went to sleep last night gnawing on Clyburn’s obvious hedging – was worried they were going to promote this piece-o-crap or some version of it

Jon – does anyone know the genesis of Carper’s idea ?

This idea was much discussed a couple of weeks ago and then seemed to evaporate, perhaps in light of the evidence that such a large swath of the population would potentially be excluded from the PO. Not to mention that the exclusion would fall inordinately on minorities, as I recall reading.

How it’s implemented would seem to make a huge difference. If there is a mandatory “in” period before states can opt out, then citizens would howl about losing something they like. Which means there are a lot of powerful interests aligned against letting that happen. (the camel’s nose defense?)

Those optout state predictions seem needlessly alarmist. The best case is actually zero states, which–based on prior
experience with GOP-dominated states deciding whether to accept federal largesse–would in fact seem to be the likeliest outcome. Otherwise, why do all 50 states have Medicaid and stimulus checks
coming in?

There’s really little evidence out there to support the idea of major opting out. And if it takes us from a shit PO in the Senate to a strong one like HELP or even Med+5, which I understand is what Rockefeller wants if there’s an optout, then I say that’s a big win.

Put it this way: Alabamans have shit insurance currently. Pass a national
weak PO or even something less, and they’ll still have shit insurance, along with the rest of us. Pass a strong PO with optout, and the chances that they get something decent go waaay up, with a chance they will optout and still have shit insurance. Meanwhile, millions more will get something decent.

Even under the weakest opt out terms, you still provide the best chance for the most people to get a good deal.

If I remember correctly AZ was the last state to add Medicaid in that was in the mid 80’s. If you live in a red state and are happy to wait until 2038 for the public option, good for your and your patience.

There is also zero evidence that the opt out will be a stronger public option. All sources say it will be an opt out for a weak “level playing field” plan not tied to Medicare in any way.

How about the law be written to allow only Republicans to opt out? Oh, and NO opt back in again, ever.

Too simple, I know, but still …

Well, we’ll have to opt Reid out of his job.

There’s been so much “leaning” in the last few weeks that they all must be ready to topple over. Absurd. Just do it.

TPM reporting that it is “level playing field” now, not opt-out since Pres. Snowe balked…

As a practical matter, only the strong Medicare+5% public option will work. If Reid puts the negotiated rates with an opt out in his mark, they’re just going to have to change it later. But I guess it’s better to have something at the start of floor debate, as long as nobody is under the impression that progressives will accept that in the final bill.

Have a national PO with an opt-out and an amendment for residents and small businesses to purchase health insurance across state lines. This makes a PO available for red and blue states.

I would like to see Republicans vote against one of their major talking points. No excuse for Blue Dogs not to vote for the bill.

Ben Nelson and Politico. Now there are a couple of reliable sources on what is going on in Harry Reid’s committee.

the games have become so stupid, it is actually painful to pay attention.

it’s not even a car wreck anymore, just a [predictable] clusterfuck brought about by people who don’t even want to reform health care.

It’s an eerie parallel to the GOP’s failure to govern effectively, because they don’t believe in government to begin with.

tip a canoe and opt-out, too!

The state Party that opts out of a robust public option is a Party that may not recover just on moral grounds alone.

o/` Leanin’…Leanin’… o/`

/Robert Mitchum in “Night of the Hunter”

I am not quite sure that I understand what would happen in a state that opted out. After the gov, lege, or whatever decided to opt-out, then what?

So it will be unconstitutional without equal representation and die in the first trial.
Isn’t it obvious?

A very, very robust PO with an opt out clause for States, – Pass the Sucker, and start fixing the bigest fucking bubble of them all: the Wealth Bubble!

Wages stagnant, jobs not coming back, easy credit which masked the transfer of wealth is not coming back, Americans are hurtling into a world of hurt.

The one issue in all of this which I think is not gettign enough attention is

Will we all be able to join it?

I don’t liek calling it a public option if I can’t join it unless somehow I’m getting screwed. I HATE my work based insurance and want to switch to the public plan ASAP.

We need to talk about this more.

Did you characterize the Senate’s process of careful and methodical deliberation as a “clusterfuck?” That’s an insult to all manner of clusterfucks everywhere. /s

The public plan will not be sold in that state. If it opted out.

This is a ridiculous option, especially for people like me who live in Arizona. Given the wingnuts out here in the Leglistature and the Governor, they WILL opt out.
It makes it terribly unfair to people who live in states that are will opt out. To be effective, this has to be passed on a national level with NO opt out.

So people are just stuck with whatever private insurance they can buy. Sounds like a gift to the insurance companies to me.
Could there be lawsuits by citizens to overturn?

Well don’t be so fucking selfish ! Kick out every cock local sucker legislator out twice in a row and your state will get a PO. Expect the US to get another run at it; 20 years.

So states get to opt out of cheaper insurance, but citizens don’t get to opt out of paying higher premiums.

Sigh.

Selfish! Methinks fuckno may be the selfish one. Just because someone lives in a Red State, like me in Texas, doesn’t mean he should be left at the mercy of the likes of Rick Perry.

Sounds like the WH is going to treat the public option like health care reform in general. Let’s dress up the opt-out as a reasonable public option, then at least we can say we passed something.

Opt-out is unbelievably unfair to those in states controlled by small-minded, heartless leaders.

We need to say loud and clear: There are no red states or blue states. There are only the United States of America!”

And: “one nation, under God, indivisible, with liberty and justice for ALL.

Jon

Wouldn’t it be better for the Senate to have some form of a public option, even an opt out version, when it had to reconcile its bill with the House version. IOW, if the House passes the strongest version of a public option and the Senate has some version, it seems that would increase the chance of a better public option being in the final bill.

appears that you don’t much give a F*ck about democracy.

What good would this be if all states choose to opt out? It’s more CYA bullshit from Congress.

The opt-out thing sort of gives me the creeps. It’s like saying that everyone has free speech except those who opt out. Doesn’t feel fair or just.

Exactly, who the hell do they think were knocking on doors and donating to their campaigns?

It has been known over the years for a bill to leave the “Conference” with weaker provisions than those in either version of the bill in question when they started.

The closer together the Senate and House bills are to start with , the more difficult it is for them to game it in conference.

Good things do not happen in House/Senate Conference committees.

The moment rates in neighboring States come down by 20%, Opt-Out will not be Politically feasible, not in Arizona or Texas.

It is surprising how many Democrats still see the South as disposable. The states are nor all red or all blue. The Democrats would not just be leaving Republicans behind in the opt out states.

ABC is reporting it now. Whaddya know. Politico found a nut.

ABC says Baucus has gone nuclear. TPM says Snowe will filibuster.

Obama’s timidity is stunning. It’s beginning to catch up with him.

The House passes a public option without an opt-out; the Senate passes a public option with and opt-out. It goes to conference. They start asking practical questions? Who has the authority to opt a state out? What about citizens in that state who might like to have a public option but are denied the opportunity because their state has opted out?

I think that this is for the Senate to trade away for something else. And that something else better not be Medicare+5%.

so should we consider going for a truly strong Day 1 national PO with a day one opt out for dissident states? I don’t think it works, but it only fails to work for those states that opt out, although there would be a small moral hazard issue in sick people in opt out states moving to “in-states” once they get sick…. in which case the opt out may need to be accompanied by a wall. Private insurer rates, which have to compete with the Medicare-based costed of the PO in in-states would presumably be a lot lower in in-states than in out-states.

Here we go again with this tired old bullshit.

I wish Rachel or KO or somebody would get one of these pols on their show and ask why an opt-out is necessary for a program that is already 100% an opt-in. Nobody is forced to purchase the public plan, it’s an OPTION, so you opt-in if you want it.

This is BULLSHIT.

Yes I know.

It has been known over the years for a bill to leave the “Conference” with weaker provisions than those in either version of the bill in question when they started.

Seems a Senate bill with no form of a public option would put us in the weakest position for anything resembling heath care to come out of “Conference.”

I am not saying that we should not continue to advocate for a robust public option in the Senate. If push comes to shove, it seems we would be better off with an opt out version in the Senate, than no public option at all.

Opt out is tremendously cynical, but probably effective, politics for the Dems.

After the bill passes, the GOP will run in 2010 against the health care bill. That is a given.

With the opt out, the Dems can say, “Hey, you don’t like it, your state had a chance to opt out. And if you didn’t opt out, then how bad is it really?”

If some states in the South opt out, and as a region the South has the most obesity and worse health coverage already, then some people will die from inability to access health care. They will be Southernors, and maybe even Republicans, but I don’t think that is a best case result.

The politics of opt-out is excellent for the Dems, however.

I would say it is “better” because the Senate is the floor of any bill. Would a public option only for people in 10 states be better than no public option at all. Yes. Of course getting shot twice instead of 8 times is “better.”

So the baseline for worst-case bill has been raised. This is good.

Quite obviously we expect Obama to sign something significantly better. But improving the worst-case is always good, since it thereby improves the *expected* result.

Too many people treat such things as though “that’s the end of it” – we saw it with the Baucus failbill. Note that *that* abomination is now gone.

Baby steps, people.

It ain’t over yet, this is one more data point in a straight line from crappy policies, baucus, coops, state coops, exchanges, towards more progressive incarbations, and if the past is any indication, there will be further, likely more progressive, iterations.

So long as we’re pointed in the right direction and continue moving in it, that is evidence that we are doing our job and the majority of Americans are being heard.

Opt-out of Medicare for All would make an acceptable fallback position as far as I am concerned. The political forces it would unleash would portend a potential grand political realignment. But now that they’ve put opt-out on the table for real, it is time to up the ante on them again, this time for enhanced robustness and availability to all, as Obama appears willing to play that game ad infinitum.

Yeah great politics for Dems. But while I’m here in Northern VA, I can’t get the P.O. because of the nazi’s running this state? Heck, they even turned away stimulus funds to extend unemployment benefits. Ridiculous.

You can’t play politics with this.

You can’t play politics with this.

We’ve been held back by red states for 30 years now, and that has to end now. 20 years ago after I graduated, I got in my truck and headed, sight unseen, like so many before me, west to California from Texas and have never looked back.

If it is possible to get immediate coverage for more than one half of Americans who live in states which don’t opt out, then that has to stand for something. If nothing passes, then the red staters will still be without coverage.

Since we believe in our policies and know that they will come close to producing the desired results, then we should feel confident that the example of Medicare, Part E set by the states which did not opt out will prove so attractive that the red states will have no option but to opt back in.

That movement will be led by the local business communities, because once insurers are competed out of states with Medicare, Part E, they will turn to the “mandate to private insurance” states for more of their profits, sending the cost of private insurance further through the roof.

Medicare, Part E is a financing option, covered either by individual premiums or public subsidy just like private insurance is a financing option which would be compulsory and paid for by individual premiums or a public subsidy. Unemployment insurance requires the states to contribute money. The distinction is there and when faced with the choice, that might make a difference.

What’s going to cover more people faster, more incremental bites at the apple or a more ambitious opt-out approach?

Bad policy: allowing the worst state electorates in America hold the rest of the country back.

There is no one to bitch at about this except your state’s own electorate. If you want help, I’ll be happy to lend a hand. If you just want to complain about people in states with more rational electorates, then you’re part of the problem.

Since I am suffering from a heart condition in a red state and can’t afford medical care (or moving to a blue state with a “more rational electorate”) with my lousy job-provided insurance I guess I can just die and get out of the way of progressive politics. Thanks for the support and solidarity! Nice to know that some progressives are more equal than others, from a purely pragmatic, political perspective at least.

Now is the time for you folks in red states to organize like we’ve organized to make your voice heard. I’ve done that in Texas, don’t tell me you can’t in your red state.

Um, I DID organize and helped Obama win Florida last year. So what’s your point? I have a Republican governor running for Senate, a Blue Dog Democrat Senator, a completely GOP controlled state legislature that has gerrymandered the state to the point of perpetual hegemony and Rep. Grayson here. Like I said, if there is an opt-out Florida probably will since the state is near bankrupt and totally wingnut controlled so I guess I get to die since I’m not from a Blue state, huh?

So either you get health care or nobody does?

And what’s this all about solidarity? If we support opt-out we’re not standing in solidarity with you, but if you oppose opt-out, you’re not standing in solidarity with us. Solidarity means sacrificing now so that others might win, not having others sacrifice so that we all might win one day down the road.

I’d rather not see an opt-out, myself. But I’m going to re-ask a question I asked in an earlier opt-out thread:

How many states opted out of taking stimulus money?