The House Will Make Sure the Senate Includes a Robust Public Option

This is the moment when Senators Max Baucus and Majority Leader Harry Reid (and President Obama) should make history by producing a Senate health reform bill that

• makes health insurance truly affordable for all Americans,
• creates a strong public option to give private insurers real competition,
• and doesn’t destroy Democratic re-election hopes by taxing hard-won middle class health benefits. 

Last week the Senate Finance Committee became the last of five Congressional committees to pass a health reform bill – this one by far the weakest of all the bills.  Almost immediately a small group of Senators – Majority Leader Harry Reid, Finance Chair Max Baucus, and acting HELP Committee Chair Chris Dodd – huddled with a White House team led by Chief of Staff Rahm Emanuel to begin the mysterious process by which the more progressive HELP committee bill will be melded with the product of Baucus’s mostly fruitless negotiation with Senate Republicans, only one of whom, Maine Senator Olympia Snowe, deigned to vote for the final Finance bill. 

Reid and even Baucus say they personally support a public option, but they repeatedly point to the so-called “moderates” in their own party whose support is necessary to get to the 60 vote majority needed to pass a health reform bill in the Senate.  With a smart legislative strategy, the 60 Democratic votes (which, with Snowe would total 61) could be called upon just to overcome a Republic filibuster, clearing the way for a 50 vote majority to pass a strong health reform bill -- while letting more conservative Democrats vote against it.  [More on this anti-filibuster unity strategy in columns to come.]

Most importantly, Reid and Baucus need to realize that even “moderate” Democrats are rethinking their positions on health reform right now.  Concentrating their minds is the realization that they are about to vote to force every American over the age of twenty five to purchase health insurance.  Moderate Democrats are the ones most receptive to the demands of the insurance industry, and the price the insurance industry is demanding in exchange for insurance reform (like preventing companies from discriminating against people with pre-existing conditions) is the “individual mandate” – which means voters are forced to buy insurance, whether they can afford it or not. 

At this moment, all Democratic politicians, even the most conservative, are realizing that their voters will blame them, not the insurance companies, if the policies the voters are required to buy are so expensive that premiums consume over 20 percent of those voters’ annual incomes.  Suddenly, more generous tax subsidies to cover middle-class premiums seem like a good idea.  And if the public option can bring down the cost of premiums those subsidies have to pay for, then the overall size of the reform price tag can be kept under control – a long time demand of moderate Democrats. 

Everyone knows that the three House bills contain more ample subsidies, two of the three have a strong public option, and none of them tax hard-won worker health benefits.   On Friday the Congressional Budget Office reported that most progressive of the House bills produces more affordable premiums, while coming in around the ten year cost of $ 900 billion goal set by moderate Democrats and President Obama.  Here’s the headline on Lori Montgomery’s story:  CBO Estimates House Health Bill at $905B or Less. 

On the Health Care for America Now Blog, Jason Rosenbaum does a nice job of teasing out the implications of these findings at this moment when moderates are figuring out how to achieve their fiscal goals, while avoiding being blamed for bad outcomes: 

The House bill covers more people, is more affordable, and is just as deficit neutral as the Finance bill

As a refresher, the bill being considered in the House is a much better bill than what Finance passed on Tuesday. It has a public health insurance option, it asks employers to pitch in their fair share, it is fairly financed, and it has much more generous subsidies (read: tax credits) to make health care affordable for everyone.

So, why, with all that good stuff in there, does it look like the will CBO say the House bill still covers millions more people and costs just as much, while remaining deficit neutral? Because things like employer responsibility, fair financing, and the public health insurance option save money.

That's right. The public option saves money. The CBO has said so before, and it looks like they're saying it again.

Combine that with raising money by taxing households that make over $350,000 per year instead of the middle class, and asking employers to chip in for their employees health care, and you've suddenly got a lot more money to work with. Which means you can give middle class people more generous subsidies than the anemic Finance bill. Which means you and I won't be on the hook for 16.5% of our income paid towards health care costs, the level a typical middle class family would have to pay under the Finance bill.

 Harry Reid and Max Baucus (and the White House) should step up to the plate and borrow the strongest parts of the HELP bill to write the final Senate health reform legislation.  If they don’t, the US House of Representatives, led by Nancy Pelosi and the Progressive Caucus, will force them to strengthen their bill in conference committee.  But if the Democratic leaders in the Senate dare to lead, the House will back them up – and even the most moderate Democrats will support them as they make history by winning affordable health care for all.

 

Follow Roger Hickey on Twitter: www.twitter.com/rogerhickey

Comments

[Manx]

If we get a robust public option, it will be in spite of the gutless and leaderless Obama. According to the NY Times, Obama has sided with Olympia Snowe, who won't vote for a public option but will settle for a "trigger."

[sc300nc]

Regarding the cost of health insurance, using government subsidies does not reduce the cost of healthcare. It will reduce the cost to some, but will dramatically increase the cost for others.

This is not health care reform, it is income redistribution. There is nothing in here that is reforming anything, except the way that insurance costs will be paid.

[iblogleft]

Would you rather subsidize corporate profit margins, or public profit margins?

[sc300nc]

There is no such thing as public profit. You think the gov't plan will produce a profit? Will it reduce costs? HAH!

I'd rather pay higher rates to keep the government out of my life.

[justobserve]

All reasons pointed to a robust public option. No other alternative can beat the real competition that a public option will certainly create. Yet it seem the minority, one committee and one woman from Maine, is leading it instead of the majority of voters and 4 out of 5 Committees supported a public option. That's weird for a democracy!

[relayer]

An excellent article. Public healthcare is an essential ingredient for the future of a fiscally and physically healthy America. I trust congress will end up doing the right thing. Americans deserve, finally, the freedom and protection universal healthcare provides.

[lsbutch]

I totally agree it is time that the Senate support the public option, the public demands it, humanity demands it, and the voters demand it. Let rhetoric be damned this is the right thing to do for all of us in the United States, and long overdue. We are responsible for caring for one another not making a buck off those with less leverage in the capitalistic system.

[weslenforever]

Members of Congress need to decide real fast which is more important! That scuzzy CEO with that million dollar bribery check in his hand still has only ONE vote.
Does that Million Dollar Check in the hand of ONE voter hold more weight than a MILLION one dollar checks in the hands of one MILLION voters? I've been asking that question for months. I have yet to hear even one of them answer.

[meko]

It does to Senators Lincoln, Baucus, Conrad, Nelson and Carper. When they voted against the Public Option in committee, even though all of their states had strong support for the public option, it was clear who they serve - and it isn't the voters.

For Baucus, Lincoln, Conrad, Nelson and Carper, anyone with a net worth of under $10 Million is worthless.

[Valkyrie Ice]

Looks like Congress is finally starting to notice what I've been saying for months.

This was never Obama's Waterloo. It was and always has been Congress's. Big money may control 90% of the wealth, but it's not money that puts them into office. It's our votes, and if they don't give US what we NEED, then next election is going to be a political bloodbath as they lose their cozy jobs for the new people we elect JUST TO GET THEM OUT OF OFFICE.

It will be interesting to see how many of them have already passed the point of no return with their constituents.

Nov 2010 should be rather exciting.

[rosiebond007]

TAX THE WEALTHY - NOT THE MIDDLE CLASS.

THEY ALREADY PAY FOR THE CADILLAC HEALTHCARE FOR THE RESPRESENTATIVES AND SENATORS.

TAX THE WEALTHY = TAX THE WEALTHY.

[masher]

Lower middle class taxes too. The middle class pays too much right now. Good luck on getting either under Obama.

[luckynewman13]

Obama just passed a middle class tax cut. I'm not here to trumpet the man, but at least give him credit where credit is due.

[schatsie]

The middle class is already paying the taxes for 50% of the healthcare in this country...Who do you think really pays for the Medicaid insurance for the Walmart Employeess... And we also pay for the Soldiers and Veterans and Medicare and governmental employees and retirees....The idea that we the middle class should pay even more is ludicrous when the Richest 400 people in this country pay 17% in taxes and that is strictly for the protection of their overseas assets.....

[janeycat]

Roger that is a Good read with excellent links to articles that reinforce your comments ....
so do me the favor of reading this that i have found concerning the public option....
it's a good read also, I think you will enjoy it...

http://thefunpie.wordpress.com/2009/08/20/the-evil-public-option/

It's not a long article, i was actually thanked by the Author for sharing it with people.
I think it's the best example that a public option will not hurt but offer a choice for the people..
thanks for the article

[codycap]

"You work three jobs?... Uniquely American, isn't it? I mean, that is fantastic that you're doing that."-- George W. Bush, to a divorced mother of three, 2/4/05.

I agree with competition. I also believe in socialism, we are and have been a country that has always combined capitalism and socialism.

Why people go to pieces over the two isms is a result of years of propaganda. I believe (and every American I have ever met-otherwise no roads, social security, VA etc) the statement below:

Socialism is required for things that we absolutely must have, like health care, the common defense, police and firefighters, clean air and water, and so forth.

Free markets are wonderful for all the crap we can live without.

[janeycat]

What are you talking about ???
are you sure you posted to the right person ??
before you even talk to me you need to learn to speak english !!!!!

The article i linked to gives support to health care ?????
get real !!!!!!

[SILVANUS]

Note to Dems:

I will put all of my focus into un-electing you if a public option is excluded.

Then we will see where you get your insurance.

[jinxed]

same place as now, the taxpayers

[hoosier96]

Soon as the public option is put in you can kiss Snowe and Lieberman's support good buy.

[gbloodgood]

And so long and hope the door don't hit you on the way out to the both of them.

[patricksmom]

That;s OK. Buy buy. If the dems , for reasons of conscience or fear of loss of seat, will vote to prevent a filibuster, there are 50 or more dem votes for a public option with the Vice president to break a tie if need be.

[valboski]

Answer this..is it tru that constitutionally a "public(gov) option will have to include all the public including Illegals? Is that why the Pres was killing Joe Wilson with his eyes?

[socaldude]

No, it's not true.

[tonewheel]

Gawd...you really need to educate yourself before posting here.

[Irmanator]

No. Illegal immigrants wont receive subsidized health insurance under any of these bills.

[mummblemouth]

Though any immigrant who is here legally should be allowed to buy into it.

[tribilin219]

For their non-actions and caring more for their party's and the needs of Special Interest Groups Over the needs of the people who voted them into office, They will pay, And they'll pay like we'll have to pay for Health care only the Health care companies like. We need some good Independents to run for office in 2010 and 2012 so we can get all these crooks out of Washington. SELL OUT'S that's what they all are!

[Cil]

You must surely be an Independent, and your comment is quite a bit
confusing.

If you really believe that members of the Democratic and the Republican
Parties are all crooks....­..........­.....why in the name of heaven do you expect
us to believe that you Independents will be any different?

[Arrech]

That is a very good point.
You just have to look at "Independent" Lieberman

[TheRealNCal]

Genetically Modified food.
You may not mind eating it but I do.
Who is the biggest creator of GM food? Monsanto.
Monsanto hold patens on several GM food crops like GM corn and GM soybean. Not to mention the Growth Hormone used in dairy cows.

In July, the Obama administration appointed Michael R. Taylor to the Food and Drug Administration (FDA). Michael R. Taylor was the Vice President for Public Policy at Monsanto Corp. from 1998 until 2001 and other interesting positions.
http://www.organicconsumers.org/articles/article_18866.cfm


I, personally, don’t want an administration that thinks Genetically Modified food is sooooo great that they would put one of it’s “people” into the FOOD and Drug Administration! To run or even make decisions about MY heathcare.

[wildedge]

Yes, and putting flouride in our drinking water was a communist plot to sterilize American men - since that happened back in the '50s, we must all be sterile now.
No? Then maybe it wasn't a commie plot afterall.
There are real dangers of misuse of technology in the production of basic foods, eg, overuse of antibiotics, etc., but genetic modification isn't one of these. If you don't like it, don't eat it. But in any event, your leap from there to rejection of government supported healthcare is nonsensical. In no country with government sponsored healthcare does the government make decisions concerning the healthcare of a client or patient, the question is merely who picks up the tab. I think we should all share a little of the burden through the agency of our government, and thus benefit the greatest number, rather than have the vast majority suffer the costly burden of for-profit insurance provided - at their anti-trust­-exemption liesure - by corporations that prefer us to die before they are forced to pay on a claim.

[TheRealNCal]

There are real dangers… you are the one who can divine them for us? Floride didn’t kill you so your logic is everything they say is great, is?

I want the information then I will decide. I don’t need YOU or Government deciding what is in my best interest. That is the point.

“In no country with government sponsored healthcare does the government …“ Why do Canadian’s come to the U.S. for treatments that are available in Canada? Maybe they just don’t want to wait for years for treatment. Government making you wait for treatment IS making a decision concerning health care. The question merely is, are you a Canadian who is rich enough to pay for universal health care in Canada and then be able to pay some more to come to the U.S. if you may be in a hurry?

As for dieing before the evil insurance company pays on a claim, are you referring to Obama’s healthcare speech to Congress? President Obama’s One man from Illinois story is not true. The man, Otto S. Raddatz's policy was reinstated before his treatment was to began, he received his life-extending stem-cell transplant, he lived 3+ more years and then passed in 2009.

We pay taxes to the Federal Government for the very few things they are responsible for doing. They don’t do what they should and they have their noses where they do not belong. Citizen daycare is NOT the business of the Federal Government.

[themainpoint]

"This is the moment when Senators Max Baucus and Majority Leader Harry Reid (and President Obama) should make history by producing a Senate health reform bill that

* makes health insurance truly affordable for all Americans,
* creates a strong public option to give private insurers real competition,
* and doesn’t destroy Democratic re-election hopes by taxing hard-won middle class health benefits.

You can say that again. Because if Congress does not accomplish those three things, we'll have no real reform at all.

It's very odd to me that the discussion has not centered on the fact that Americans are charged more than twice the going rate for health care due to an antic-competitive industry that is filled with above market giveaways to big drug, insurance and other players. Because if we make sure that players within the health industry have to compete like the rest of us do for a living, we not only cover everyone and lower everyone's rates, we take out the constant artificial inflation of health care prices.

What better stimulus for small businesses and the Main Street economy than that?

[dagmaclugh39]

For what it's worth, a Ph.D. in Psychology who has been following the Health Care debate told me that Big Pharm "spends $13,000 a year on each doctor, and there are two million doctors in the U.S. Who do you think picks up the tab?"

[themainpoint]

Exactly.

[lsbutch]

This cost of payments to doctors, hospitals, etc. is passed on to the public, and is also written off their corporate profits as a deduction before they pay taxes. Isn't this double dipping? Oh, I forgot the oil industries do it for their empty wells, and this has also set the pattern many other businesses to follow. Just imagine how much more they actually own American in back tax revenue if this wasn't possible? When is enough, enough? Time for a flat rate tax, no deductions, for business or individuals, just bottom line them, earnings, times 10% equals tax due. Now this is justice, don't you think?