Vivek Murthy 1, NRA 0

The National Rifle Association has certain expectations when it comes to dictating developments on Capitol Hill. But once in a while, the NRA picks an important fight and loses. Take yesterday, for example.

The Senate on Monday narrowly confirmed President Obama’s pick for surgeon general, Dr. Vivek Murthy, after the nomination was held up for more than a year. The Senate voted 51 to 43 to confirm Murthy, who received both an M.B.A. and M.D. from Yale.
More than a year has passed since anyone has served as the U.S.’s top doctor; the country’s most recent surgeon general, Regina Benjamin, served from 2009 to 2013.
The final roll call on Murthy’s confirmation is online here. Note, three conservative Senate Democrats – Sens. Joe Donnelly (Ind.), Heidi Heitkamp (N.D.), and Joe Manchin (W.Va.) – voted with Republicans to defeat the nomination. One Republican, Illinois’ Mark Kirk, voted with the Democratic majority.

For Murthy, the fact that he’s qualified and well suited for the position was never in doubt. As regular readers know, the nation’s new Surgeon General-designate is an impressive medical professional with sterling credentials. He’s also an attending physician, an instructor, and a public-health advocate – who, like so many in his field, sees a connection between gun violence and public health.

And that alone was enough to draw fierce opposition from the NRA, conservative media, and nearly every Republican in the Senate, including alleged “moderates” like Maine’s Susan Collins.

Indeed, let’s not forget that when Murthy’s nomination first reached the Senate floor back in March, Republicans derailed him, at least temporarily, with the help of nervous red-state Dems with election-year jitters, which is why the nation didn’t have a Surgeon General during the Ebola public-health scare.

So what changed? A couple of things, actually.

The first is that a whole bunch of red-state Democrats lost last month, and with defeat comes liberation. Dems in states like Arkansas, Louisiana, Alaska, and North Carolina, while previously eager to make the NRA happy and prove their centrist bona fides, suddenly have no pressure hanging over head – they already lost; the threats of political retaliation no longer have any salience.

Besides, as Donnelly, Heitkamp, and Manchin will soon realize, Democrats who vote to satisfy NRA demands eventually discover that the far-right group is surprisingly hard to please – Arkansas’ Mark Pryor voted exactly the way the NRA wanted on every major vote related to gun policy in recent years, and for his troubles, the NRA rewarded Pryor with brutal attack ads that helped end his career.

The other development of note was the bizarre procedural tantrum thrown by Sens. Ted Cruz (R-Texas) and Mike Lee (R-Utah), who unwittingly helped Democrats line up confirmation votes, including Murthy’s.

On Twitter last night, Dan Pfeiffer, a senior advisor to President Obama, twisted the knife a little,writing, “There’s a first time for everything, but public health advocates can thank Ted Cruz tonight for his help in getting Vivek Murthy confirmed.”

Steve Benin, MSNBC

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