Blue Dog Opposition To Public Option Fades In Whip Count

Blocking a public health insurance option is a relatively low priority for conservative Blue Dog Democrats, according to an ongoing survey of its members. The fading House opposition could clear the way for the public option to move through the chamber.

The Blue Dogs have been surveying their membership over the last several days; coalition co-chair Stephanie Herseth Sandlin (D-S.D.) has been collecting the responses. She listed the four top priorities that have emerged: Keeping the cost under $900 billion, not moving at a faster pace than the Senate, getting a 20-year cost estimate from the Congressional Budget Office and addressing regional disparities in Medicare reimbursement rates.

So, the Huffington Post asked, the public option is not a top priority?

"Right, the group is somewhat split," she said.

That leaves the Senate and the conference committee between the two chambers as the final battlegrounds for the public option. While several Senate Democrats have said they oppose it, no Senate Democrat has yet said publicly that he or she would oppose any bill that included a public option.

House Speaker Nancy Pelosi (D-Calif.) was the catalyst for the Blue Dog self-reflection when she floated the idea that roughly 20 Blue Dogs could support a public option.

"There was some suggestion that there were 20," Herseth Sandlin said. "There clearly are not. From the numbers that I have seen, although not everyone has submitted the surveys, even if they had and they all said yes it wouldn't be 20. Right now it's less than a dozen."

What about a public option not tied to Medicare rates?

Story continues below

"We haven't drilled down on that. I understand the media's focus on the public option, but for the Blue Dogs right now it's much more on cost," she said.

The lack of concerted, ideological opposition to a public option opens the possibility for negotiations in the House. Blue Dogs, along with other rural lawmakers, very much want an increase in Medicare reimbursement rates in certain areas to fix what they see as a disparity.

"If the Medicare rates were adjusted, I think there would be less resistance to tying the public option to Medicare rates," said Rep. Sandy Levin (D-Mich.).

In regions where one insurer has an effective monopoly -- which includes most rural regions, but others, as well -- that insurer pays, on average, a high rate of reimbursement so that it can keep out competition. Health care providers have no incentive to work with a new insurer, which would pay lower rates, and so new competitors can't establish a network. The insurer with the monopoly is therefore free to increase premiums at will. The lack of insurance competition is a key driver of health care costs.

Medicare, however, doesn't operate that way. Its reimbursement is more closely related to the actual cost of care. The disparity between Medicare reimbursements and insurance reimbursements is greater in rural areas, since insurers must keep down premiums and costs in areas where there is greater competition. In urban areas, where the cost of living is higher, Medicare reimburses at higher rates.

Blue Dogs and others representing low-competition areas see the disparity as unjust and want the rates increased. The push for more government spending goes against their core priority of fiscal discipline, but Blue Dogs have never been known for their ideological coherence.

Pelosi told HuffPost after a morning press briefing that no decisions had yet been made on regional disparities. "That's an issue that affects regions, whether people are Blue Dogs or not," she said.

House leadership is currently blending three committee bills into a final package. Pelosi said at the briefing that the bill that passed the House would "definitely" include a public option.

Energy and Commerce Committee Chair Henry Waxman (D-Calif.) said the decision of whether to tie it to Medicare rates -- as the Congressional Progressive Caucus insists on doing -- hasn't been made yet. "The decision will be made by leadership," he said.

Backers of the public option say that it must be tied to Medicare rates in order to be effective and to keep costs down. Requiring the system to negotiate new rates with each health care provider would be unfeasible, they argue.

Herseth Sandlin said that despite the survey, the Blue Dog position remains as it has been. "We have not moved back from the position we took previously, which is: if you're going to include a public option, it should be structured to ensure a level playing field, negotiated rates and [be] subject to a trigger."

The notion of the trigger has been advanced by Sen. Olympia Snowe (R-Maine), a key swing vote in the Senate. A public option would be triggered after a certain time period if private insurers didn't meet certain requirements.

Pelosi rejected the trigger Thursday, saying it is "an excuse for doing nothing." She said that the bill itself was the trigger and when asked a follow up, said, "I don't even want to talk about a trigger."

Herseth Sandlin wasn't sure that adjusting reimbursement rates would bring many Blue Dogs over to a public option tied to Medicare rates.

"While there's a link between the Medicare reimbursement disparities and the public option based on Medicare rates, I don't know that addressing a regional disparity issue necessarily alleviates all the concerns of the public option based on Medicare rates," she said.

The CBO has estimated that tying a public option to Medicare rates could save more than $80 billion over ten years in addition to what would be saved from the public option itself. During the caucus meeting, Rep. George Miller (D-Calif.), chair of one of the committees to pass a health care bill, dangled that cash in front of members who want funds to address regional reimbursement disparities.

That's unfair, said Herseth Sandlin.

"It's a false choice to present this to the Blue Dogs as, 'Well, if you're all about lowering the cost, then you need to be for a public option based on Medicare rates,'" she said. "The point that we continue to make to the Speaker and to others is those savings should not be borne by those of us where our patients and providers have been at a disadvantage for decades. You can't make that argument on your savings because of the inherent disparities and inequities that have existed. So if you're not willing to make the tough choices to deal with that, then your argument for cost savings rings hollow."

True or false, it's the choice they're facing.

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Comments

[Philclock]

Medicare, public option, it's all the same government monopoly.

What's a monopoly do? Crush the competition, restrict supplies, price to the max.

I want consumer power, buy my own health care (cash preferably), I get what I want, doctors hospitals etc. listen to me not the government.

My dad a goverment worker, I was in the Navy, I know what standing in like waiting for rations is like, no thanks.

[Eris23Skidoo]

Yay, Pelosi!

[Bronxdude]

Something is amiss. Bush and his evil puppet master – Dick Cheney – lie to manipulate American patriotism to justify invading Iraq, and conservatives are silent. Bush inherits, then squanders a $759 billion surplus, and conservatives are silent. Bush appoints a horse trader to head FEMA, thousands die of thirst in the aftermath of Katrina, and conservatives are mute. Bush guts the Geneva Conventions, authorizes torture, and conservatives are silent. Bush condones risky subprime mortgage derivatives, America dances on the precipice of economic annihilation, and conservatives are silent. Bush razes the Fourth Amendment, authorizes warrantless eavesdropping, and conservatives are silent. Bush signs $1.2 trillion Prescription Drug Bill, a federally subsidized give-away which balloons the deficit, and conservatives are silent. Bush diverts $1 trillion from the counter-terrorism struggle in Afghanistan, making America significantly less safe, and conservatives are silent. Bush signs unfunded NCLB legislation, the most intrusive federal education law in history, and conservatives are quiet. Bush sends troops to war with no body amour, and conservatives are silent. Bush deregulation exposes 2.5 million children to toxic toys from China, and conservatives are silent. Birthers delegitimize the first black president, choosing instead to ignore 8 years of Bush inflicted plunder and ruination, and conservatives are silent. Obama talks to school children about being successful, conservatives cry foul. Bush rambles incoherently while addressing school children in Florida, and republicans anoint him God. Racism, bigotry and hypocrisy: cherished planks in the republican platform.

[Philclock]

Does Obama soothe an achey brachey soul?

[Bronxdude]

President Obama truly cares about the prosperity and well-being of every American—regardless of class or race—and is offering this country healthcare stability and security. Afraid of the impact Obama might have on unifying America, republicans are villainizing, dehumanizing and delegitimizing him to advance their exclusionist, racist and elitist agenda. Since Obama is not part of the entrenched Washington establishment or the elite upper crust, he feels no pressure to return favors that would unnecessarily sacrifice precious political capital he’ll need in the future to strong-arm self-serving politicians. Republicans are singularly fixated on maintaining the status quo to ensure their continued generational access to wealth, influence and power. Similar to segregated country clubs, republicans are concerned primarily with separating and distancing themselves from members of the working-class. After all, the purpose of the working-class is to serve the wealthy by cooking their meals, rearing their children, cleaning their homes and doing whatever tasks deemed essential to ensuring their existence is awash in luxury, simplicity and overindulgence. Working-class conservatives have been duped into believing that their concerns are championed by republicans, a political party heavily comprised of aristocrats. In reality, the GOP is only concerned with advancing their own self-serving interests, which is why they exploit the working-class, oppose worker rights and want to keep America angrily divided by class and race. Universal health insurance would elevate the standard of living for working-class Americans, something republicans vehemently oppose.

[Bronxdude]

Forget bipartisanship; true reform will provide affordable options that include a public offering. Chuck Grassley is an idiot, charlatan and health industry prostitute. For his efforts to embarrass the President and sabotage reform, Grassley has received millions in blood money from insurance corporations like UnitedHealthcare, and should be censured by Congress for his treasonous lies. Real reform will end the monopolistic strangle-hold enjoyed by ruthless insurers like UnitedHealthcare. In Georgia, UnitedHealthcare executives colluded with sleazy republican politicians like Johnny Isakson to eliminate competition, with the end result being higher premiums, reduced benefits, and greater profit. With no real competition, UnitedHealthCare is free to rape consumers. When compared to the second quarter of 2008, profits for UnitedHealthcare increased by a whopping 155%, yet premiums continue to climb 4 times faster than wages. UnitedHealthcare is leading the charge to defeat healthcare reform. Regarding healthcare, America spends 17% of GNP, while France, Canada and Britain, respectively, spend 10% of GNP and everyone is insured (America is the only democracy in the world that does not provide universal coverage for its citizens). Republicans want watered-down reform so when it fails to achieve meaningful change, they can point to democrats and say, “see, government is the problem”; thus, to ensure success, I want access to the same options enjoyed by Congress and 8.5 million federal employees. The public option will control costs, expand coverage and end the single profiteer insurance system killing Americans.

[Bronxdude]

Since sell-out Blue dogs sanction the looting of the middleclass by the same ruthless health insurers they fought to deregulate during the Reagan years, we need the government between the public and degenerate insurance profiteers. Republicans are spreading malicious lies that the democrats’ reform plan will lead to rationing and the government determining which medical procedures a patient can have. Really? Millions of Americans already face rationing, as parasitic insurance companies like UnitedHealthcare arbitrarily rule on what they will cover. To solidify their monopolistic stranglehold in Georgia, UnitedHealthcare executives colluded with elected republican bureaucrats to artificially control marketplace competition, with the goal being to increase the profit margin for UnitedHealthcare. To further reduce utilization costs, and gin up profits, state employees in Georgia have no due process appeal rights, a negotiated constraint that gives UnitedHealthcare carte blanche to deny medical care or coverage at will with no consequences. Limiting choice drives up cost, increasing the profit margin for UnitedHealthcare, which translates into republican whores receiving bigger payoffs. Real reform will end the monopolistic strangle-hold enjoyed by soul-less insurers like UnitedHealthcare. Hospitals, entrepreneurs masquerading as doctors and insurance parasites get paid regardless of the outcome: if you live, they get paid; if you die, they get paid; if you’re maimed, they get paid. Only lawyers, politicians and prostitutes enjoy a sweeter financial arrangement. The republican legislated status quo is not working for middleclass America. Competition with government works: just ask FedEx and UPS.

[Bronxdude]

Predatory insurance corporations – the real death panels – are spending more than $1.6 million per day to buy republican votes, gin up fear and defeat reform. When it comes to receiving payoffs from the insurance industry, of 535 Congressmen, Grassley and Conrad rank 29th and 35th, respectively; therefore, how can I trust them to represent my best interest when it comes to negotiating healthcare reform? Making money off human pain is a republican principle. Real competition is the de facto monopoly buster. 100,000 people die each year due insurers denying coverage. This is criminal and immoral. Georgia state employees have no due process patient protection rights, a negotiated constraint that gives UnitedHealthcare carte blanche to chose who lives and who dies. If competition is the lynchpin of free-market capitalism, why is UnitedHealthcare afraid to compete on a level playing field? Limiting choice drives up cost, benefiting the insurer, which is why slime-dog republicans defend the middleclass being systematically bilked by corporations like UnitedHealthcare. Through mendacious scare tactics, lying republicans curry favor and fear monger by preaching that reform will lead to rationed healthcare and place restrictions on doctor choice. Contrary to specious talking points propagated by solution-less republicans, as it stands right now, without true marketplace competition, insurers not only dictate the cost of medical care, but they also get to choose who receives care. Despicable republican profiteers will not retreat quietly from millions in payoffs. Public option now!

[Bronxdude]

UnitedHealthCare is relying on collusive and exclusionary practices to eliminate competition, consolidate their monopolistic stranglehold on consumers and corner the insurance market. In an effort to defeat reform, UnitedHealthcare is ordering its employees to disrupt town hall meetings. Under the current greed-driven arrangement negotiated by the parasitic insurers, 1 of every 4 healthcare dollars spent goes to insurance companies, which generates approximately $2.2 trillion annually in profits for the health insurance industry, to include UnitedHealthcare and WellPoint. The public option would cut reimbursement revenue to insurers and drug companies, not doctors. Morally corrupt insurers like UnitedHealthcare are aggressively pushing legislation (so far, the insurance industry has paid out $26 million in bribes to republicans) to shift more of the cost (from 25 to 35%) to consumers, so insurers can spend less of every premium dollar on actual healthcare, which translates into increased profit. In comparison, predatory casinos limit their profit on gamblers to no more than 20 cents on the dollar. Twofaced, shallow, soul-less, hypocritical Christians: When Jesus healed people, he didn’t require precertification or verification of coverage with BC/BS of Nazareth! Ruthlessly inspired capitalism that exploits the sick, downtrodden and poor represents a wicked collaboration between republicans and Satan. 50 million uninsured Americans is an evil blight upon our civilized nation. Public option now!

[Bronxdude]

In an attempt to divide Americans by race, defeat health insurance reform and unite Blue Dogs, Tea Baggers, Tinfoil Hatters, compassionless Christians and other bigoted malcontents – the new republican base, soul-less prostitutes Chuck Grassley (R-Iowa) and Phil Gingrey (R-Georgia) are ginning up fear, advocating hate inspired civil disobedience, rejecting fact-based discourse and condoning violence as an acceptable change agent. Similar to Klan rallies, idiots like Gingrey are openly encouraging people to bring loaded guns to town hall meetings. The Limbaugh led Republican Party has evolved into an insidious, compassionless and implacable evil force totally committed to social injustice; starting with Reagan, republican ethics have slowly devolved into a seething mass of callous and destructive self-centeredness a notch below child molesters. Reagan demonized Medicare and sought to end reduced-fee lunch for students barely surviving in abject poverty. The notion of quality, affordable health insurance for every American is not complicated, especially when contemplated as a moral rather than a business decision. Health care is a fundamental right, not an expensive privilege decided by class, lineage, race or wealth. With Ted Kennedy gone, the marginalized, downtrodden, exploited and disenfranchised – manipulated like pawns and denied access to the political power necessary to influence constructive change – no longer have a standard-bearer, a voice at the table. Since soul-less republicans have collectively abandoned their moral reasoning, who among the democrats will emerge to save America and replace the “Lion of the Senate.”

[Bronxdude]

It’s not about healthcare reform or the economy. It’s about race – the race of our president. Without a sound, Joe Wilson sat through 8 years of Bush telling America everything was hunky-dory in Iraq and on Wall Street. First Black president arrives on the scene and Wilson is suddenly overcome with patriotic emotion and promptly blames and demonizes Obama for every mishap that has occurred from 2000 through 2008. In the immediate aftermath of Katrina, thousands of Americans are unseen and unheard by their government and Joe Wilson is silent (was the silence due to them being poor and Black?). Republicans and their Neanderthal-base are petrified that the racial make-up of America is changing, which is why they are stirring up despicable stereotypes about Black Americans and directing their lynch-mob hatred towards delegitimizing, dehumanizing and disrespecting President Obama. It would appear that republicans universally believe no Black person is capable or worthy to lead America. It’s no mistake that 80 percent of all Birthers and Tea-baggers hail from states with a long and present history or racial hatred, intolerance and brutality. Like Birthers, Joe Wilson is jack-booted racist who can’t accept a black President – plain and simple. The Limbaugh led Republican Party has evolved into an insidious, compassionless and implacable evil force totally committed to starting a race war and advancing social and racial injustice.

[Eris23Skidoo]

Its really ironic that they've framed themselves as the champion of the common soldier. See, in the Army, everyone is GREEN. There is no race. I'm sure there are exceptions, but the values that the Army tries to instill in soldiers is that the institution of the Army is past racism. I guess I was in the Army when soldiers still wore green, now it's kind of a sandy brown. I wonder if in basic training, the drill tells everyone that we are all brown now instead of green. Hmm...

[Bronxdude]

The healthcare insurance monopoly thriving in Georgia represents a textbook example of what happens when competition is ruthlessly eliminated. In Georgia, scheming UnitedHealthcare executives colluded with corrupt republican politicians to eliminate Blue Cross and Blue Shield as a competitor, narrowing the slate of choices for state employees to two – Cigna and UnitedHealthcare. Georgia state employees have no due process patient protection rights, a negotiated constraint that gives UnitedHealthcare and Cigna carte blanche to deny claims, cancel coverage, dictate treatment and pick who lives and dies. There is no real choice in Georgia, just monopolistic and morally corrupt Cigna and UnitedHealthcare – the real death panels. In the 12 months following Cigna and UnitedHealthcare hijacking the Georgia employee health benefit plan, premiums have increased by 88%, while worker wages have increased a meager 4%; as a result, when compared to the second quarter of 2008, 2009 profits for UnitedHealthcare increased by a whopping 155%. In Georgia, health insurers like Cigna and UnitedHealthcare deny 1-out-of-every-4 treatment recommendations prescribed by physicians; nationally, UnitedHealthcare and Cigna deny over 45,000 physician directed treatment and diagnostic recommendations per day with no oversight and horrific outcome, i.e., people die. The public option will force real competition and put a stop to the monopolistic stranglehold enjoyed by UnitedHealthcare and Cigna. Every 12 minutes, an American citizen dies because they lack health insurance.

[Eris23Skidoo]

If I was in charge, UH and Cigna would be disbanded and their executives would face one count of attempted murder for every claim denied and every doctor-recommend denied. For each of these that resulted in the death of a patient, they would be up on murder one.

[JohnHKennedy]

The Blue Dogs are right to stop being obstructionists. If they don't, they will pay for it in the 2010 election.

Keep asking ALL politicians at ALL public events "Why do they support Torture?"
If they aren't actively calling for enforcement of our Federal Torture Laws They Support Torture.

SIGN THE PETITIONS
Demanding both a Commission of Inquiry
and Prosecution for All the Bush-Cheney Crimes at ANGRYVOTERS.ORG

http://ANGRYVOTERS.ORG

Only Prosecution Stops Torture!
Only Prosecution Stops Violations of Our Constitution and Rule Of Law.

[Dale Larson]

It's time to end our "risky experiment" of "For-profit health insurance". It's a proven failure.

HR676 http://hr676.orgg) Single Payer system that is proven, pro-business and pro-people:

* Slashes at least 30% of costs off the top by removing private insurance overhead.
* Companies take health care expenses off their books. Stock value increases. Better able to compete internationally.
* Small companies could have access to higher skilled workers because previously they couldn't compete in the labor market by offering similar benefits.
* More entrepreneurial ventures will launch since they have more money and less unrelated risk.
* Dramatic drop in bankruptcies.
* Dramatic drop in lawsuits. Most of these lawsuits are simply to obtain money to cover health care if something interrupts their coverage.
* Reduced system complexity. Greater efficiency due to fewer regulations.
* Savings from employees not having to fight with their insurers during work hours.
* HSA and MSA dollars redirected back into the economy for goods and services.
* Additional money to spend from not having to carry "uninsured motorist coverage" on your auto policy.
* Contract employment is more viable for workers since they are guaranteed access to health care.
* People are covered when unemployed. No chance of being wiped out financially if you lose your job.
* Health care providers (doctors, hospitals, therapists...) see increase in business with much less administrative expense.

[Eris23Skidoo]

A typical GOP response to the above points:

1) Some of that 30% pays for republican elections
2) Change the subject
3) Hey, WE are the supposed "champions" of small business
4) What do you know about entrepreneurs? They don't even HAVE a word for that in French
5) Hey, if you're irresponsible, maybe you SHOULD be bankrupt
6) We can end lawsuits our way: by denying the right of non-corporate citizens to engage in them
7) We like fewer regulations and less complex systems, in fact, we invented that idea. Have I pitched my idea for a flat tax to you yet?
8) Employees who engage in personal business during work hours should be fired to make an example
9) Why don't we just stop funding HSA/MSA and pay for it with a big fat tax cut for millionaires?
10) If you can't afford car insurance, you probably don't vote so I could care less
11) We're the ones who invented putting a contract on workers
12) Why should I have to pay for other people's safety nets?
13) I don't believe you

[Dale Larson]

Excellent "analysis"! Totally cracked me up.

(fanned and faved)

[BPCentrisAmerican]

Could it be that there numbers are falling faster than a King Kong, if you think it's just the so-called far left base, Grassley numbers are tanking also and so will Snow's if she dosen't show some commitment to something, anything. As for the bought and paid for whores on the right, they can't even stay awake for the debates on there BS amendments, than again, who wants to listen to Senator potato head Kly through pointless hessy fits and Robert's trying to buy time for lobbyist. I've always thought that Congress was a whorehouse, little did I know.

[ThanksMatt]

Since Blue Dogs are Republican Lite's they should change the party and leave the place for real Democrats.

[FreedomBeforeSecurity]

Great just what we need... polarization from the left as well as the right.

[clutchkill]

It is needed.

[ThanksMatt]

Americans voted for change. Those who obstruct change in their own party should be honest enough to follow their heart, mind, purse or whatever it is and register with the party they belong to.

[ThanksMatt]

And PS: instead of continuosly moving towards the center the center should be moved to the right direction once in a while. The right direction is obviously to the left right now....