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One X-factor in the Dems' run of lame duck wins was the GOP. They didn't exactly make it easy for Dems to do stuff...but they could've made it harder. Much harder. They ceded back hours of time; they handed Dems the food-safety bill after Dems basically botched it; they wrote this high-dudgeon letter vowing to block all Dem initiatives until taxes and spending were resolved, but then basically didn't.

I think there were a few reasons for this. Part of it was that they knew Dems had more time on their hands than most people realized, and were willing to eat into it. Another was that, with the election over, there was little value added to blocking everything, particularly for moderate Republicans.

But Republicans must at some level have understood that some of these things weren't going away. DADT would've stayed on the agenda. 9/11 responders would have stayed on the agenda. DREAM will stay on the agenda. And I'm guessing they made the simple calculation that it would be easier and wiser to give Dems these victories now, rather than fight it out with them publicly next after the GOP takes over the House with a caucus that's divided over these things.

Now the issues are off the table, and that creates more space for them to set the agenda.

by T. Christian Miller, ProPublica, and Daniel Zwerdling, NPR

Last month, the Pentagon sent a soothing letter to members of Congress worried about the treatment of soldiers who suffered brain injuries in Iraq and Afghanistan.

The letter, previously unreported, told House and Senate members that the military was studying the efficacy of a treatment known as cognitive rehabilitation therapy. Cognitive rehabilitation is a lengthy, often expensive program designed to retrain troops with brain injuries to do everyday tasks from remembering grocery lists to recalling words and names.

The letter includes contradictions of previous Pentagon statements. Notably, it makes no promise that brain-damaged soldiers will receive cognitive rehabilitation any time soon.

In the letter, George Peach Taylor Jr., the acting assistant defense secretary for health, acknowledged that the military health care's plan for troops and many veterans, called Tricare, does not cover cognitive rehabilitation therapy. One of the main reasons? A contractor hired by Tricare found limited evidence it works.

But as NPR and ProPublica reported Monday, Tricare's review came under fire in a series of confidential reviews by leading brain specialists. Scientists criticized the study as "deeply flawed" and "unacceptable." One even called it a "misuse" of science designed to hold down costs by depriving soldiers of care.

Cognitive rehabilitation has been used for decades to help civilians with brain injuries. Some major insurance companies, including Aetna and Humana, cover the treatment. Several major peer-reviewed studies support its efficacy. The Pentagon's own specialists and a panel convened more than a decade ago by the Institutes for Medicine have recommended its use.

Taylor's letter, which was written before the NPR and ProPublica stories appeared, did not mention the critiques of the Tricare study. But Taylor did make passing reference to another issue: money.

Comprehensive cognitive rehabilitation therapy can cost more than $50,000 per patient -- potentially adding enormous bills to the military's medical system at a time when hundreds of thousands of soldiers have suffered traumatic brain injuries on the battlefield. Tricare officials told us that money played no part in their considerations to deny coverage for the treatment. But Taylor told Congress that cost was a factor in figuring out which therapies to provide.

"Establishing the effectiveness of cognitive rehabilitation is an important issue for reimbursement of clinical services within the healthcare industry," he wrote to the chairs of the House and Senate Armed Services and Appropriations committees.

Taylor's letter also discussed a second set of studies, funded by $10 million set aside by the congressional committees in last year's defense bill. He wrote that the Pentagon's Defense and Veterans Brain Injury Center, known as DVBIC, had launched its own studies on how to treat mild traumatic brain injury. One of the signature wounds of the wars, mild traumatic brain injuries are often a result of blast waves from roadside bombs. Most soldiers recover quickly, but studies suggest as many as 15 percent go on to suffer lingering cognitive problems.

For careful readers of the military spending bills, this represents a significant change from what Congress had asked. The defense spending bill for 2010 asked the Pentagon to assess the value of cognitive rehabilitative in treating "traumatic brain injury in members and former members of the armed forces" (for those who want to read this passage in its full PDF context, you can check out the language on page 232 of the 1,236-page bill).

The difference is crucial. Why? Because cognitive rehabilitation therapy is actually a pretty well proven treatment for those suffering from moderate to severe brain injury. So by focusing only on mild traumatic brain injury, the Pentagon has avoided having to acknowledge the efficacy of the therapy for those with severe injuries, while tying up decisions on how to treat soldiers with mild traumatic brain injuries in a series of new studies.

In the letter, Taylor did say that cognitive therapy has proved promising: "Cognitive rehabilitation is a long-standing and significant component of comprehensive rehabilitation for individuals with moderate and severe TBI. There is an accelerating, but still small, body of scientific literature supporting cognitive rehabilitation in mTBI," he says, referring to mild traumatic brain injury.

Taylor said it will take years to complete the necessary studies. One should be finished in 2011, another in 2013. By then, many more troops will have suffered brain injuries. And many more who have already suffered blows to the head will have gone without cognitive rehabilitation therapy.

Why the delay? That's the question raised by soldiers, their families and brain injury advocates: if a treatment has some proof that it works, and no proof that it hurts, why not move faster to provide it?

"There should be a way to provide TRICARE coverage for cognitive therapy while further studies are ongoing," Sen. Mark Udall, D-Colo., who serves on the Senate Armed Services Committee, told us in a written statement. "We can't ignore the fact that many studies and experts have determined that cognitive therapy is effective for brain injured patients and the fact that the Department of Veterans Affairs already recognizes its value."

Rep. Bill Pascrell, D-N.J., co-chair of the Congressional Brain Injury Task Force, promised to send a letter to the Pentagon protesting its slow progress on cognitive rehabilitation therapy.

"It's unfortunate that this kind of foot-dragging has been what many have come to expect from the Pentagon when it comes to soldiers who have sustained traumatic brain injuries," Pascrell told us. "Brave Americans who risked everything for their country and sustained traumatic brain injuries -- the signature injury of the wars in Iraq and Afghanistan -- deserve cognitive rehabilitation therapy to help them secure the best futures possible. It is unacceptable that the United States has been at war for nearly a decade and there is still no plan to treat these soldiers."

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As noted here, the physics of what happened during lame duck were anomalous, but not very complicated. I think the reason it came as such a surprise to so many people -- myself included -- is that the Democrats spearheaded it.

Remember, these were the same Democrats who needed weeks and weeks to get it together and pass health care reform after Scott Brown won. That night, all sorts of members, from the rank and file to Barney Frank -- Barney Frank! -- stumbled like zombies out of a caucus meeting to eat the bill alive. It would be an insult to Democracy to jam it through the weeks-long window between his victory and his swearing in, they said.

Well, that's basically the same principle as lame duck.

And based on that history, you'd think the midterms would have resulted in more, not less, political paralysis. These aren't Republicans, who happily impeached Bill Clinton during a lame duck session. These are Democrats: impressionable, divided, ideologically insecure.

It'd be nice to think that the positive feedback loop they just enjoyed might break them of this instinct. But I don't think that's very likely.

Is momentum building for Senate Democrats to change the filibuster rules, following the past two years in which Senate GOPers used their reduced numbers to throw up more procedural blocks than in any past Congress?

As Greg Sargent reports:

At a caucus meeting this week attended only by Senators and no staff, Reid and fellow Dems devoted a significant chunk of time to a discussion about specific ideas on how to proceed, the aide says.

...

"They are already talking it through and devising a plan," the aide said of Reid and fellow Dems, adding that Reid is having "conversations" with other members of the caucus "about the best way to move forward."


Sargent reports that various ideas have made the rounds, including efforts to do away with the modern phony filibuster and force Senators to actually talk on the floor. But how would they change the rules? Sargent reports: "Dems are also coalescing behind the so-called 'constitutional option,' which has it that each new Congress has the right to set its own rules by simple majority vote."

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This Wednesday, a group of prominent Bush-era Republicans, including former NYC Mayor Rudy Guiliani, former Homeland Security Secretary Tom Ridge, former White House adviser Frances Townsend and former Attorney General Michael Mukasey, flew to Paris to speak in support of an Iranian exile group there -- one that's been designated a terrorist organization by the U.S.

"The United States should not just be on your side," Giuliani told the group, the Washington Post reported. "It should be enthusiastically on your side. You want the same things we want."

The group, known as Mujaheddin-e Khalq or MEK, is a militant group that's been violently fighting the Iranian government since the 1960s. It has ties to the regime of Saddam Hussein, which trained and outfitted the MEK and for whom the MEK fought in the Iran-Iraq War of the 1980s. According to the State Department, which declared the group a terrorist organization in 1997, the group's philosophy is a combination of "Marxism, Islam, and feminism."

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I heard a lot of lazy thumbsucking yesterday about how the Dems' lame duck accomplishments somehow gave Barack Obama his mojo back, etc, etc, comeback kid and whathaveyou. Riiiiight.

Let's face it, Obama and the Democratic Congress got four headline-making things done in lame duck: a very popular tax cut plan, a very popular international arms treaty, a very popular civil rights advancement, and a very popular bill to make sure sick 9/11 heroes get health care now. What you'll notice about all four of those things is that they're very popular -- more popular than the somewhat popular immigration bill and unpopular spending bill, both of which failed during lame duck. That they didn't pass before November says much more about the GOP's pre-election political strategy, and the dysfunction of the Senate, than it does about Obama's mojo.

What allowed congressional Democrats to do those things was a decision they made to wait out the GOP. With the election behind them, and holidays in front of them, Democrats made clear that they'd oblige GOP procedural delays right up until January 5, spotlighting their silly objections all the way.

Don't confuse this for the new normal. The new normal will be tons of Republicans, and a bare minimum of common ground. Democratic elected officials seem to understand this, but based on the coverage yesterday, it's not clear that the media, and therefore Obama supporters, really do.

Maybe the midterm elections weren't such a referendum on the President after all.

According to a CNN poll released Wednesday, 56% of Americans approve of President Obama's job performance during the lame duck session -- 14 points higher than the 42% approval rating for Congressional Republicans over the same period. Even the Democratic Party, which just one month ago suffered enormous midterm losses, polled slightly higher than the GOP, with 44% of Americans approving of their job performance in the lame duck session.

Respondents also said they believe Obama's policies rather than those of the GOP would move the country in the right direction. Fifty-five percent of respondents said Obama's proposals would move the country in the right direction, while 42% said they would do the opposite. By contrast, 51% said the Republicans' policies would be good for the U.S., versus 44% who said they would be bad for the country.

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Top social conservative Bryan Fischer is outraged that "President Obama wants to give the entire land mass of the United States of America back to the Indians. He wants Indian tribes to be our new overlords."

Fischer is the Director of Issues Analysis for the Christian conservative group the American Family Association, and appeared alongside top Republicans at this year's Values Voter conference.

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Ahead of the November elections, one of the House GOP's biggest promises to its base was that it would make sure legislation was publicly available online for three days before putting it on the floor for a vote. From the Pledge to America: "We will ensure that bills are debated and discussed in the public square by publishing the text online for at least three days before coming up for a vote in the House of Representatives."

However, in a draft of their proposed rules for the House in the 112th Congress, they reportedly left themselves quite a loophole: the powerful Rules Committee seemingly won't be subject to the transparency requirements and can amend and even replace any bill. As Politico reported Wednesday, "That would leave GOP leaders a significant exemption to make last-minute changes without such a long period of public scrutiny."

This does not please the Tea Party.

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