Obama, Senate Dems Consider Public Health Care Option With A Trigger

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First Posted: 06- 2-09 01:50 PM   |   Updated: 06- 2-09 02:41 PM

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The Obama administration and Senate Democrats are debating a health care reform outline that will insist upon a public option for insurance but leave open the possibility for it to be kicked in via triggers.

Multiple Democratic sources tell the Huffington Post that the White House and key members of the Finance and Health, Education, Labor and Pensions (HELP) Committees are in the process of hammering out key principles on health care reform -- with a meeting scheduled at the West Wing this afternoon. One of the components will be music to progressive ears: that any bill includes an option publicly run health insurance coverage. But it also comes with a caveat that could engender opposition from that very same constituency.

A trigger would pave the way for public option to come into place only after certain market conditions are met -- mainly if private insurance companies are unable to achieve various metrics for coverage within a certain time frame. The proposal would placate many of the private health care actors who consider a public plan the first step towards a single-payer system. Progressives, however, view it as reform in name and not substance.

"This is really, obviously, a mechanism to kill the public plan," said one progressive health care reform advocate. "We will see what comes out, but the fact that they are debating this is problematic."

An official at the White House said he could not immediately confirm the report.

The proposal for a public plan with triggers has been welcomed among some moderate Democrats who want to forge a compromise on what is shaping up as the major fault line on health care reform. Sen. Max Baucus, one of the major players in the debate, has offered his support for this approach. As have Senators Ron Wyden (D-Ore.) and Thomas Carper (D-Del.).

That said, opposition to the proposal is fierce.

"I would have very strong reservations about [a trigger], but I think we have to keep talking," said Sen. Barbara Mikulski (D-Md.), a powerful subcommittee chairwoman on the health committee.

Senator Chuck Schumer has insisted that, if anything, "reasonable criteria for triggering a public plan has already been met."

"Premiums are high," the New York Democrat said, "and either one or two insurers dominate the market. As we've seen with Medicare part D, a trigger option has so far meant no public option at all."

Indeed, as Schumer notes, there is a trigger in the Medicare part D program and, to this date, the conditions have never been met for a public option for prescription drug coverage. The standards were set by private market, all but ensuring that they would remain unreachable. Progressive officials working on health care reform worry that should the same system be put in place for insurance coverage, the same result will occur and public health care will never come to pass.

With additional reporting by Ryan Grim.

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The Obama administration and Senate Democrats are debating a health care reform outline that will insist upon a public option for insurance but leave open the possibility for it to be kicked in via tr...
The Obama administration and Senate Democrats are debating a health care reform outline that will insist upon a public option for insurance but leave open the possibility for it to be kicked in via tr...
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- marlainWA I'm a Fan of marlainWA 8 fans permalink

At least the word public is finally in there. Now the debate is open. Let's talk!!!!!!!!!!!!!!

    Favorite    Flag as abusive Posted 11:56 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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Exactly debate and tell them that ProfitCare has already pulled the trigger and it stinks.

    Favorite    Flag as abusive Posted 12:03 AM on 06/03/2009
- TrueSense I'm a Fan of TrueSense 11 fans permalink

I call. I write. I have donated but my money pales in comparison to insuance providers.

They are also in their face everyday offering bribes, I mean donations.

Laslty, they threaten them with opponents or no more money and these wimps fold.

All they care about is themselves. For heroes proved through liberating strife. For their country loved more than sefl and mercy more than life.

How can they honor and admire our veterans and servicemen and then show nothing of the traits they admire ?

We have no Tommy Douglasses in this country. I used to hate the draft but may be it had its purposes. My relatives told me, this was even during peace time, how they were forced to deal with people from all walks of life and formed bonds and had a sense of common purpose.

    Favorite    Flag as abusive Posted 11:43 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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But if enough people tell them they will not vote for them the money doesn't matter does it?

I keep track of the healthcare debate on a daily basis and read all the articles on both sides.

For one this whole trigger thing is not new it started floating out there a little while ago. It really has not picked up momentum and we need to push back on the idea.

The real fact is congress and the administration are looking for enough votes to pass universal healthcare especially in the Senate. It's still relatively early but we need to push against bad ideas as well as support good ideas.

    Favorite    Flag as abusive Posted 11:48 PM on 06/02/2009
- TrueSense I'm a Fan of TrueSense 11 fans permalink

Thanks for the encouragement ! I am willing to march and be seen but what's the best way to do so ?

Just calling and may be even marchng might not be enough. Somehow they never believe that or it rarely happens. Since the Repubs are so much worse, except for those in the mid-west industrial arear that are getting pissed, they no they can get away with it.

Third party or real challenger from the progressive side ?

Heck, John Tester barely remembers why he ran !

    Favorite    Flag as abusive Posted 12:09 AM on 06/03/2009
- masher I'm a Fan of masher 38 fans permalink

No they aren't. They are listening to people like Geithner who keep telling them that capitalism is giving bailouts to failed CEOs with no strings attached. There was no pressure on Obama there, and there were no votes there either. The $5 billion to GM didn't take a vote. Obama just caves.

    Favorite    Flag as abusive Posted 01:06 AM on 06/03/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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Oh and BTW reading both sides the right wing is far ahead of progressive blogs like HP that have been muddled at best with the healthcare debate and obsessed about banks and other issues.

    Favorite    Flag as abusive Posted 11:50 PM on 06/02/2009

The wealthy and powerful in this country in general do not want a powerful populist. This is why George W. Bush and friends did everything in their power to make this country an "us vs. them". It will take a lot of discussions and healing before we can get a common purpose but is attainable in my opinion - at least I'm hopeful, otherwise this country is doomed to spiral downwards.

    Favorite    Flag as abusive Posted 11:50 PM on 06/02/2009
- Davwbaird I'm a Fan of Davwbaird 24 fans permalink
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Based on what I can see this country is bought and its not by us. We need a revolution NOW>

    Favorite    Flag as abusive Posted 12:00 AM on 06/03/2009
- sarabono I'm a Fan of sarabono 18 fans permalink

Medicare Part D works very well. Many competitors to choose service from. Very competitive prices that can easily be compared. I have been on the program since it's inception and am very pleased with how it works. I have no idea what Schumer is talking about. I for one want absolutely no changes to Part D.

    Favorite    Flag as abusive Posted 11:37 PM on 06/02/2009

How do you know for a fact that you have "competitive" prices? Your idea of competitve pricing may in fact be price-fixing within Medicare part D.

    Favorite    Flag as abusive Posted 11:41 PM on 06/02/2009
- Davwbaird I'm a Fan of Davwbaird 24 fans permalink
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It is. ll those folks insurance holes selling their plans must make uddles off us older fools.

    Favorite    Flag as abusive Posted 11:49 PM on 06/02/2009

if you think consider a 300USD doctor visit competitive and a 50 dollar band aid

    Favorite    Flag as abusive Posted 11:52 PM on 06/02/2009
- sarabono I'm a Fan of sarabono 18 fans permalink

Each Provider lists the drugs they cover by class. It is easy to compare between Providers since the Government requires that the data be in a uniform format.

You find providers that have the drugs you use and compare the cost of the policy.
All cost data is also in a uniform foremat for easy comparison.

In addition, company's like Wallgreen's have there own computer program which will print out providers and cost for the drugs you take. The service is free and takes only a few minutes. In addition, the Gov. has a Medicare Part D Web Site that also provides provider comparison and cost information.

    Favorite    Flag as abusive Posted 11:54 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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Part D is BS.

    Favorite    Flag as abusive Posted 12:04 AM on 06/03/2009
- nana4g I'm a Fan of nana4g 106 fans permalink

I pay $30.50 a month for the Plan D benefit premium. Every 90 days I get a 3 month refill of thyroid medication for $16.00 for 3 months. So far, that is the only medication I am on, unless I have a need for a short term like an antibiotic, etc. So, basically, I pay a lot for that $16.00 prescription ($5.00 a month plus $30 a month for 30 pills.) Of course, every 3 months, I think I am getting a bargain because I forget that I am paying $30 a month on a routine basis. If I had lots of prescriptions, it would be more cost effective, I guess. It is just a nickle and dime sham. I also pay $98 a month for Part B Medicare, outpatient care, MD visits, lab, xray, procedures, home health, Hospice, etc) and $141 a month for a Medicare Supplement, so, even though I have Medicare Part A "free" if I go to the hospital, I pay a lot for health care coverage in my retirement. More nickle and diming to death. Too many games, too much profit and gain for everyone except the consummer. It's a business. Just reform Medicare and open it to everyone who wants to join.

    Favorite    Flag as abusive Posted 12:49 AM on 06/03/2009
- nana4g I'm a Fan of nana4g 106 fans permalink

You must not have very many prescriptions that you need, like me, so far. In that case, surely, it works well. However, if you have sufficient prescriptions and you reach a "capitated amt", you go into the famous "donut hole" or the gap period. Which means you have used Level I of the benefits and you need now to have a "gap period" in which you begin paying out of pocket for the entire cost of each prescription until you reach a Level II amount, while you continue to pay for your monthly premium, by the way. After you reach Level II amt, the benefits kick in again and pays at 100%. If you have many, many costs for prescriptions it works well because in no short order, you will have met that Level II amt, or if you have one or few prescriptions it works well because you will never reach Level I. If you are in the middle somewhere, you are out big bucks. There is no need for this gap provision. Insurance companies get major discounts for drug coverage; they are not going broke over Plan D, it is another profit product; and if they claim they cannot afford the costs, how can the retiree afford them? Competition for the product is a sleight of the hand, slick marketing. They are, in reality, all the same because they must conform to the design of the government's regulations for this product since it is a Medicare product.

    Favorite    Flag as abusive Posted 12:40 AM on 06/03/2009
- sarabono I'm a Fan of sarabono 18 fans permalink

My wife went into and through the "Donut Hole" last year. Yes it cost me some good size bucks but that is the way the program was set up by the Government so that it could hold down the overall costs to the Government.

You must remember, that until President Bush pushed through Medicare Part D, there was NO drug coverage in Medicare unless you were in the Hospital or in a Rehabilitation Post Hospital Care Facility.

The was no coverage at all for the drugs that older folks take on a daily basis like cholesterol or blood pressure medicine. Now, under Part D, it is easy to order a three month supply which will be delivered to my door. Easy. Effective and very cost efficient has been my experience.

    Favorite    Flag as abusive Posted 01:08 AM on 06/03/2009
- kjstjohn I'm a Fan of kjstjohn 225 fans permalink
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Carrying forward KQuark's work:
These are the Democratic Senators on the fence about at least the public option. Please e-mail each of them and tell them you want a single-payer option with no triggers.

General Contact Information
http://www.senate.gov/general/contact_information/senators_cfm.cfm

Max Baucus MT
http://baucus.senate.gov/contact/emailForm.cfm?subj=issue
Evan Bayh IN
http://bayh.senate.gov/contact/email/
Mark Begich AK
http://begich.senate.gov/contact/contact.cfm
Michael Bennet CO
http://bennet.senate.gov/public/index.cfm?p=TransitionalSiteEmailSenatorBennet
Robert Byrd WV
http://byrd.senate.gov/contacts/
Maria Cantwell WA
http://cantwell.senate.gov/contact/
Thomas Carper DE
http://carper.senate.gov/contact/
Kent Conrad ND
https://conrad.senate.gov/contact/webform.cfm
Byron Dorgan ND
http://dorgan.senate.gov/contact/contact_form.cfm
Dianne Feinstein CA
http://feinstein.senate.gov/public/index.cfm?FuseAction=ContactUs.EmailMe
Kay Hagan NC
http://hagan.senate.gov/?p=contact
Mary Landrieu LA
http://landrieu.senate.gov/contact/index.cfm

    Favorite    Flag as abusive Posted 11:37 PM on 06/02/2009
- kjstjohn I'm a Fan of kjstjohn 225 fans permalink
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Patty Murray WA
http://murray.senate.gov/email/index.cfm
Bill Nelson FL
http://billnelson.senate.gov/contact/email.cfm
Mark Pryor AR
http://pryor.senate.gov/contact/
Harry Reid NV
http://reid.senate.gov/contact/index.cfm
Arlen Specter PA
http://specter.senate.gov/public/index.cfm?FuseAction=Contact.ContactForm
Jon Tester MT
http://tester.senate.gov/Contact/
Mark Udall CO
http://tomudall.senate.gov/contact/contact.cfm
Mark Warner VA
http://warner.senate.gov/public/index.cfm?p=Contact
Ron Wyden OR
http://wyden.senate.gov/contact/
Here are Independents and moderate Republicans
Joe Lieberman CT
http://lieberman.senate.gov/contact/index.cfm?regarding=issue
Susan Collins ME
http://collins.senate.gov/public/continue.cfm?FuseAction=ContactSenatorCollins.EmailIssue
Olympia Snowe ME
http://snowe.senate.gov/public/index.cfm?FuseAction=ContactSenatorSnowe.Email

    Favorite    Flag as abusive Posted 11:38 PM on 06/02/2009

NOPE IM NOT CARRYING IT FORWARD UNTIL OBAMA PUTS A VIABLE PUBLIC SINGLE PAYER PLAN ON THE TABLE. IF IT HAS TO BE AN OPTION TO COMPETE. IT MUST BE COMPETITIVE AND ADEQUATELY SET UP AND CAPITALIZED WITH GOOD SERVICE.

SO FAR I SEE NO SUCH PLAN.

    Favorite    Flag as abusive Posted 11:54 PM on 06/02/2009
- kjstjohn I'm a Fan of kjstjohn 225 fans permalink
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Please carry these two comments forward for KQuark. The links should work.

    Favorite    Flag as abusive Posted 11:39 PM on 06/02/2009
- Davwbaird I'm a Fan of Davwbaird 24 fans permalink
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I responded to both wa state senators no holds barred.

    Favorite    Flag as abusive Posted 11:57 PM on 06/02/2009
- kjstjohn I'm a Fan of kjstjohn 225 fans permalink
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Better words would be that you want single-payer public health insurance with no triggers. do I have the wording right, KQuark.

    Favorite    Flag as abusive Posted 11:50 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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You are right indeed. The trigger idea is BS.

    Favorite    Flag as abusive Posted 11:57 PM on 06/02/2009
- FogBelter I'm a Fan of FogBelter 274 fans permalink
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"Triggers? We don't need triggers. We don't need no stinking triggers!"

For Profit Health Insurance = BAD

Universal Single Payer Health Care = GOOD

    Favorite    Flag as abusive Posted 11:35 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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I agree with you. That's why I'm not afraid to give Americans the option. Study after study shows that ProfitCare can never compete with public healthcare insurance.

That's why I'm not afraid to give people the option because I believe in it that much. ProfitCare insurers know this too and that's why they are fighting it.

    Favorite    Flag as abusive Posted 11:41 PM on 06/02/2009
- kwinyan I'm a Fan of kwinyan 11 fans permalink
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And the trigger is playing into their hands. Private health insurance has long proven itself to not be able to keep costs down reasonably and unfair in its coverage.

    Favorite    Flag as abusive Posted 11:46 PM on 06/02/2009

The only trigger in such a proposal should be one where any Congressperson who opposes a public health option NOW, immediately loses their tax payer funded public healthcare plan. They will have to buy their health insurance from a private HMO, as an individual (not as a group).

    Favorite    Flag as abusive Posted 11:35 PM on 06/02/2009
- salkoc I'm a Fan of salkoc 17 fans permalink

if the president allows this trigger to take shape i will lose alot of respect for him .....he has the voters and he has the votes .....jam it right down the corporate throats.th­e 3 headed monster ..ins companies, lawyers , hospitals have been slowly bleeding the public forever...­.time to ante up.

all democrats that stand in the way of this reform should feel the wrath of the voters .

    Favorite    Flag as abusive Posted 11:34 PM on 06/02/2009

The votes are NOT there yet. No jamming of throats is going to happen, regardless. Get a clue.

    Favorite    Flag as abusive Posted 12:50 AM on 06/03/2009
- TrueSense I'm a Fan of TrueSense 11 fans permalink

I have one question. Would this plan have helped Barack Obama's mother through the stories he told the public ?

If not, he needs to be trying harder or does it just get that easy to look at yourself in the mirror once you have been a pol hthat long ?

If that meant nothing to him, what do we mean to him comared to the elites who have have his ear or his love or the rest of his money chaning senators ? He will not go against them.

Bully pulpit ?

    Favorite    Flag as abusive Posted 11:32 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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For someone like me without healthcare even being able to buy affordable private healthcare would be an upgrade.

But I know that public healthcare would be cheaper and more efficient that's why I'm pushing for it so hard.

There are all degrees of success but the minimum that should be available is the public option for all.

    Favorite    Flag as abusive Posted 11:36 PM on 06/02/2009

I think a good point was made below that the issue isn't about public health care but instead about public health insurance.

    Favorite    Flag as abusive Posted 11:39 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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Contact the white house and say just that.

http://www.whitehouse.gov/contact/

    Favorite    Flag as abusive Posted 11:37 PM on 06/02/2009

You have no idea what is going on.

Get on board and be part of the solution,not the problem. On June 6th the battle begins. It is going to be a long fight. We are going door to door to get this.

Be brave and get back into battle mode.

    Favorite    Flag as abusive Posted 12:52 AM on 06/03/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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The trigger is a trial balloon that must be popped out of existence. ProfitCare already triggered what is happening now.

Contact info for congress.

http://standwithdrdean.com/where_congress_stands

Contact info for the white house.

http://www.whitehouse.gov/contact/

Send a free fax.

http://www.1payer.net/action-alerts/send-a-free-efax-to-policymakers.html

Attend a march on Washington June 25th if you can.

http://www.1payer.net/action-alerts/313-national-rally.html

Even do a virtual march on Washington.

http://www.1payer.net/action-alerts/march/sign-up-to-march.html

    Favorite    Flag as abusive Posted 11:28 PM on 06/02/2009
- tbone99 I'm a Fan of tbone99 93 fans permalink

Look if they're not going to give us universal healthcare at least make euthansia legal!

because being sick and fighting the insurance companies is a no win situation. You work all your life paying for healthcare insurance you never use and the first time you're unemployed you fall apart but guess what .... no healthcare for you. I've seen it a million times as a nurse.

    Favorite    Flag as abusive Posted 11:26 PM on 06/02/2009
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Looks like the HMOs are already greasing the right palms...HA­LF the country will be uninsured by the time Obama leaves office...a­waiting the "triggers"

    Favorite    Flag as abusive Posted 11:24 PM on 06/02/2009
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"Indeed, as Schumer notes, there is a trigger in the Medicare part D program and, to this date, the conditions have never been met for a public option for prescription drug coverage. The standards were set by private market, all but ensuring that they would remain unreachabl­e."

THE STANDARDS WERE SET BY THE PRIVATE MARKET...a­nd WERE NEVER MET!!!

Here we go once more....B O H I C A.....
Bend Over Here It Comes Again!

This nation is owned Lock Stock and Barrel by the Corporate Profit Machine by virtue of Prost1tute Politicians.

    Favorite    Flag as abusive Posted 11:22 PM on 06/02/2009
- Siren I'm a Fan of Siren 3 fans permalink

if your premium is scheduled to be 18,000 dollars next year, a family in Maine IS facing this now, why would they need a trigger. Its horrific out their now. Cutting costs 1.5 % is a joke as the insurance companies have said nothing about cutting their huge overhead. Aetna CEO got $24 Million in compensation last year. This is not acceptable given the horrible situation we are in now. No more waiting, no more triggers. Its awful now. Stop playing around, we need heathcare now. Not insurance and notr prmises from the most despicable business on the planet. Murder by spreadsheet is their intent. They have no incentive to pay for adequate care.

    Favorite    Flag as abusive Posted 11:20 PM on 06/02/2009

I think part of the plan is to let these companies hang themselves as much as possible. Every time they come up with some lame solution, the public gets madder an=d madder. This is the way Obama works.

Keep up the pressure, get ready for the real fight, which is coming June 6th.

    Favorite    Flag as abusive Posted 01:18 AM on 06/03/2009

This article uses the term "health care" where it means to say "health insurance". To be certain, the issue at hand is whether to create a federal health insurance plan (or just expand the existing Medicare). Just as certainly, that government insurance plan would pay for private health care services. Nobody that can be taken seriously is talking about the government providing health care services.

This is no small distinction; nor is it dickering about words. Those that are opposed to health insurance reform, and not least the private insurance industry, love the use of the term "public health care". It's synonymous with "socialized medicine", a concept that is very unpopular in the United States. But those same interests never use the term "government health insurance plan" because that is what Medicare is. And Medicare is extremely popular amongst American voters.

The Huffington Post, and all of it's writers, as well as those of us that would like to see some serious reform of health care financing in this country, should take care to frame our remarks with the term 'insurance' when it is, in fact, insurance that we are talking about. Furthermore, it would not hurt to clarify that you are talking about 'private' medicine or 'private' health care services, since it is almost certain that you are not referring to publicly provided services.

    Favorite    Flag as abusive Posted 11:15 PM on 06/02/2009
- williamg I'm a Fan of williamg 251 fans permalink
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Good post.

    Favorite    Flag as abusive Posted 11:20 PM on 06/02/2009

Thanks for the post. Good suggestions.

    Favorite    Flag as abusive Posted 11:26 PM on 06/02/2009
- kwinyan I'm a Fan of kwinyan 11 fans permalink
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I think it's public health insurance that's been proposed -- it was supposed to be offered as an alternative or option to private insurance. I never heard about expanding Medicare, which could amount to universal coverage.

    Favorite    Flag as abusive Posted 11:27 PM on 06/02/2009
- KQuark I'm a Fan of KQuark 267 fans permalink
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Cheers part of the problem is the nomenclature people are using in these arguments.

One big problem is progressives are not distinguishing between single payer and mandatory single payer.

Single payer is part of the public option Dr. Dean and moveon.org are supporting and is attainable.

Mandatory single payer scares the heck out of millions of Americans who like their insurance now and is not attainable in one step.

I'm still pushing for and requesting single payer with the public option for all being my ultimate goal.

    Favorite    Flag as abusive Posted 11:33 PM on 06/02/2009
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Great post....Ke­ep it coming...

    Favorite    Flag as abusive Posted 01:02 AM on 06/03/2009
- kwinyan I'm a Fan of kwinyan 11 fans permalink
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Obma has been insisting within the last weeks or so that a health plan needs to be passed in an ASAP manner. I would certainly hope that a trigger one isn't implemented quickly. If that would pan out, there would be a lot of disgruntled Americans given the majority want an actual public health plan, rather than the threat of one being used with insurance companies.

    Favorite    Flag as abusive Posted 11:14 PM on 06/02/2009
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