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Posts Tagged ‘reid’

Reactions To Hectic Senate Weekend

The Senate voted early this morning to file cloture, or move forward, in the final steps toward passing its health overhaul bill. The vote was not certain when the weekend began, and only after Sen. Ben Nelson, D-Neb., announced his support did the action proceed. Reid is now saying a final vote will take place by Christmas.

Bloggers were recovering from a busy weekend, trying to make sense of the big picture as the legislation moves forward.

Wonk Room’s Igor Volsky notes, “The Senators voted from their desks — a customary practice reserved for the most significant votes. Once the presiding president read the final tally, Democrats rushed over to congratulate Majority Leader Harry Reid (D-NV).” He posts video of the vote, below:

The Washington Post’s Ezra Klein compares the Senate’s version with President Obama’s campaign health plan. Klein notes that the public plan was dropped and Obama didn’t initially include an individual mandate,

But whether you love the Senate bill or loathe it, whether you’re impressed by Obama’s effort or disappointed, it is very hard to argue that the bill Congress looks likely to pass is fundamentally different from the approach Obama initially advocated. “The Obama-Biden plan both builds on and improves our current insurance system,” the campaign promised, and on that, for better or for worse, they’ve delivered.

Despite Klein’s conclusion that the plan isn’t very different from Obama’s campaign promise, Heritage’s Conn Carroll says the Senate bill’s passage “is only the beginning of a much larger health care fight.” He continues, “This bill will only make every single problem with out health care system worse: higher spending, higher deficits, and worse care. Former-Democratic National Committee Chair Howard Dean said on Meet the Press yesterday, ‘[This bill] simply sets us on a track in this country which is expensive and where we’re going to have lots more political fights.’ Dean is dead on. President Barack Obama’s signature on this health care bill settles nothing.”

Jacob Goldstein of the Wall Street Journal’s Health Blog looks at Congressional Budget Office estimates released this weekend that found certain provisions are estimated to make little difference: “During all the last-minute action this weekend, CBO put out its estimates on the latest version of the Senate bill. As it turns out, replacing the public option with private plans overseen by a government agency — a sort of “public option lite” that was a key part of the compromise — makes almost no difference to how the bill would work in the real world, according to CBO.”

Grace-Marie Turner lists 12 “constituencies that will be gored, to which senators will have to answer next time they go before the voters.” She includes “everyone.”

Huffington Post’s Drew Westen is disappointed with Obama’s leadership, saying his actions “soured” young people to politics:

Somehow the president has managed to turn a base of new and progressive voters he himself energized like no one else could in 2008 into the likely stay-at-home voters of 2010, souring an entire generation of young people to the political process. It isn’t hard for them to see that the winners seem to be the same no matter who the voters select (Wall Street, big oil, big Pharma, the insurance industry). In fact, the president’s leadership style, combined with the Democratic Congress’s penchant for making its sausage in public and producing new and usually more tasteless recipes every day, has had a very high toll far from the left: smack in the center of the political spectrum.

The American Spectator’s Philip Klein notes that some health insurance stocks are rising this morning.

James Capretta takes a closer look at the final version and says it’s “still a budget buster.”

And from the other perspective, Health Beat Blog’s Maggie Mahar has a series of posts looking at the details, including potential affordability challenges for older Americans, Ben Nelson’s abortion compromise and the “glass half empty/glass half full” viewpoints.

Mark Trahant reports that the Indian Health Care Improvement Act is in both the Senate and House versions.

And in the wake of the coming vote, Bob Laszewski wonders, “Is there anyone left, on either side of the political spectrum, who wants the Senate health care bill to pass?”

Monday, December 21st, 2009

Tags: abortion, costs, howard dean, nelson, reid, senate
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Democrats Frustrated By Lieberman

Independent Senator Joseph Lieberman made a splash on Sunday after he announced he would not support a Medicare buy-in compromise intended to gain votes from a handful of moderate senators. Democratic leaders have been courting Lieberman for months — but he has not agreed to their terms.

And Democrats are angry. Huffington Post’s Sam Stein reports “More than 80 percent of Democrats say they believe Sen. Joseph Lieberman (I-Conn) should be stripped of his powerful chairmanship in the Senate if he ends up supporting a Republican filibuster of health care reform, according to a new poll.”

A frustrated Ezra Klein is definitely one of the 80 percent:

To put this in context, Lieberman was invited to participate in the process that led to the Medicare buy-in. His opposition would have killed it before liberals invested in the idea. Instead, he skipped the meetings and is forcing liberals to give up yet another compromise. Each time he does that, he increases the chances of the bill’s failure that much more. And if there’s a policy rationale here, it’s not apparent to me, or to others who’ve interviewed him. At this point, Lieberman seems primarily motivated by torturing liberals. That is to say, he seems willing to cause the deaths of hundreds of thousands of people in order to settle an old electoral score.

Andrew Sprung on Andrew Sullivan’s blog says Lieberman’s announcement means “the Gang of 10’s compromise is dead and that a bill can’t get through the Senate with either a public option or Medicare expansion. Unless Lieberman makes one more grandstanding reversal. Or all of Barack Obama’s courting of [Maine Sen. Olympia] Snowe pays off somehow. Or Susan Collins has an epiphany. Or someone resigns abruptly and Santa is appointed to the Senate.”

The New Republic’s Jonathan Cohn picks out another reason Lieberman may oppose the compromise: “Lieberman isn’t waiting for CBO or anybody else to weigh in. He says he’s worried that the Medicare buy-in would be the first step towards a single-payer system–and that it would bust the budget. (At least, that’s his latest argument. As Steve Benen has noted, it’s changed a few times.) Ergo, it doesn’t have his support.

But Hot Air’s Ed Morrissey thinks Dems have been naive:

Why did this surprise anyone? Last Wednesday, Lieberman warned that he couldn’t support a Medicare expansion. A week ago, he appeared with Susan Collins for both of them to publicly oppose a government-run insurance option, reiterating the same position that he had publicly declared two days before Thanksgiving.

How can this be a “total flip-flop”? It sounds as if Lieberman’s colleagues have wax stuck in their ears.

The American Spectator’s Philip Klein notes things have just gotten tougher for Majority Leader Reid: ”Either Reid will have to pull a new compromise out of his hat like magic or get liberals to accept all of Nelson and Lieberman’s demands, or this thing is going to spill over into next year, and the whole effort may collapse altogether. But before you get too excited, just remember that the media was declaring health care legislation ‘inevitable’ last Tuesday, so we shouldn’t assume it’s doomed today. The story keeps changing.”

Monday, December 14th, 2009

Tags: compromise, lieberman, medicare, reid, senate
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About That Compromise…

Senate Majority Leader Harry Reid announced a cryptic compromise last night — providing just enough detail to send the blogosphere scrambling to eek out the rest.

Today they’ve unfolded this much — there will be some sort of option for those 55-65 to buy into Medicare, coupled with new national nonprofit plans and a “triggered” public option. The problem? No one seems very happy.

TPMDC’s Brian Beutler reports: “The picture, therefore, is decidedly mixed. Which means, after all this effort, 60 votes remains uncertain. That’s probably why Reid sent an array of options to CBO, and why nobody will know the nittiest, grittiest details of the compromise until it’s unveiled.” Beutler also rounds up Senators’ comments thus far.

There’s still a ton to figure out – The New Republic’s Jonathan Cohn made a list of 10 wonky policy questions, including who exactly will be allowed into Medicare (all workers? only uninsurable?) and what kind of plan would appear, should it be triggered?

Bob Laszewski thinks Democrats have latched onto Republican ideas in terms of the national nonprofit plan — and he says it will fail: ”an out-of-state health plan by definition isn’t going to have a local provider network and will have health care costs that are a lot more expensive than a local plan that does have discounts and managed care protocols negotiated with providers. Well, at least neither side–Democrats or Republicans–have the upper hand on this issue.”

And economist Austin Frakt sees flaws in the proposal to open Medicare to more people: “That is, Medicare for the 55-64 age range will probably only be available to those who meet certain tests of neediness, which is closer to the way it operates for disabled individuals than for the elderly. In effect, Medicare will likely be a dumping ground for bad risks, risks that the insurance industry is happy to transfer to the federal government. This version of Medicare for more will not lead to Medicare for all, it may only lead to Medicare for all bad risks. That’s also why it may pass.”

Heritage’s Conn Carroll thinks the deal “reveals how desperate Reid is” and thinks the process continues to violate Obama’s promises: “When President Barack Obama gave one of his first national health care addresses in June, he instructed Congress: ‘As we move forward on health care reform, it is not sufficient for us simply to add more people to Medicare or Medicaid.’ But after months of debate in Congress, that is all Obamacare has turned out to be.”

And Cato’s Michael Tanner says “No wonder Senator Reid wants to keep it a secret,” and gives “afew reasons to believe this is yet another truly bad idea.”

Wednesday, December 9th, 2009

Tags: medicare, public option, reid, senate
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Reaction to Senate Bill

The Senate finally released its merged health overhaul bill, sending the blogosphere a specific document to pour over.

The action took off when Democratic staffers announced the Congressional Budget Office’s assessment: $849 billion over ten years, a federal deficit reduction of $127 billion, and coverage for an additional 31 million Americans. Director Douglas Elmendorf offers a brief overview on his blog and is careful to note the uncertainties in some of the estimates.

Here’s what various folks are saying:

Hot Air’s Allah Pundit is very unimpressed, and argues that a CBO score matters only “when it’s bad:”

Another week, another “scoring” of a bill that (a) looks nothing like what it’ll look like in its final form and (b) almost certainly has been crafted to hide certain key costs (a la “doctor fix” in the House bill) to improve its “score.” Realistically, the only time a CBO score matters is when it’s bad: Were this to come in at over $900 billion or be judged a deficit-buster over the long term, it would be rejected for failing to meet the White House’s baseline demands. But this one just makes the cut, so look for the obligatory back-pat in this weekend’s presidential message about it being a “fine starting point” or an “encouraging beginning” or whatever. Reid managed to come up with a bill that isn’t too expensive … for Barack Obama. Congratulations.

The New Republic’s Jonathan Cohn compares the Senate’s offering with the House-passed bill. Cohn seems cautiously optimistic, although he admits it’s “worse than the House:”

But, again, the Senate was never going to pass the House bill. Realistically, the question going forward was whether Majority Leader Harry Reid was going to be able to improve what came out of the Senate Finance Committee–and move it closer to what the Senate Health, Educaiton, Labor, and Pensions Committee produced. And there it seems pretty clear that he did, mostly. The early consensus among experts (and, again, this is pending further analysis) is that the new Senate bill boosts financial support for people purchasing health insurance. And, of course, it has a public insurance plan.

It’s not huge progress. But given the political pull to the right from conservative Democrats and independent Joe Lieberman, any progress is an accomplishment. And Reid clearly deserves credit for that.

The Washington Monthly’s Steve Benen thinks some Democratic holdouts should be satisfied: ”it’s worth taking a moment to remember that center-right Democrats, who’ve been complaining about this initiative all year, have very little to complain about right now. Indeed, they should be thrilled — Senate Majority Leader Harry Reid (D-Nev.) has put together a reform package custom made to give the so-called “moderates” just about everything they said they wanted.”

Jacob Goldstein of the WSJ’s Health Blog lists the key tax provisions in the Senate bill, which include a tax on high-end health insurance plans and an increase in the payroll tax for high-income earners.

Insure Blog’s Henry Stern is nonplussed with the bill’s estimated savings: “That bears repeating: if (and that’s a big if) it really meets expectations, Sen Reid’s baby will cut, over 10 years, the equivalent of one month’s deficit. Color me underwhelmed.” (Italics/bold Stern’s).

The Washington Post’s Ezra Klein disagrees, looking at the bill’s cost provisions in the three decades following its passage. “In the second decade, however, …savings from Medicare and Medicaid, paired with the excise tax (which CBO says “is effectively a reduction in the existing tax expenditure for health insurance premiums”) and a handful of other changes, leaves the government spending no more on health care than it otherwise planned to. That’s impressive stuff. And it implies, of course, that in the third decade, the federal commitment actually goes down relative to expectation. The curve, as they say, is bent.” Klein goes on to argue that getting these cost controls in the bill was part of a “grand bargain” that would not have passed without coverage expansions.

Critical Condition’s Kathryn Jean Lopez posts a message from the National Right to Life Committee on the bill’s abortion provisions. The anti abortion group says: “Regrettably but predictably, Reid rejected the bipartisan Stupak-Pitts language. Instead, Reid has sought to please the militant minority that demands funding of abortion through federal programs, even though substantial majorities of Americans believe that abortion should be excluded from government-funded and government-sponsored health programs.”

Amy Allina of Raising Women’s Voices takes a look at the abortion provisions from the other side of the issue:

Senator Reid rejected the calls of antichoice activists to add the House-passed ban on abortion coverage in the exchange. For the most part, the Senate bill confirms current law on access to abortion, as the Senate Finance bill did. To respond to the concerns of antichoice Democrats, Reid’s bill spells out more specific accounting guidelines for the segregation of public and private funds to ensure that no federal money would be used to pay for abortion care. It would allow insurers to offer abortion coverage to women in the exchange, including women who choose the public option if the Secretary of HHS ensures that federal money is not being used to pay for the services. It also confirms that states would be allowed to pay for abortion services on their own, if the federal government decided not to include them in the public option.

Wonk Room’s Igor Volsky made a table comparing the House and Senate bills, saying, “The merged Senate legislation has lower affordability standards, covers less people, invests less in prevention, does not require all large employers to provide health insurance, and includes a weaker public option. But the bill goes further in controlling health care spending and reducing the deficit.”

And you can always follow the action on Twitter. A selection of this morning’s many thousands of tweets below.

Thursday, November 19th, 2009

Tags: abortion, cost, cost curve, deficits, reid, senate, uninsured
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Senate CBO Score Expected This Afternoon

Citizens of the blogosphere are twiddling their thumbs waiting for the Congressional Budget Office to release a final score of the Senate health overhaul bill, which many expect when Majority Leader Reid meets with the Democratic Caucus at 5 p.m. today. In the meantime, many can’t resist guessing the outcome.

Perhaps in preparation for today’s release, Former Speaker Newt Gingrich, R-Ga., sent a letter to Speaker Pelosi, Majority Leader Reid and President Obama. Gingrich and his 50 cosigners ask the Democratic leaders to “slow down…open up…don’t break the bank.” Critical Condition’s Tevi Troy has the letter (pdf), saying “it’s worth a read.”

The Washington Post’s Ezra Klein says, contrary to claims from some Republicans that they will repeal a health reform bill if elected in 2012, “There’s just not much precedent for changes in partisan power ending in the repeal of large pieces of recently passed legislation. In part, that’s due to the nature of the Senate: Repeal requires 60 votes as surely as passage.”

Wonk Room’s Igor Volksy (who includes a shot of Reid praying) rounds up the latest rumors on how the Senate may rush to pass the bill:

Democrats are also indicating that they may “short-circuit the legislative process” to pass health care reform by December 18th, the last day Congress is in session. “The most talked about method is end running the formal conference committee process in favor of some sort of mini-conference. Democratic officials in the White House and Congress are envisioning an end game similar to the way the $787 billion stimulus package came together with congressional leaders and White House aides hashing out the differences behind closed doors.”

The New Republic’s Suzy Khimm reports on another piece of the soon-to-come bill. According to Khimm, “Amid all the concern about subsidy levels in health care reform comes word that Senate Majority Leader Harry Reid is, in fact, going to boost the financial assistance available to Americans buying health insurance. The problem? It’s not the group who needs help the most–and it may come at the expense of those who do.” Reid is expected to lower the maximum percent of income for middle-income earners and raises the percent of income spent on insurance for low-income earners.

Commentators on the right are likely to have their frustration piqued even more — Heritage’s Brian Darling explains objections to even beginning debate: ”The bottom line is that Senators will be voting to proceed to a bill on Friday that they have yet to see and will have little time to read before the first critical vote. Sadly, the secretive procedure used to roll out this legislation has severely restricted the rights of Americans to participate in this process.”

And in other news, Conservative columnist Ross Douthat uses his new blog on the New York Times’ site (where his column runs) to put in his two cents on the health bills: “That means that 10 years and hundreds of billions into health care reform, two-thirds of the uninsured will have coverage — but the remainder, 18 million strong, will be paying more and getting exactly nothing in return. We’ll be effectively taxing a third of the uninsured to cover the rest. Liberals, of course, will say this just proves that we just need to spend billions more on subsidies. But I say that it makes Tyler Cowen’s alternative approach seem vastly more attractive.”

Wednesday, November 18th, 2009

Tags: cbo, gingrich, reid, secret, senate, slow down, subsidies
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Taxing and Saving?

Yesterday we looked at Ezra Klein’s list of ways Democrats could avoid a filibuster, and today abortion rights supporters might see a benefit to using a different way of bypassing the Senate tradition: Politico’s Jonathan Allen reports that “Democrats will almost certainly kill the anti-abortion Stupak amendment in the process if they go to Plan B on passing health care — using a filibuster-proof reconciliation bill — budget experts say.”

There’s been another theme emerging during this recess week besides more back-and-forth over the Stupak amendment: controlling costs and raising taxes.

Hot Air’s Ed Morrissey is unhappy with a proposal to increase the capital gains tax, saying, “The Pelosi Plan would strangle the economy.”

Wonk Room’s Igor Volsky makes a table that compares increasing the Medicare payroll tax (currently being floated in the Senate) versus the House’s surtax on high income earners.

Robert Laszewski expands on his nod toward an independent commission to look at health care costs. He thinks the fate of a bill “might just hinge more not on how ‘robust’ the public option would be but on how ‘robust’ an entitlement commission would be.”

Perhaps there’s another reason for a commission: Heritage’s Ed Haislmaier is unconvinced that Congress will make the future cuts to Medicare that it is proposing: “Enacting H.R. 3961 would mean that Congress has thrown in the towel on its previous attempt to control Medicare spending. It will also mean that no rational person can believe that Congress will actually enforce any new Medicare spending cuts included in pending health care legislation. That, in turn, would mean that new health care legislation would actually result in further, massive increases in either Federal borrowing or taxes.”

Lastly, a key architect of Massachusetts’ reform plan and an economic adviser to many Dems, MIT’s Jonathan Gruber, offers his thoughts on the amount of cost control in the bills. It’s not necessarily a ringing endorsement (via an interview with Ezra Klein):

Here’s how I think about this: Do you know Pascal’s wager? Why not believe in God? I think of health-care reform similarly. We don’t know if we’ll really bend the cost curve. But if we do this and we don’t do anything, we still go bankrupt in 100 years. We don’t lose much. But if we do it and it works, then it’s a savior.

It also moves the conversation on cost control in a way that’s impossible without this bill. It does real things on cost control, and then it does real things to make cost control more politically viable. It lays the groundwork for doing more. To kill this bill for not doing enough on cost control would be like criticizing the Yankees for not winning the Super Bowl. They won the World Series! They did what they could do!

Friday, November 13th, 2009

Tags: abortion, costs, house bill, medicare, reid, senate bill, spending, taxes
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On Taxes, Filibusters and The Simpsons

Bloggers have been speculating what Senate Majority Leader Harry Reid is up to, in terms of health bills, and over the possibility of a filibuster.

The Associated Press broke the news this morning that Reid is considering higher payroll taxes on those making more than $250,000 per year. Jacob Goldstein reacts on the The Wall Street Journal’s Health Blog that ”Whatever Reid settles on, his bill could be significantly amended once it reaches the Senate floor. And if the Senate does pass a bill, it will have to be reconciled with the House bill. And the House has very different ideas about how to pay for health care — the House bill has a new tax on individuals with incomes over $500,000 and families with incomes over $1 million, and no tax on high-value health insurance plans.”

Bob Laszewski gives high praise to another idea floating around the Senate – an independent commission to control health costs– “the best health care idea all year.”

The New Republic’s Suzy Khimm explains we could be waiting a while for a bill from the Senate, where ”it’s likely to be a much longer slog. Due to differences between House and Senate rules, there’s plenty on the Senate side that could delay the bill for weeks, or even months, prompting Senate Majority Leader Harry Reid to announce that the final bill won’t pass until Christmas, at the earliest.” Khimm gives an overview of the variables setting the schedule.

Time’s Karen Tumulty notes, “things get exponentially more complicated in the Senate. There the ideological balance among Democrats is closer than in the liberal House, and the rules allow amendments that could send the bill in almost any direction. Most crucially, it will take a supermajority of 60 votes — exactly the number Reid has in his Democratic caucus — to progress in the face of a GOP filibuster.”

But reform advocates fearing a ”filibuster” may take a closer look at Ezra Klein’s blog. He’s outlined four options that could avoid the filibuster altogether, including “provok[ing] a crisis” or “wait[ing] for an actual crisis.” Of course there’s always his last suggestion: ”end it.”

Elsewhere, Louise Norris of Colorado Health Insurance Insider hosts a Simpsons-themed Health Wonk Review, a biweekly roundup of health policy blogging.

Thursday, November 12th, 2009

Tags: filibuster, reid, senate
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Mulling Over Lieberman’s Threat

Bloggers are trying to figure out why Senator Joseph Lieberman, independent from Connecticut, announced yesterday that he would filibuster any bill containing a public option.

Slate’s Timothy Noah asks if “Lieberman just killed the public option?” Noah thinks Lieberman’s motives lie with the clout of insurance companies in his state (approximately 64,000 emploees). He concludes, “If I’m right that Lieberman is determined to line up behind the insurance industry, then there’s no hope he will ever support any version of the public option, even on a procedural cloture vote, because there’s no hope insurers will support a public option. And if health insurers decide in the end to oppose health reform without a public option, Lieberman will oppose that, too.”

The American Spectator’s Philip Klein quips, “Momentum for Government Plan Stopped by Joe-Mentum.”

Nate Silve of FiveThirtyEight.com says what Lieberman “wants, in all probability, is attention.” Or maybe a puppy.

Hot Air’s Allah Pundit says, “I’ve got a crazy hunch that he media’s strange new respect for free-thinkin’ independent-minded centrists like Snowe and Susan Collins won’t be extended to Joe Liebs,” and offers an ‘exit question’: “Is it a bluff?”

The New Republic’s Jonathan Cohn doesn’t seem surprised by these developments: ”I’ve been thinking for a couple weeks that Joe Lieberman is the Democrats’ biggest potential problem. The rest of the party has a strong incentive to pass health care reform and avoid a 2010 catastrophe. But Lieberman? He’s not a Democrat and won’t be running on the Democratic ticket in 2012. Moreover, my read on him is that he’s furious with the party, resentful of President Obama (who beat his friend in 2008) and would relish a Democratic catastrophe.”

Heritage’s Conn Carroll says Lieberman’s critique is “dead on.” He announces, “Americans who like making their own health care choices received welcome news yesterday when Sen. Joe Lieberman (I-CT) said he would be willing to block final passage of Obamacare if the government run health insurance program Majority Leader Harry Reid (D-NV) announced Monday survives the amendment process during the Senate debate.”

But the Washington Post’s Ezra Klein takes a different tack: “I don’t know why I don’t take Joe Lieberman’s threat to filibuster health-care reform more seriously, but I just don’t.” Klein thinks Lieberman’s objections to the bill will likely be settled by a CBO score.

Wednesday, October 28th, 2009

Tags: lieberman, public plan, reid
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Reid’s Public Plan Compromise

Senate Majority Leader Harry Reid’s new announcement on the health overhaul front: the inclusion of a public plan option in the Senate’s soon-to-be announced final bill.

Reid settled on a state “opt-out” provision, which, as NPR’s Scott Hensley reports, could send the lone Republican supporter packing: “But Snowe cautioned her vote in favor of Baucus’s plans was just her vote for that day and not a guarantee of future support. Indeed, as Reid acknowledged Monday afternoon, Snowe ‘doesn’t like a public option of any kind.’ But, he hasn’t given up on her, ‘There will be a time, I hope, when she sees the wisdom of supporting a health-care bill” that includes a public option.’”

There’s plenty of time to keep lobbying Snowe, according to the New York Times’ David Herszenhorn: “Don’t get overexcited just yet. There’s still a long way to go. In the Great Health Care Debate of 2009, brief flashes of news, like Monday’s announcement by the Senate majority leader, Harry Reid of Nevada, that he would include a government-run plan in the Senate bill, are typically preceded and followed by long stretches of waiting and waiting. And this week will be no exception.”

Moving onto the opinion blogosphere, a read of reactions across the ideological spectrum reveals a fundmental disagreement between conservatives and liberals over what Sen. Reid’s compromise really represents.

Hot Air’s Allah Pundit is unimpressed: “[Reid] hasn’t even sent the bill to CBO to be scored yet so I’m not sure what we’re supposed to react to here, aside from the left’s success in getting something with a public plan to the floor which (a) may not even have 60 votes behind it and (b) is almost guaranteed to lose The One’s very small fig leaf of bipartisan support as Olympia Snowe walks away.”

Connie Hair of Human Events thinks the term “opt-out” is a “facade”: “Reid also said his bill will include an ‘opt out’ at the state level which is a façade. Can individuals ‘opt out’ of the penalties and the mandatory coverage? Can individuals ‘opt out’ of paying for government-run health care for everyone else in the country in the form of higher premiums, higher taxes, and Medicare cuts? Can small business owners ‘opt out’ of the higher payroll taxes?”

Heritage’s Conn Carroll says, “Opt out, the trigger, and co ops will not get to government run health care immediately. They will all take time to develop. But no matter what road they try and bring Americans down, the destination is always the same: everybody in out, nobody out; that is, was, and always will be Obama’s ultimate goal.”

Bloggers on the left have a vastly different interpretation: the Washington Post’s Ezra Klein calls the opt-out plan “conservative:”

In many ways, this is a fundamentally conservative approach to a liberal policy experiment. It’s only offered to individuals eligible for the insurance exchanges, which is a small minority of the population. The majority of Americans who rely on employer-based insurance would not be allowed to choose the exchanges. From there, it is only one of many options on the exchange, and only in states that choose to have it. In other words, it has been designed to preserve the status quo and be decided on the state level. Philosophically, these are major compromises liberals have made on this plan. They should get credit for that.

Jonathan Cohn’s reaction? “Wow.” Cohn, The New Republic’s health policy maven, continues, ”it is hard to overstate what a turnaround this is–or how quickly it happened. By late summer, passing any reform at all looked like a fifty-fifty proposition at best. And even as the political environment shifted, the public option looked doomed. It was going to take sixty votes to get a public option through the Senate. The votes just weren’t there. To be clear, they still aren’t there.”

Wonk Room’s Igor Volksy hews to his blog’s namesake by explaining what exactly the states could be opting-out from. According to Volksy, it could be a national public plan that pays Medicare rates plus 5% or a national public plan that negotiates its own rates with providers.

Volsky continues, “the other possibility — less likely given Reid’s reluctance to ask the CBO to score the proposal — is to combine the opt-out public option with a trigger — ensuring that states could only opt out of the public option if the private market offers meaningful and affordable coverage. Any opt-out proposal should also provide for a simple ‘opt-back-in process’ (mandating that state legislatures vote on the opt out every year, for instance.)”

Then there’s libertarian Michael Cannon, who thinks the compromise is just plain politics: ”it helps [him] survive as majority leader by appeasing his left wing. It doesn’t make it any more (or less) likely that Fannie Med will survive.”

Tuesday, October 27th, 2009

Tags: public plan, reid
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Reid’s Message to Senators and a Threatened Timeline

Health reform rumblings from Capitol Hill were buried early in the week under news of Michael Jackson, President Obama’s visit to Russia and ethnic violence in China. But commentators are taking to their keyboards with delight and dismay as it remains uncertain whether Congress can stick to the Obama administration’s ambitious schedule to pass health reform by the August Recess.

The Wall Street Journal’s Health Blog reports, “This morning, for example, we find a raft of articles suggesting that the effort is stalling amid dissension in Washington and beyond.” And Time’s Karen Tumulty writes, “One thing that does seems clear is that it seems less likely today than it did on Monday that the Senate is actually going to pass a bill before Congress leaves town in August for its annual vacation district work period. None of this is fatal, mind you, but it is a reminder of what we have known all along, which is that this is not going to be an easy or smooth process.”

James Capretta of the New Atlantis titles his post, “Let the Unraveling Begin.” Capretta, who opposes the current push for reform, writes, “there are clear signs that Congressional Democrats and the Obama White House have steered the health-care effort into seriously choppy political waters.”

Liberal bloggers appear nervous as well, in no small part because the Senate Finance Committee has yet to release a bill. The New Republic’s Cohn reports that the Finance Committee distributed a list of 20 options to pay for reform just yesterday (for comparison, the Senate HELP Committee released their bill last month.) According to Cohn, Senate Majority Leader Harry Reid on Monday told Finance Chairman Max Baucus, D-Mont., that a number of Senate Democrats won’t accept the removal of the tax exclusion for employer-sponsored health insurance. He writes, “That’s why Baucus and his colleagues on Finance are back to looking for money.” Whatever the reason, Cohn believes the Committee “is, in a sense, stuck at square one.”

Trish Turner of Fox News’ The Speaker’s Lobby blogged a meeting with Reid and Senate Republicans yesterday on health and reports Sen. Orrin Hatch, R-Utah, said, “I think he understands we can’t meet the time table he has set, but he doesn’t want to give up trying.” For the Democrats, the public option is a sticking point. “Harry said the votes aren’t there on his side without it,” Hatch said, meaning Reid does not have 60 votes needed to break any filibuster.

Elsewhere on the health policy interwebs:

It’s that time again — Health Wonk Review, a biweekly look at the best health policy blogging, is up at BNET Healthcare.

Cato’s Chris Edwards calls House Dems’ new proposal to impose a surtax on high-income earners a “socialist surtax for health care.”

The Atlantic’s Marc Ambinder zeroes in on health care reform for his question of the day: “How optimistic are you that President Obama will sign health care reform legislation into law by the end of the year? If so, why? If not, why not?”

Louise Norris of Colorado Health Insurance Insider looks at the pros and cons of a nationally regulated health insurance market.

Philip Klein of the American Spectator says the Medicaid expansion as part of a health overhaul currently under consideration in Congress will likely cost the federal government and the states more than $500 billion over ten years.

Health Reform Watch: American Medical Association President J. James Rohack responds to suggestions the organization changed its stance on a public plan option.

Wednesday, July 8th, 2009

Tags: hatch, health wonk review, reform, reid
Posted in Blog Watch | No Comments »

KHN: Kaiser Health News

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