was the president.

By WES ALLISON
Published August 14, 2006


Part 2: the senator and the snowflake babies

May 24, 2006

The grounds of the U.S. Capitol, Washington

As the stricken gathered with the hopeful on a splendid spring day, the chit-chat in the waiting crowd kept looping back to the same point, with the same disbelief:

An entire year had passed since the U.S. House passed a bill to vastly expand federal funding for embryonic stem cell research, one of the most promising branches of science in decades. But the Senate's Republican leaders still had done nothing with it.

Waving placards in a shady park across Constitution Avenue from the Capitol, the paraplegics, diabetics, cancer patients and their families were having trouble understanding the inaction. Polls showed the bill had the support of more than 60 percent of the public. Nearly 60 senators were on record as supporting it, too. Why the delay?

Lisa Clare stepped to the microphone. Her 11-year-old daughter, MacKenzie, was paralyzed from the chest down last April, when a pickup crossed the highway median and struck their car as they headed to a Girl Scouts outing in Baltimore.

MacKenzie's doctors tell her to keep exercising, to keep hoping, because they believe embryonic stem cells may one day offer treatments for spinal cord injuries. Already they've helped paralyzed mice partially regain the ability to walk.

"I'm just a suburban mom whose life and family has been turned upside down in the past year," Clare told the crowd. "One year may not seem like a long time up in Congress, but to us it was a very long year."

The problem is that up in Washington, winning takes a majority, but that doesn't necessarily mean the majority rules.

July 27, 2005 Stanford University

Dr. Irving Weissman was working in his lab when his private line rang just after lunch. It was Bill Frist, the Republican leader of the U.S. Senate.

They had not talked since they met four years earlier, when Weissman led a panel on cloning for the National Academy of Sciences. Now Frist wanted Weissman's opinion on President Bush's restrictions on federal funding for embryonic stem cell research.

Frist was in an awkward spot. Four years ago, he had helped the president craft his policy, which says federal funds may be used for research only on stem cells already derived from some 60 human embryos. But most of those lines of cells had been contaminated or were unavailable for research. Many top scientists agreed that the president's restrictions were hampering research.

Frist, a heart-lung transplant specialist, knew all that. But he also was contemplating a run for president in 2008, and he would need the Republican Party's conservatives to win the GOP nomination.

Because the embryo is killed when stem cells are harvested, many conservatives liken the research to abortion, the destruction of life for the sake of convenience. Aides and evangelical leaders were warning Frist that supporting the House-passed bill to expand federal funding, known as H.R. 810, could be political suicide.

Like other experts Frist consulted, Weissman told him to put science over politics.

"You need to know the facts on the issue," Weissman told him. "Not what you hope is true. Not what your religion or personal ethics tell you is true. You need to know the facts."

The facts are that the lines of stem cells approved by the president are no longer of much use.

"You're absolutely stopped with the old lines," Weissman said just before they hung up. "This bill allows you to go ahead."

July 28, 2005 The U.S. Capitol

At about 8 the following evening, Frist called President Bush at the White House. The fate of H.R. 810 in the Senate rested with its leader, because he controls the agenda, and official Washington was waiting to see where he stood.

Frist wanted Bush to hear his decision directly from him.

"You need to vote your conscience when it comes to this legislation," the president told him.

At around 10 p.m., with the Capitol empty, Frist sent an e-mail to other Senate Republicans outlining what he would say on the Senate floor the next morning. His press secretary slipped a copy of the speech to a reporter for the New York Times, and booked Frist on ABC's Good Morning America.

July 29, 2005 The U.S. Senate

Frist has a soft Tennessee accent and an even, measured way of speaking, and he delivered the speech with all the spark of a week-old campfire. But it was his boldest of the year, a political bombshell, and it lit up official Washington.

"Every day we unlock more of the mysteries of life and more ways to promote and enhance our health," he began. "This compels profound questions: moral questions that we understandably struggle with both as individuals and as a body politic."

He said he had believed the president's plan was workable, but leaders in the field had convinced him it is hindering research that could offer hope for millions of people. "Embryonic stem cell research must be supported. It's time for a modified policy, the right policy for this moment in time."

H.R. 810 wasn't perfect, he said, but he supported it, and it deserved a vote in the Senate.

The reaction from the right was swift and harsh.

Rep. Dave Weldon, the Melbourne-area Republican who had fought H.R. 810 in the House, castigated his fellow physician for caving to liberal pressure.

Tony Perkins, president of the Family Research Council, and James Dobson, founder of Focus on the Family, warned Frist he risked losing millions of their voters, exactly the reaction his aides had feared.

Frist tried to patch things up the next morning with calls to Perkins, Dobson and others, to assert his conservative, "prolife" beliefs. To Perkins, he offered an analogy: As a transplant surgeon, he takes from a life that's ending to give life to others, and that's how he viewed embryonic stem cell research.

But all was not forgiven. "Politically, it does put him in a more difficult position if he has future desires," Perkins said.

Two weeks later, Frist was not invited to Justice Sunday II, a gathering of conservative evangelical and political leaders - even though it was held in Frist's hometown of Nashville. Frist had spoken at Justice Sunday I.

But elated proponents hoped Frist's support would convince more Republicans to back it, too.

"When he speaks, it has very significant implications for science because of his renowned stature as a doctor and a scientist and a researcher, and it has very substantial implications for government," said Sen. Arlen Specter of Pennsylvania, the bill's lead Republican sponsor.

"And I use the word 'government' as opposed to 'politics' because, as majority leader, I believe his views will be influential on other senators and perhaps even with the president."

The Senate was leaving for a monthlong break. With Frist on board, Specter figured they could count on a vote on H.R. 810 when they returned in September.

As it turned out, September's schedule would not be Frist's own. The headlines told the story.

Aug. 30: AGONY ON THE COAST: A city isolated and underwater

Sept. 4: WILLIAM REHNQUIST: 1924-2005 - SUPREME COURT LOSES LEADER

Sept. 6: Katrina now tops Senate agenda

Oct. 5: Bush assures his base it can trust his pick; Miers may require a Supreme sales job

Events kept bumping stem cell research down the list. Grumbling began among the bill's proponents that Frist was putting his political ambitions first, squelching a vote to kowtow to the right.

Frist assured Specter and two other co-sponsors, Tom Harkin of Iowa and Orrin Hatch of Utah, that he was trying. It didn't matter they had the votes to pass it; what mattered was that one senator fiercely opposed it.

Oct. 21, 2005

Sam Brownback grew up on a farm in Kansas. Now 49, the senator is a national leader on conservative right-to-life issues and was a chief sponsor of congressional intervention in the Terri Schiavo case.

Conservatives and liberals alike respect him for his advocacy of less politically potent evangelical causes, such as combating genocide in the Sudan and human sex trafficking.

Like Frist, Brownback has presidential aspirations. Like Frist, his main support would come from conservative Republicans. The same folks Frist offended with his support of H.R. 810.

While many liken embryonic stem cell research to abortion, Brownback has taken it further, comparing it slavery and the Nazi experimentation on Jews: Using one class of humans to benefit another.

Brownback lacked the votes to beat H.R. 810 on the Senate floor. So he turned to a senator's most reliable weapon: Parliamentary procedure.

Since the 1950s, when Lyndon B. Johnson was majority leader, Senate business has been conducted under "unanimous consent." To move ahead on anything, from ending debate to adding amendments to a bill, all 100 members must agree.

Negotiating on behalf of several like-minded conservatives, Brownback told Frist he would grant consent for a vote on H.R. 810 - for a price: A vote on his own bill to ban all types of human cloning, including a procedure commonly used in stem cell research.

The procedure is called somatic cell nuclear transfer, or SCNT. It is used to create stem cells with specific genetic malfunctions, to study how diseases develop. Researchers also hope to use it to create stem cell treatments with a patient's own DNA.

For many scientists, outlawing SCNT would outweigh the benefits of relaxing the president's restrictions on funding for stem cell research.

It was a master stroke by Brownback. If the champions of H.R. 810 wanted a vote on their bill, they would have to allow a vote on his.

That led to other problems: If Frist was going to allow a vote on Brownback's bill, then Hatch demanded a vote on his cloning bill, which would ban the cloning of humans but allow SCNT. All told, Frist was trying to win agreement for a package of six semirelated, often conflicting bills.

By late October, Specter was tired of waiting. He decided to attach expanded funding for stem cell research to the National Institutes of Health spending bill he oversees. Thanks to the president's restrictions, the NIH will spend $38-million on embryonic stem cell research this year, a fraction of its total $609-million stem cell budget.

Frist implored Specter to hold off: The move would be messy, bringing the Republicans' private squabbling to the open, and it could jeopardize the bill. In exchange for Specter's patience, Frist pledged he would find some way to bring the stem cell bill to the floor shortly after the New Year.

Specter agreed. On Oct. 21, he announced the deal on the Senate floor, to make it part of the Congressional Record:

H.R. 810, first of the year. They had a deal.

March 2006 The U.S. Capitol

Bill Frist holds the most powerful job in the Senate. He sets the agenda and decides what bills will be heard, and when.

But the founders designed the Senate to be, as George Washington put it, a "cooling saucer" to the hot, populist fervor of the House. Each senator has the power to stall or amend legislation, so Frist must find common ground not only with Democrats but with strong-willed GOP senators like Brownback.

Frist, 54, rose to prominence in 2001, when anthrax-tainted letters were sent to the Capitol. Then the only physician in the Senate, he calmed the public and fellow senators alike.

Republicans hoped he would have a calming influence when he was tapped as majority leader the next year to replace Trent Lott, who resigned after making controversial remarks. With degrees from Princeton and Harvard, Frist founded the transplant program at Vanderbilt Medical Center. He was a pioneer in the dicey realm of pediatric heart and lung transplants and the author of more than 100 research articles.

He was not, however, proving so successful in forging compromise and moving legislation in the Senate. He had never held elected office until he reached the Senate in 1995. He had never been a committee chairman, a job where members learn the art of political persuasion and compromise to get results.

Now he was working what many call the toughest job in Washington.

"If you are risk averse," Lott said, "you're going to have a hard time."

Frist embodies risk-averse.

Every step seems calculated, some colleagues and Senate staff say, and it was worse now that he was squaring his actions as majority leader with his presidential aspirations: Will this offend the conservative base? Will it alienate the business community? Appear too liberal? Not moderate enough?

"You can fumble with something until you rub all the fur off, or you finally make a decision," Lott grumbled. "Just make a decision and do it. Decisions is what we need around here, and nobody seems willing to make them."

Frist could have used a series of procedural votes to bring H.R. 810 up for a vote without unanimous consent, and his unwillingness to do that bolstered the complaints. Opponents of H.R. 810 were winning simply by delaying it.

But Frist said forcing the bill to the floor would anger many Republicans and might lead to an uncertain outcome. He said he was committed to bringing the bill to the floor.

"I just don't think it's in the best interest of society not to have a good, healthy debate," Frist said. "As majority leader, it is my responsibility to lead the majority, but also to work with the entire Senate."

Finding an agreement on H.R. 810 was testing all his skills. Most Republican senators hated the bill. They worried that bringing up something that most Americans supported but most Republican senators opposed would only add to the GOP's troubles in the midterm elections.

The Democrats could hardly wait to make a campaign issue of it.

Frist knew that supporters would tack H.R. 810 on as an amendment to everything they could. He told his colleagues it was best to debate it once, on the majority's terms, and be done with it.

Besides, he said, he believed in the science. And he was determined to hold a vote before he left office this year because the next Republican leader, whoever it is, likely would let the bill die. Brownback was finally persuaded to drop his cloning bill, but other Republicans still were balking.

"It's a big fracture, a fault line, and I think Frist has had a bit of a problem trying to balance this," said Harkin, who talked with Frist almost weekly about it. "You're always going to have outliers. But once in a while you have to say this is the majority's will, and you just have to do it."

May 16, 2006 The White House

Mike Castle figured it couldn't hurt to run it past the new guy.

President Bush had recently shaken up his staff, and Castle, the lead Republican sponsor of H.R. 810 in the House, sought a meeting with the new chief of staff, Josh Bolten, to make his case for embryonic stem cell research.

He got bumped to the new deputy chief of staff for policy, Joel Kaplan, and two health policy advisers. Castle, of Delaware, and his aide, Elizabeth Wenk, arrived at Kaplan's West Wing office promptly at 1:30. They hoped to wangle some compromise with the White House that would boost stem cell funding while addressing the president's moral concerns. They had several suggestions:

The president had allowed federal funding on stem cells created from embryos before Aug. 9, 2001, the night he announced his policy. Why not simply move the date back, to now? That would allow the NIH to pay for research on the estimated 400 lines of embryonic stem cells created overseas or privately in the United States over the past five years.

Or, why not allow funding for cells taken only from embryos already created at in vitro fertilization clinics - not any new embryos? Or establish national "centers for excellence" to monitor the research?

Kaplan and the advisers were cordial but firm. They wouldn't budge.

May 18, 2006 Majority leader's conference room, the Capitol

It was 5 p.m., after a long and contentious week of debating immigration policy, when the majority leader brought together the Republican factions that had been warring over stem cell research.

They numbered six: Frist and two leading sponsors, Hatch and Specter, and three key opponents, Brownback, Rick Santorum of Pennsylvania and Jim Talent of Missouri.

Frist had been meeting individually with Republican senators for the past 2½ months, and had distilled their wants and fears into a three-bill package that offered something for everyone.

Supporters of H.R. 810 would get a vote on the bill.

Opponents would get two bills that they could vote for.

The first, sponsored by Brownback and Santorum, would outlaw "fetus farming," the growing of fetuses simply to harvest their cells, tissue or organs. No serious scientist has suggested this, but some evangelicals fear that fetus farming will be a natural outgrowth of regenerative medicine.

The second directed the NIH to conduct research into extracting stem cells without harming the embryo. This research already is being tried, with limited success.

But the bill really was aimed at providing political cover to conservatives because it gave them something to vote for. Then they could vote against H.R. 810 and still send out a press release saying they support "ethical" embryonic stem cell research.

It was a must-have for several Republicans, including Santorum and Talent, who were facing tough re-election battles in states where polls showed stem cell research was popular.

Talent was in an especially tight spot.

Some of Missouri's leading Republicans were for embryonic stem cell research, and come November, when his name will be on the ballot, voters also will decide whether to amend Missouri's constitution to protect stem cell research from conservatives' attempts to ban it.

Talent had co-sponsored a bill to outlaw all cloning, including SCNT. His Democratic opponent was portraying him as an out-of-touch zealot. He really needed a stem cell bill he could vote for.

As for Santorum, he and Specter could not be further apart on H.R. 810. Specter has been treated for Hodgkin's disease and has been pushing for expanded stem cell research longer than any Republican in the Senate. Santorum is a favorite of antiabortion forces who abhor the notion of destroying embryos to harvest stem cells.

But Santorum had helped fellow Pennsylvania Sen. Specter woo conservative voters during his tough primary race in 2004, and Specter has said his priority this year was helping Santorum win his seat back, too. Polls show Santorum is in trouble. Putting him in a position to oppose a bill as popular as H.R. 810 wasn't likely to help.

So Specter co-sponsored the alternative stem cell bill with Santorum. He would rather it not come up at the same time as H.R. 810, because he worried it could siphon off votes.

But if Santorum needed an alternative stem cell bill in the package, so be it. Specter would help.

After 45 minutes, the members left with their marching orders: Sell the package to your fellow Republicans, all three bills or nothing. Then Frist would tell the Democrats to take it or leave it.

May 24, 2006 Outside the U.S. Capitol

The friends of H.R. 810 were not about to let the anniversary of the House vote pass quietly.

Patients, families, scientists and pro-stem cell lawmakers gathered in the park outside the Russell Senate Office Building, waving posters like "Sen. Frist Vote on 810 Now!!" and "Give us Hope, YES on 810."

Hatch, a solid party man and conservative stalwart, had never spoken at a rally targeting his party's leader. But this afternoon, Hatch was arm-in- arm with the disabled and their families, people like Lisa Clare, frustrated with the delay.

"Patients are waiting," Hatch told the crowd. "There's no reason for them to be waiting any longer. It is time for the Senate to act, and I intend to see that they act. Why would anybody stand in the way of utilizing these unused embryos?"

Inside the Capitol, Frist was finishing the upcoming Senate schedule, which placed the priorities of the social conservatives at the front of the line, even though they had scant chance of passing: A couple days on a constitutional amendment to ban gay marriage, followed by an amendment to ban flag burning.

But Frist also was trying to sell the three-bill stem package to a few Republican outliers. The most stubborn was Sen. Tom Coburn, a physician from Oklahoma, who was arguing that advances in so-called adult stem cells, those taken from cord blood, organs and other body parts, were outpacing the need for embryonic stem cells. He would not agree to let H.R. 810 come to a vote.

June 29, 2006 The U.S. Capitol

Frist's staff put out the word just after lunch: The majority leader had an agreement to bring the stem cell bill up. Then, word was, Coburn was going to object. Or not. No one could find Coburn to ask.

At 6:30 p.m., 11 months to the day since Frist announced his support of H.R. 810, he took the floor and asked for unanimous consent for the three-bill package. The bills would be debated together, for a total of 12 hours. No amendments. Each bill must pass with 60 votes.

Everyone watched for Coburn to appear. He never did.

The gavel dropped. H.R. 810 was heading to the floor.

* * *

Later, Coburn was asked why he didn't object.

"If I was leader, we'd stop the Senate before we'd bring a bill up that has a false pretense to it. And that's what this is," he said.

But Coburn said he looked forward to disabusing his colleagues of the notion that embryonic stem cells would be the savior of man, when progress was being made with other cells.

Also, the majority leader and others asked him not to block the agreement. So he didn't.

July 12, 2006 The U.S. Senate

Soon after the Senate opened for business at 9 a.m., Frist announced what advocates of H.R. 810 had been waiting more than a year to hear: Debate would start next Monday, with a vote the following day.

Minority Leader Harry Reid of Nevada thanked him. But since May, Democratic leaders had been moaning about Frist's inability to bring the stem cell bill to the floor. Even though Frist had accomplished it, there were still political points to be had.

As Frist left, assistant minority leader Richard Durbin of Illinois joined Reid on the floor for a little tag-team wrestling, Senate style:

Durbin: "If I am not mistaken, I would like to ask the minority leader, the stem cell research bill has been sitting on the Senate calendar, as passed by the House in a bipartisan way, for more than one year, as we meet today."

Reid: "For 13½ months."

Durbin: "I ask the minority leader: Have the Democrats come forward and asked that this bill be scheduled for floor consideration and debate repeatedly during that 13-month period?"

Reid: "I am sorry to reflect on what we have done. We have begged."

Durbin: "I ask the minority leader, in the month of June, when we wasted two weeks on the floor of the Senate on a constitutional amendment relative to flag burning, gay marriage ... could we have called up this bill, H.R. 810, if the Republican leadership of the Senate had wanted it?"

Reid: "Absolutely."

July 17, 2006 The U.S. Senate

If anyone was going to try to play both sides, it was Frist.

He wrote a column for this morning's Washington Post in favor of H.R. 810 that began with the line, "I am prolife." In debate, he spoke for H.R. 810 - but emphasized his belief that embryos indeed are human and must be treated with respect. Unlike other senators, he never mentioned relatives with Parkinson's, or kids with diabetes, or suggested stem cells offer relief for anyone soon.

Outside the chamber, he appeared briefly with actor Mary Tyler Moore, who has diabetes and is a major advocate for stem cell research. But he declined an invitation to attend a news conference with Specter and Harkin, the leading Senate sponsors of H.R. 810.

He hosted a news conference with Brownback to tout the fetus farming ban. He shared the stage with H.R. 810's biggest critics, including leaders of the Family Research Council and the National Right to Life Committee, and thanked them for their dedication.

July 18, 2006 Vote day

Unlike in the House, it was almost a foregone conclusion that H.R. 810 would pass the Senate. So while proponent Nancy Reagan phoned a few senators still said to be on the fence, the bill's advocates focused mostly on the next target: the White House.

Senator after senator used their time in debate to encourage the president to reconsider his opposition. Conservatives like Hatch and Sen. Gordon Smith, of Oregon, were especially strong, staunch opponents of abortion rights who also backed H.R. 810.

"If this bill is vetoed, another election will occur, another chapter of American democracy will be opened, and ultimately the will of the American people will be reflected in our policy," Smith said.

"I believe the sooner, the better. So to my prolife friend, President Bush, I urge in the name of life to let this bill become law."

When the votes were called, H.R. 810 passed, 63-37. Because it had already passed the House, a clerk ran it down Pennsylvania Avenue to the White House.

Santorum's "alternative" stem cell bill and Brownback's fetus farming ban passed unanimously. Both were sent to the House.

6 p.m.

The original sponsors of H.R. 810, Reps. Mike Castle and Diana DeGette, knew what President Bush was going to do to their precious bill. But they didn't have to make it easy for him.

So Castle and DeGette asked stem cell supporters to oppose Santorum's alternative bill, which directed the NIH to explore ways to extract embryonic stem cells without harming the embryo.

If the president was going to veto H.R. 810, they wanted to rob him of the "fig leaf," as DeGette put it, that Santorum's bill was meant to provide.

Their chances of beating it were slim until the House leadership handed them a gift: To send the bill to the president right away, Republican leaders bypassed the normal procedure and brought it directly to the floor. Instead of a simple majority, the bill now needed two-thirds of the House to pass.

Thanks to 15 Republicans who voted nay, the Santorum bill failed.

The president wouldn't get his alternative after all. It wasn't much, DeGette and Castle acknowledged. But it was something.

July 19, 2006 2 p.m. The White House

President Bush left his office for the East Room, where he was surrounded by nearly 30 "snowflake babies" born after being adopted as unused embryos. Many had been here a year ago, when Bush warned the House against passing H.R. 810.

"These boys and girls are not spare parts," Bush said to applause. "They remind us of what is lost when embryos are destroyed in the name of research. They remind us that we all begin our lives as a small collection of cells. And they remind us that in our zeal for new treatments and cures, America must never abandon our fundamental morals."

He thanked Brownback and Weldon, who were in the crowd. Vindication would be theirs.

Bush announced he had just signed Brownback's fetus farming ban. He had vetoed H.R. 810.

After more than five years as president, and signing more than 1,100 bills from Congress, it marked his first veto. The crowd erupted in cheers.

5 p.m. The U.S. Capitol

The clerk of the House read the veto statement to the chamber. Under the rules, debate on the override would begin immediately, with 30 minutes given to each side. It would take two-thirds of those present to override the veto, or 285 votes.

Supporters fell 50 votes short, gaining two Republicans and losing one who had voted their way last year - Rep. C.W. Bill Young of Indian Shores, who said a new national umbilical cord blood bank, named in his honor, offers a good supply of stem cells.

He also believed Santorum's alternative bill would pass soon. "We have a two-pronged approach now to stem cell research that was not in existence ... when we had the original vote a year ago," he said.

DeGette held a news conference to promise the fight wasn't over. We'll tack H.R. 810 to other bills, she said defiantly. Congress will make its will - the will of the American people - known to the president as often as it takes.

But as a practical matter, Castle knew it was dead for the year. Part of the deal in the Senate was that once the vote was held, stem cells would not be mentioned again.

Though they lost, Castle said, they showed the public the limitations of the president's restrictions on stem cell research. They convinced some of the most conservative Republicans that they can oppose abortion and still support this research.

And in 30 months, America will have a new president. Either of the two leading candidates by Castle's reckoning - Democratic Sen. Hillary Clinton or Republican Sen. John McCain - would sign H.R. 810.

If only the moderates can get it through Congress again.

H.R. 810

The Stem Cell Research Enhancement Act of 2005 says that human embryonic stem cells are eligible for federal research funds if:

(1) The stem cells were derived from human embryos that have been donated from in vitro fertilization clinics, were created for the purposes of fertility treatment, and were in excess of the clinical need of the individuals seeking such treatment.

(2) Prior to the consideration of embryo donation and through consultation with the individuals seeking fertility treatment, it was determined that the embryos would never be implanted in a woman and would otherwise be discarded.

(3) The individuals seeking fertility treatment donated the embryos with written informed consent and without receiving any financial or other inducements to make the donation.

About this story

Reporter Wes Allison closely followed the behind-the-scenes maneuvering on H.R. 810 for 18 months, from when it was introduced in the U.S. House in February 2005 until it was resolved last month.

He observed all the public events described and interviewed key players and their staffs, including Senate Majority Leader Bill Frist, former Majority Leader Trent Lott, and Sens. Arlen Specter, Tom Harkin, Orrin Hatch, Sam Brownback, Rick Santorum, Johnny Isakson and Tom Coburn. Jim Talent declined repeated interview requests.

Dr. Irving Weissman described his phone call with Frist, who confirmed it.

Rep. Mike Castle and Deputy Chief of Staff Elizabeth Wenk described their meeting at the White House, which did not dispute it.

The scene in Frist's office where six senators hashed out the plan to bring H.R. 810 and two other bills to a vote was reconstructed based on interviews with three of the six senators and aides to two others, who also attended the meeting.