03/18/2010 05:12 am ET Updated Dec 06, 2017

Friday Talking Points: Is Opt-Out The Answer?

In a surprising turn of events today, the Nobel committee awarded this year's Nobel Peace Prize to "Not George W. Bush." The chairman of the committee was quoted saying, "Lordy, Lordy, we were so happy to see the United States run by someone who wasn't George W. Bush -- even for eleven days -- that there simply was no other choice than to award 'Not George W. Bush' the prize unanimously."

OK, seriously, President Obama's new award should be seen as a giant thumb in the eye to Bush -- the third one so far (Gore and Carter being the other two). It's the Nobel committee's money, remember, so it's their right to do whatever they will with it. But talk of Obama refusing the prize (which would doubtlessly make Republicans feel better) is just plain silly. Obama will accept the award, give a nice speech, and donate the money to charity (my tea leaves tell me that ACORN isn't going to see any money out of this one). But until Henry Kissinger (or Woodrow Wilson, for that matter) gives back his award in shame, I don't think Obama's going to turn down his own award.

But while the award is already causing spontaneous rightwing cranial explosions across the land (if you listen close, you can hear them: Foom! Blam!), it's really nothing more than a footnote this week. Because larger things are afoot. I speak, of course, of Playboy putting Marge Simpson on its cover.

No, wait, that can't be it -- let me check my notes. OK, here it is, sorry. Let me start over.

I speak, of course, of the new health care reform compromise idea being batted about over in the Senate. Trying to build a bridge between the public-option-supporting Progressive Democrats and the fiscally-conscious Blue Dog Democrats was always going to be the Grand Compromise which had to be forged to pass a bill. Various ideas have been floated to build this Compromise Bridge (my metaphors seem to be getting all mixed up today), which all eventually collapsed into the metaphorical chasm below. The "trigger" option, where a public option would be in the law but wouldn't activate unless a "trigger" was pulled at some later date was probably the most-talked about plan prior to this, mostly because it was the favorite of the only Republican who actually may vote for health care reform in the Senate. The "co-op" plan, which will be in the bill Max Baucus' committee votes on (Um, guys? Weren't you supposed to have voted this week? I'm just saying...), has also been declared a non-starter.

Enter the "opt-out" plan. Actually, it's not even a plan yet, merely an idea floated by Senator Charles Schumer. Meaning there are no solid details to analyze, as of this writing. Meaning that a lot of people still have questions as to how it would work, even if others have enthusiastically endorsed the idea or come out against it.

The idea is fairly simple. Pass a national public option, and start with every U.S. state in the plan. Then allow individual states to "opt out" of the plan (this is one of those vague details -- would it be the governor's decision, or the state legislatures', or the people's by way of a referendum?). Using some mechanism involving the state government, each state could decide not to participate in the public option.

Let's go through the pros and cons of this idea, at least as I see them at this early stage. First, the bad news. The biggest thing the opt-out plan has against it seems to be fears (from both pro-reform and anti-reform people) that the idea just won't work. Backers of the "strong public option" (to say nothing of the single-payers) warn that this is just one more disappointing compromise from what really should be passed -- a robust public option. People against reform are going to howl if (again, this isn't clear yet either way) the people in their states can opt out of the public plan -- but will still be subject to the rest of the bill (taxes, mandatory coverage, etc.). They are going to quickly demand that states be allowed to "opt out" of the entire bill if they don't like it. This could indeed doom any chances of the bill actually doing some good -- or maybe not.

Without details, it is really impossible to know that at this point. Detractors of the idea are going to start using civil rights language to make their case -- that changes of this basic nature need to be federal because all Americans should be equal under the law. One other big question remains as well -- will states be able to opt back in later, if they decide they made a mistake? Can they opt in for a few years, opt out for a few years, and then opt back in again? Such a scenario is pretty easy to see, especially in "purple" states whose state government isn't dominated by one party or the other. The public option could become a perennial political football, and every change in party of the state government could mean a change in the optiness (or, if you prefer Alex from A Clockwork Orange, "the old in-out"). If states are switching back and forth year by year, it could destabilize the whole system -- or maybe not.

Finally, one drawback (due to accounting and political trickery) is that the plan isn't going into effect until 2013 (this is one thing all the plans agree upon, so you can consider it a done deal in whatever final legislation is considered). This leaves four long years for corporate interests to continue the battle in each and every state. Think you're tired of television ads and screaming folks at town hall meetings now? Picture a more local version of that for the next four years -- not a pretty sight to contemplate.

But having torn down the opt-out plan, allow me to build it back up again. Right off the bat, Howard Dean supports the idea. This is a major, major endorsement, since Dr. Dean is seen as the champion of fighting for the people instead of the corporate interests in this whole debate by the Progressives. So his support carries a lot of weight on the Left. And he has proclaimed that the opt-out plan is "real reform," and that he'd vote for it if he was a senator.

The pros of the plan are easy to see, when stacked up against these other compromises. The public plan would be (mostly) nationwide in this scheme, instead of a state-by-state patchwork. That's a big victory right there, and one that shouldn't be sneezed at (so to speak). If, eventually, every state came around to joining in, then the framework for a nationwide plan is already in place. Actually, it's even better than that. Because by starting every state in the plan (as opposed to an "opt in" plan, for instance), it forces the state governments to decide on denying their citizens something that other states will have. And denying people stuff isn't usually a good way to get re-elected, even in the red states (just look at the many Republican governors who said they wouldn't take Obama's stimulus money, and then were overruled by their state legislatures). So while it was looking like -- up until Schumer proposed the new idea -- whatever compromise the Senate agreed upon was probably going to be a state-level plan, it is now looking like the default plan will be nationwide. And that's a good thing, even if it does turn out to be "nationwide" with a few holes in it.

Another good thing about it is that it is an excellent political move. There are many reasons for this, the biggest of which is that it gets the Democrats out of the corner they were painting themselves into. Meaning that the fight that was shaping up was entirely within the Democratic Party (Republicans, due to their intransigence, have made themselves entirely irrelevant to the discussion). Which isn't exactly great politics for Democrats. But if -- and it's still a big "if" at this point -- both sides in this fight see the opt-out plan as an answer, then this epic battle will not be fought and Democrats can unite. This, as is obvious, is absolutely crucial for any chance of success. Democrats must be united, or else nothing's going to get out of the Senate. The fight between the Blue Dogs and Progressives can be avoided if they both see this as a workable compromise.

This is crucial, because it could avoid two very ugly scenarios. The first is Democrats voting with Republicans against "cloture" (the fake filibuster succeeds, in other words). This would be a nightmare for Democrats -- health care reform getting this far and then failing, due to Democrats crossing the aisle to help Republicans kill it. Even the Blue Dogs themselves ought to fear this scenario, because it would be devastating for Democrats at the polls next year in the midterm congressional elections. Democrats would, quite rightly, be painted as the party that "can't get anything done" even with a 60-vote majority in the Senate. The other ugly scenario this compromise would avert is watering the bill down so much that Progressives scream "Sell-out!" and come out against the final legislation. If the opt-out plan is accepted by both sides, then the Progressives can say "We fought to win a national public option and won," and the Blue Dogs can say, "We fought to give every state a voice, so that people can make their own minds up about the public option." It could give a lot of political cover to both sides.

It also, it should be noted, punts the decision. The members of Congress who will vote on the bill will not be the ones responsible for deciding whether their state opts out or not. This kicks this political football back to the states' legislatures -- who are a lot closer to the voters themselves than a U.S. senator. If the Republicans were actually acting in a reasonable manner ("Yeah, right," I hear several of you say...), then they could even get behind the idea because it is all Tenth-Amendmenty and respectful of "states' rights."

Politics aside, though, would it work? Without some more details it is really impossible to know. But it could. Imagine the nay-sayers are right, and every single red state opts out immediately. I don't think that's likely (again, look what happened with the stimulus money), but let's start from there. So you have in the "opt out" column the whole South (excepting perhaps Florida and Virginia, depending on how you color them), all the way west to Texas, and then most of the Plains states and then northern Mountain states (Alaska, Idaho, Utah, Wyoming, perhaps Montana). But you still have over half the country in the plan, and likely a majority of the actual population covered. Well, that's half a loaf, and a pretty good start.

But most red states are notorious for decrying federal spending, while at the same time being the biggest recipients of such federal money (see, for example: Alaska). And if the states are only allowed to opt out of the public plan (and not the rest of the bill), then their citizens are going to feel like they're paying for something that they're not getting. This is going to put some pressure on their state governments, to varying degrees. The state governments are going to take a long, hard look at whether businesses will relocate (taking all those lovely jobs with them) to states which are in the public plan. This hits the states where it hurts -- their tax base. Eventually a few of these states will sheepishly move into the public plan -- especially if it starts saving other states money. Then a few more. Sooner or later, there will only be a few states left in the opt-out column. This may even involve a few changes of party control in state legislatures, as voters react to their elected officials' short-sightedness.

That's the rosy scenario, at least. If the public plan winds up being a failure, or not controlling costs as advertised, then the scenario could work backwards as well, with more and more states eventually opting out, and the public plan shrinking to such a small size that it cannot possibly control costs as designed.

So it's a risky idea. But the whole project of reforming health care is a risky proposition in the first place. The real question is whether this risk is a good one to take, and whether it would improve both the bill itself as well as its chances for passage this year. It's still an open question, but this compromise certainly looks, from where I'm sitting, a lot better than any of the others floated so far.


All sneering at prematureness aside, President Barack Hussein Obama winning the Nobel Peace Prize today pretty much locks up another award for him -- the Most Impressive Democrat Of The Week. Now, I know that on Obama's trophy shelf the Nobel is going to get a more prominent place than our humble award, but this is immaterial. Obama will now be known as the third sitting president (after Teddy Roosevelt and Woodrow Wilson) to have so been honored (by the Nobel, of course, as we weren't handing out MIDOTW awards back then). While it likely would have made more sense to wait a year to give Obama the Nobel, who are we to argue with the Nobel folks' decision? If they're making a political statement, fine. The fact remains that the United States of America is seen in a much better light now than a year ago by the rest of the world. Polls back this up -- since Bush left office, America has climbed in the world's eyes once again. So we add our own congratulations to the president by way of his thirteenth MIDOTW award.

But, of course, before the news broke of Obama's new shiny gold medal, we had already selected a MIDOTW winner for the week, so the president will have to share this week's award with Speaker of the House Nancy Pelosi. Pelosi has not only been the toughest fighter in Congress for the public option (her backbone in this matter is above reproach), but has also shown the same toughness to her many critics from the Right.

Which is really why she's getting her ninth MIDOTW award this week. It all started when the National Republican Campaign Committee (the guys in charge of electing more Republicans to the House) sent out a letter saying, in part: "...if Nancy Pelosi's failed economic policies are any indicator of the effect she may have on Afghanistan, taxpayers can only hope McChrystal is able to put her in her place."

This is the language, it needs pointing out, of wife-beaters. Not the sleeveless undershirts with the charming nickname, but actual guys who justify "smacking the old lady around when she needs or deserves it." This is what, historically, "put her in her place" refers to. Perhaps whoever wrote the letter was unaware of this odious connotation. Perhaps not.

Pelosi, though, responded with the quote which wins her her own MIDOTW award:

"I'm in my place. I'm the Speaker of the House -- the first woman Speaker of the House -- and I'm in my place because the House of Representatives voted me there. ... That language is something I haven't even heard in decades."

Well done, Madam Speaker! Impressive indeed!

[Congratulate President Barack Obama on the White House contact page, and Speaker Nancy Pelosi on her Speaker contact page, to let them know you appreciate their efforts.]


Representative Charlie Rangel is chairman of the powerful House Ways And Means Committee -- who, pointedly, write our nation's tax code. Rangel seems to have misread some of this code, to put it mildly, when filling out his own taxes. Now, this could be the launching point for an argument to simplify our tax system, but instead it has become the launching point for Republicans to tarnish not only Rangel, but the whole committee and the important work they're doing on healthcare reform as well.

While what Rangel did didn't exactly happen last week, Republicans are turning up the heat on him to step down as chairman of the committee (which could set up a nasty succession fight among Democrats).

Plus, he continues the Republican theme of "Democrats cheat on their taxes," which had largely died down after a few Obama cabinet nominees got torpedoed by the issue. Which is just what the Democrats don't need right now.

So Rangel, for drawing such heat right now (by forgetting about half a million dollars in assets), is hereby awarded the Most Disappointing Democrat Of The Week.

Moral of this story: If you write the tax laws for everyone else, you'd better be damn sure you follow them yourself.

[Contact Representative Charlie Rangel on the House Ways And Means Committee chairman contact page to let him know what you think of his actions.]


Volume 97 (10/9/09)

While I'm not 100 percent sold on Senator Schumer's opt-out health care reform plan (I would need to see some details for that to happen), I have to say that as a political compromise "it might just work." So I'm going to use this week's talking points to offer some ideas for Democrats to sell the idea. Especially to other Democrats (which is where the whole battle rests currently). Also this week are a few talking points about Obama and Afghanistan, which I wrote about more extensively yesterday, if you're interested.

But before we get to that, I'd like to highlight a contest I wrote about last week. Because, even though we bloggers seem to be barred from entry, I still think the Washington Post is breaking some real ground in redefining the newspaper industry, with their "America's Next Great Pundit" contest. Have you ever thought you'd be a better opinionator than the people paid to do it? Now is your chance to prove it. Check out my column for details, and then get your 400-word essay together, and enter the contest at the Washington Post website. Good luck!


   This could get 60 votes

This is the strongest argument by far. The problem with the squabble between the Blue Dogs and the Progressives is that neither side wanted to appear to back down. The Blue Dogs, in particular, appeared ready to defeat reform this year to prove this. Progressives felt exactly the same way about the public option -- they would vote against any bill that didn't have it. The opt-out compromise could be a way to break this stalemate in the Senate.

"We are confident that the opt-out plan can get the required 60 votes in the Senate to move the bill forward. This means we will not have to resort to budget reconciliation to pass health care reform, because every Democrat can vote for this plan with a clear conscience. This is the first compromise I have seen yet which I think will get 60 enthusiastic votes on the Senate floor. I think the opt-out plan is going to be a winner."


   Saves the nationwide public option

Tie together the words "save" and "public option" as often as you can, and used "watered-down" to describe all the other plans.

"Every other compromise idea I've seen yet has watered down the public option to the point where it wouldn't work as designed. Co-ops, or forcing each state to come up with their own system would weaken the public option beyond repair. This is the first compromise I've seen yet which starts from the point of a nationwide public option. This opt-out idea could save the strong public option in the final bill."


   Allows both sides to claim victory

If you don't think face-saving is a big deal on Capitol Hill, then you don't know the place very well. The beauty of the opt-out plan -- which has been missing from the other compromises -- is that both sides can plausibly claim victory. This alone is enormously important.

"Those who feel that the public plan may not be to their state's liking can rest assured that their state -- if it so chooses -- will not have to participate. And those who favor the public option can vote for this knowing it is not some watered-down state version, but rather a nationwide plan from the very start. I think that both sides in this heartfelt debate can actually claim that fighting for what they believe has forged a stronger bill and a stronger compromise than anything else we've seen. Both sides deserve praise for sticking to their principles until a true compromise which addresses everyone's concerns could be reached."


   You can always opt out...

This one's important for convincing the Blue Dogs to support the idea, and is directed specifically at them.

"If your state decides that the public option is not a good fit, then you can always opt out of it. If your state thinks the idea will cost more than advertised, then you can always opt out. If your state's voters hate the concept of a public plan, then you can always opt out. If you don't want your state to participate in the public plan, then you can vote for this legislation and then convince your state's government to opt out of it. For all of the concerns some Democrats have had over the public option, the opt-out plan provides a safeguard against some federal mandate that isn't politically acceptable to your state's voters -- because they can always opt out."


   Dr. Dean supports it

This one is used primarily to assuage Progressive concerns about the plan.

"Dr. Howard Dean, for whom I have an enormous amount of respect in the healthcare reform debate, has come out in support of the opt-out plan. He has said the opt out plan, quote, is real reform, unquote. I don't think Howard Dean would support a plan that is some giveaway to the insurance industry or some sort of bill that is watered down to the point of not being effective, do you? If it's good enough for Dr. Dean, it is good enough for me."


   Afghanistan (part 1)

OK, we're going to change gears for these last two, and talk about the situation in Afghanistan. This subject has been a major media focus for the past few weeks, and there are a few things which need saying in this debate to counteract the breathlessness from the "journalists" quacking about it.

"President Obama is taking his time deciding his strategy for the next phase of the war in Afghanistan, just as President Bush took three months to decide on his 'surge' strategy in Iraq. While the media seems to feel that Obama is somehow dragging his feet, or taking too much time to make up his mind, we would all do well to remember that whatever strategy he comes up with, it will not be implemented until next spring, when the Taliban launches their yearly post-winter offensive. So taking a few weeks now to get it right will have no effect on the actual situation on the ground. Any increase in troops in the country won't happen for months, and even if they got there a few weeks early, if the mountain passes aren't open, it won't make a bit of difference. So let's give the president some elbow room here, folks."


   Afghanistan (part 2)

This one seems bizarre to me. Obama has already sent a lot more troops to Afghanistan than George W. Bush left there. He has already increased the war effort. But, strangely enough, when you watch the mainstream media, it's like this never happened. This needs some attention drawn to it.

"All this talk of President Obama 'doubling down' on the troop levels in Afghanistan ignores the fact that he has already doubled down there. One of the first things he did after he took office was to send 30,000 more troops over there. So when we're talking about McChrystal's requested 40,000 more troops, we are talking about actually tripling down on the troop levels. Because Obama has already doubled down on them. Just to make that clear."


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Cross-posted at: Democratic Underground