What have you done Ben Nelson?

Ben Nelson, Democrat Senator from Nebraska, is now probably best known for cutting the final deal needed to get the Healthcare Bill  passed through the Senate.

If you've not been following this whole heathcare debacle, here's the short version:

Nevada's national embarassment, Harry Reid, as Senate Majority Leader, had to find a way to get 59 of his colleagues to agree to vote for a bill that most members of both parties are calling fundamentally flawed.

His last holdout was Ben Nelson, who had openly criticized the bill in the media, and had flat out said he wouldn't vote for it.

So, Harry started doing what he has always done in times of crisis: throw money at the problem.

And make no mistake, Ben Nelson was a big problem.

Whiney Harry secured the pivotal 60th vote after acceding to the demands of Nelson for tighter restrictions on insurance coverage for abortions, along with increased federal aid for his home state and breaks for favored health-care interests.

An interesting collection of bribes, especially when you consider that Nelson enjoyed a successful career in insurance law, served as CEO of the Central National Insurance Group, as chief of staff and executive vice president of the National Association of Insurance Commissioners, and as director of the Nebraska Department of Insurance.

Favored healthcare interests indeed.

But Nelson's biggest bribe was an unprecedented, unique, and likely unconstitutional, special provision for his Nebraska constituents.

He secured full and permanent federal funding for his state to extend Medicaid eligibility to everyone below 133 percent of the federal poverty level.

The bill requires all states to do so, but Nebraska alone would not be required to pay a portion of the additional cost after 2016.

That's right, only Nebraska will have its Medicaid costs paid by the Federal Goverenment.

Paid for by taxpayers in other states.

Taxpayers who will get absolutely no benefit from that payment, and who can't get the same deal for their own states.

Only Nebraska will have no cost for the Medicaid requirements of the new bill.

Ever.

And that provision of the bill has been identified as "unalterable", meaning that it can't be repealed or modified.

Now this provision, which Nelson has called a "hard earned concession" from Reid, flies in the face of Nelson's longtime fiscal conservative stance, the stance that has identified him as one of the strongest Blue-Dog Democrats for years.

So, did Nelson sell out his values?

Or, did he do something more devious?

There's really only two options as to how this provision can be treated, if it is to be handled in compliance with the provisions of our Constitution.

See, the Constitution requires equal treatment of its citizens under the law, regardless of their place of residence.

And the Supreme Court has traditionally found that all citizens must be treated equally when it comes to tax law, Federal benefits, and Federal Social Service programs.

So, if Ben Nelson was really staying true to his fiscally conservative views, and also looking out for the interests of his insurance pals, he may have actually forced a provision into the bill that he knew would result in legal challenges and the subsequent finding of the bill to be unconstitutional.

That would move the obstruction of Whiney Harry's agenda off of Nelson and onto the courts, letting Nelson off the hook without it being obvious.

But, there's another possible scenario in Nelson's actions.

If he has truly abandoned his principles and his allegiances to the insurance industry he has served for years, then his act of requiring permanent Federal funding for Nebraska's Medicaid program may truly be more sinister.

Because the other way to make this situation comply with contitutional requirements is to make every state eligible for the same Federal largesse.

To require the Federal Government to cover the entire costs for Medicaid for every state, not just Nebraska.

Making this whole healthcare bill an even bigger government takeover than it has appeared to date.

Essentially federalizing the entire process and the entire cost.

At a time when our economy is already wounded and our deficits are already beyond huge.

Medicaid began as an extension of the earlier Kerr-Mills legislation and was titled "Grants to States for Medical Assistance Programs."

It provided funds "for the purpose of enabling each State, as far as practicable under the conditions in such state," to furnish medical assistance to welfare recipients and the medically needy.

It clearly created an entitlement for the states but was more vague as to the rights and remedies it offered individual recipients.

It was designed, and enacted, as a state run program, administered, overseen, and controlled by the states, not the Federal Government.

Medicaid programs can cover almost any health care service but are only required to provide a short list of services, including hospital, physician, and skilled nursing facility care.

The main definition as to adequacy of services is a regulatory requirement that each service "must be of sufficient amount, duration, and scope to reasonably achieve its purpose."

Medicaid regulations also prohibit states from arbitrarily denying or reducing the amount, duration, or scope of a required service "solely because of the diagnosis, type of illness, or condition."

Beyond those requirements, the administration and operation of the program was left to the states, including the important area of determining appropriate compensation to Medicaid providers --- doctors and hospitals that actually provide the services.

So by Federalizing the program, the costs and the provider compensation become just another big government entitlement, one that will be paid for by every taxpayer, regardless of the desires of the states and their voters.

Making the ability of each state to tailor its program to local conditions void.

Does anyone think that the medical situation of a coal miner in West Virgina is the same as an autoworker in Michigan or a cattleman in Wyoming?

It has been said that only the government fails to achieve economies of scale, and history has shown that to be absolutely true.

The costs of Ben Nelson's act will be borne on the backs of taxpayers for generations to come if he indeed helps make the Nebraska benefit a universal program.

So which is it, Ben?

What have you done?

"One of the traditional methods of imposing statism, or socialism on a people has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it." --- Ronald Reagan