It is time for some very simple political math. The public option–or a public alternative like a Medicare buy-in–has always been extremely popular. Despite a multi-million dollar, all-out campaign against it, the public option never stopped polling well. Back when the health care bill still contained a public option, the health reform was more popular.
The private health insurance companies are very unpopular. The individual mandate, requiring people to buy a product from the private health insurers or face a fine, is extremely unpopular. The Senate health care bill with the unpopular individual mandate forcing people to buy a product from the very unpopular private insurance companies is (surprise!) very unpopular.
A public alternative to the private insurance companies is so popular that it makes the individual mandate amazingly acceptable for most people. Americans, for the most part, don’t mind forcing people to buy health insurance if they have the option of buying it from the government instead of only from the private health insurance industry.
What is now facing Congressional Democrats is an unpopular Senate bill that contains a very unpopular mandate forcing people to buy private health insurance. Unfortunately for Democrats, even in swing districts, the majority of voters have not completely soured on the general idea of health care reform. When asked if they would prefer if their Representative vote against any possible health care bill, the results in each of the three districts we polled were below 50%. (It was 48% in AR-02, 40% in OH-01, and 41% in NY-01.)
If Democrats move with clarity, it is possible that they could still make voting for the health care bill reasonably popular, or, at least, not politically damaging. They can use reconciliation to add the very popular public option–that would make the individual mandate more popular, and save the government money. They could use that money to help fix the incredibly unpopular tax on employer-provided insurance benefits to make that provision less unpopular, too. Or, Democrats could use the money saved by the public option to provide some Americans immediate health care relief before the 2010 election. This would make selling the bill and voting for the bill much easier.
This is not rocket science. To make an unpopular bill more acceptable to the American people, Democrats can add a very popular provision, the public option, stand up to the very unpopular insurance companies, and make some very unpopular provisions less politically unpalatable. Or, the other option is to use a special parliamentary tool to raise taxes for what would appear to be a special tax break for labor unions. Congressional Democrats, please don’t make me have to explain–even more simply–why the second choice is the wrong one.



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We can take back the 60 seats in November. We just have to start now.
I wonder what happens (assuming both are passed and signed into law) when the Senate bill and the reconciliation bill conflict… I should remember this from law school but I don’t.
I don’t think the reconciliation bill can strike out specific provisions from the Senate bill, however the power to tax is not just the power to destroy but its also (as the Georgia Supreme Court put it about another state power) ‘as broad as the Atlantic and as saving as the power of salvation’. Don’t like the Cadillac tax? Fine, offer a 100% tax credit to anyone who is forced to pay it. Don’t like rescission? Impose an insurance premium excise tax (used to pay for coverage of the uninsured– there’s your budgetary impact) that can be legally avoided only if the CEO of the company swears out an affidavit that no policyholder has had a policy rescinded in the past year. And don’t forget Jay Rockefeller’s Medicare buy-in plan for those 55+, his bill provided a refundable, advanceable 75% tax credit for premiums paid. Drop the age limit to birth + and that’s a bill.
Hmm, why do we need to pass the Senate bill again?
Why not just let the mandate die along with the current bills and try to pass a good highly subsidized public insurance program through reconciliation along with new progressive taxes on wealthy people to pay for it? We could then come back later and consider regulatory reform and mandates last, if they proved necessary.
We can’t take them back if we keep doing things for Wall Street and not Main Street.
belowulf, I can’t imagine. Your alternative seems great to me. BTW, I quoted your idea about sidecar reconciliation favorably here.
I doubt that the senate has the stomach for any more debate about health care.
It’s likely dead unfortunately.
Obama needed to be clearer up front about what he wanted and keep it simple. Letting congress beat the thing to death for months and junk it up to the point where no one understood what it was was deadly
In the end, this failure was less of an issue of ideology and more an issue of mismanagement. Obama’s weakness is his lack of management experience, and that just showed up like a sore thumb.
“We can take back the 60 seats in November. We just have to start now.”
Strange, it seem like just last year that the Dems had a filibuster proof majority, but that can’t be true because, they were bending over backwards all year to make the GOP happy. Seriously, we need less Democrats in Congress…specifically Pelosi and Reid. Addition by subtraction.
Jokes aside all congressional Dems can do at this point is make it illegal to use pre-existing conditions as basis for refusal of service. I doubt the Democrat Party can get that much done though.
Obama on ABC: “Here’s one thing I know and I just want to make sure that this is off the table: The Senate certainly shouldn’t try to jam anything through until Scott Brown is seated,” the president said. “People in Massachusetts spoke. He’s got to be part of that process.”
You’re right of course. Not sure why so many journalists and bloggers are in love with the Senate bill, I mean I know why Jon Gruber loves it, but Ezra Klein or Kevin Drum… I don’t understand it.
Who cares if budget reconciliation bill can’t regulate private insurance markets (which is BS of course, just add an excise tax to behavior you don’t want or a tax credit for behavior you do), there’s no need for private insurance reform if a “public option on steroids” is opened up immediately to everyone. Oh that’s the other village blogger line of crap, since a reconciliation bill only runs 10 years, we’ll only get 6 years of coverage before it times out– as if Obama’s incredibly stupid (related to his even dumber $900 billion cap) 4 year waiting period is a law of nature.
As I mentioned the other day, LBJ had Medicare up and covering every senior within 11 months of bill signing, Clinton had SCHIP (passed via reconciliation) enrolling kids within 3 months of bill signing. Somewhere between 3 to 11 months is all the time Obama needs to get a Medicare expansion or public option plan up and running.
You guys keep thinking that the lesson Dems are going to take from this is to be MORE aggressive….whatever it takes for you to get to sleep at night I guess. As for me, I’ve been paying attention and the Democrat Party is completely cowardly and useless. Go Green.
Thanks for the kind words (and link). As nice as the idea of a Medicare buy-in tax credit is, it’d be even better to allow (and give a tax credit for) civilian buy-ins to to the Pentagon’ Tricare single payer system. For the last few years, reservists have had a public option plan they could buy into as individual or (and unlike Medicare) for their families called Tricare Reserve Select.
Granted the (28% “employee-side) premiums are absurdly low because military reservists are an unusually health lot, but from just looking at the benefits package, Tricare is a better insurance plan than Medicare.
http://www.tricare.mil/mybenefit/home/overview/Plans/LearnAboutPlansAndCosts/TRICAREReserveSelect
Just like Al Franken being part of the process for the first half of 2009.
Obama’s good at taking progressive things off the table. Single payer, public option, public jobs programs, etc. I don’t see reconciliation of a strong health reform bill coming from this White House or Senate Weiner, Franken, Grayson, Kucinich, Sanders and all the other should break off and form a real progressive party and stop fooling around with a Democratic establishment that has been bought and sold.
By reconciliation(51 votes), just change the age for medicare to 50 from 65, set up public option for catastrophic care for everyone under 50 and pay by payroll deduction, tax those making over $500,000k and set up to start right away so people can see it in action and be done with it.
This will be so easy to pass with reconciliation and so popular that repubs will not be able to defeat it just as with social security and medicare today.
Yeah, I’m afraid you’re probably right. Here’s what I respect about the Republicans… you give them power and, to paraphrase the first Republican president, they won’t get up from the table until they’ve played every card they have. They got hammered in the ’98 midterms and House Republicans still went ahead and impeached Clinton. They lose both Houses in 2006 over the Iraq war and Bush still ordered the Iraq surge (and I give him credit that his bet paid off). They didn’t hesitate to use reconciliation when they couldn’t get what they wanted by regular Senate rules.
In war and in politics, sometimes the only way to get the fishhook out is by first pushing it in further. Ever see We Were Soldiers (which was based on an actual battle in Vietnam)? The battalion’s pinned down and nearly out of ammo and their options are similar to what the Hill Democrats face this year– retreat and get mowed down as they run, or fix bayonets and charge the enemy (close air support helps too). :o)
http://www.youtube.com/watch?v=tC2Ewn7Vnq4
Sad to say, I’d have to bet on congressional Democrats all getting shot in the back (electorally speaking) after they throw away their rifles and flee.
OMG, I just had the extremely PAINFUL experience of listening to that BLOWHARD Chris Matthews trying to pigeon hole Howard Dean in breaking down the results of the Mass Debacle.
Howard just has to say that Brown was more successful in tapping into grassroots outrage at Democrat Corporatism, to the point that voters perceived him (erroneously) as being the candidate of breaking the status quo.
Dean just did not want to get cornered into saying:
1) THat Coakley’s campaigning SUCKED (even though it did)
2) The the Mass Voters voted irrationally (even though they did)
Matthews makes my head explode.
Rifles? Dems are STILL playing with Super Soakers!
Is Obama a real progressive? this is the million dollar question.
People want to talk about Coakley being a huge failure, what about Obama, this president went from 70% approval to 48% approval in 12 months. If Obama would have took a couple of steps FDR took during the great depression he would have stayed at 70%.
Does Obama really care about the Public Option? who knows
Obama is exposing what all progressive may have to realize. A lot of Dems are just puppets of large corporations.
The best option for Progressives is to find a couple of strong progressives and help them get elected to congress.
The major problem progressives have is that not one progressive in congress person stood up for the public option. This is a major problem.
Is my logic correct here?
1. McCain runs on an individual mandate and lost
2. Obama runs on no individual mandate but with a public option and wins
3. Democrats call McCains individual Mandate a horrible idea
Then Obama wins and this happens:
4. Insurance companies pay democrats and Obama millions to install a mandate.
5. Republicans campaign against the healthcare bill with a mandate
5. Democrats run on passing healthcare bill with individual mandate
6. The Republicans pick insurance and drug company canadites to run in New Jersey and Mass against the mandate and win.
We are supposed to wonder why the democrats lost in MA last night? If the democrats just wanted to pass this healthcare bill why didn’t they elect McCain? Are all the democrats bat shit crazy?
The WH definitely got the wrong message from this loss. They are talking of watering down senate bill more, not taking any action till the MA senator is sworn in for fairness (now lets put legislation that affects millions on hold for 1 repub senator who is going to vote no anyway), bringing snowe back in(she’s been in touch with WH all along) as she has been telling them all along to slow this down (yes lets listen to repubs instead of the 70% voters).
I’m afraid in the end they will totally abandon reform and blame it on the progressives.
Definitely need reconciliation – Pelosi is the only one for public option.
and here I had hi hopes of opening up medicare for all with reconciliation, now that senate bill won’t pass.
I think it’s all over but the cryin’.