That is the big question everyone is wondering about these days. Most of the traditional media is drooling over the idea of a train wreck, hyping the disagreements and hoping for failure. But the disagreements are also quite real and quite significant. Conservative Democrats don't want a public option, progressives are insisting on it. Conservatives don't want to spend too much, progressives want to be sure insurance is actually affordable to the middle class. Conservatives don't want businesses to pay anything for their workers' health care, progressives don't want businesses to get a free ride, especially if their workers are being forced to buy insurance. Conservatives want workers taxed on their health plan if it's a good one, progressives would rather have the super rich pay more in taxes instead of the middle class worker with a decent insurance package.
These are tough issues to work out, but I am confident that the White House and the legislative leaders will figure out a way. When legislation is this important to pass - substantively and politically - leaders figure out a path to getting it done. I have seen it happen many different times over the years - seemingly impossible to solve policy differences worked out with patience, muscle, and creativity.
Take the public option. In what is either a sign we will pass health reform, or sign of the apocalypse (or maybe both for certain fundamentalist Christians), conservative Blue Dog Mike Ross and I, one of the original hard core public option advocates, actually agree on something related to the public option. Ross is now suggesting that "instead of creating an entirely new government bureaucracy to administer a public option, Medicare should be offered as a choice." I have fought like crazy for a new public health insurance option to be created for people under 65 years old, but I actually think that this idea is a very reasonable compromise: don't create a new entity, just open up the perfectly good public option we have - Medicare - to anyone who wants to buy into it. That would actually strengthen Medicare because younger, healthier people would be joining the risk pool. And it would satisfy progressives by giving some real competition to the private insurance industry.
Or take affordability. For the fiscally conservative Democrats, they can take reassurances on that issue from the latest CBO report which says that both of the two House bills comes close to (one slightly above, and one slightly below) the $900 billion amount targeted by fiscal conservatives, but they also cover more people, are far more affordable and are deficit neutral.
Here's the bottom line on middle class affordability: the compromise the Blue Dogs forced on the House Energy and Commerce bill made the cost for middle class families $551 a year more, while the Senate Finance bill was a staggering $3,900 a year more for middle class families than the Senate HELP Committee bill. And yet the CBO now says that the better House version of the bill (which is closer to the Senate HELP Committee) is just as fiscally responsible as the "centrist" alternatives that cost the middle class families so much more. When you look at the actual numbers and policy implications of the bills, it's easy to come to terms. In this case, the House bill allows both fiscal conservatives and those of us who want more affordability for the middle class to win.
When conservatives and progressive Democrats in the Senate and House sit down to look at these bills, compromise ideas like Ross' idea of letting everyone buy into Medicare will emerge, and when the merits of the bills are analyzed, I believe that people will come to understand that the political and policy logic of going with the better alternatives in all these areas. This is too important - to the country, to the President, to the Democratic Party - for this not to get resolved.
And if Mike Ross and a lefty like Mike Lux can find a common ground, then anything is possible.
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