| A couple pieces of good news today on the healthcare front. First, this news: Senate majority leader Harry Reid said legislation coming out of Congress will have a public option. Additionally, Sen. Harkin said that no Republican will participate in the group that will merge the two Senate health care bills before sending one to the floor. Which makes sense, if you think about it for a half-second: Republicans have shown no interest in reform, and Senate Democrats ultimately decide whether a bill is filibustered.
The public option is alive and well, folks. It's slowly seeping into the consciousness of Congressional Democrats that any healthcare bill passed has to include it. Why? This chart. The public option is popular. Kevin Drum:
If they don't pass a healthcare bill at all, they'll be viewed as terminally lame. If they pass a bill, but it doesn't contain popular features that people want - like the public option - they'll be viewed as terminally lame. At a wonk level, a bill without a public option can be perfectly good. But wonks aren't a large voting bloc, and among people who do vote, the public option is very popular. So, um, why not pass it?
(Of course I disagree that reform without the public option "can be perfectly good." Well...it could if the regulations over private insurers had teeth...but...well...the same people who would define the regulations are the same people who say they can't pass a public option.)
Okay. Fine. A "public option" is on the table. But, what will it look like? Will it be open and available to all? Ezra Klein has summed up the various public option "compromises" of late (and interviews Maria Cantwell and Tom Carper about their proposals), but the one that's catching the eye of the DC insiders is Carper's compromise, which would essentially allow states to create their own public plans - although an amendment dropped into the Baucus bill by Ron Wyden may have already done that. Of the Carper/Wyden-type state-based compromise, Klein has this to say:
Each state would, in other words, be allowed to create a public option. And states could band together to give their public options more bargaining power and efficiencies of scale. This would do a couple of things. First, it would give residents access to a public competitor. Second, it would provide an acid test of whether a public competitor substantially changes an insurance market. Does it force private insurers to bring their prices down? Does it create more competition and transparency? Are consumers more satisfied? And if all that happens, will other states really resist adopting the public option?
The problem with it is that it is, at best, regional. It doesn't have the buying power of a national public option. But that's a question of votes. If Schumer's proposal doesn't have 60 votes, which is what he's currently saying, this might well be a better option than Snowe's trigger.
Wyden's amendment apparently would not place any restrictions on states as to how they would choose to implement their public plan. Is Wyden's amendment essentially the Senate version of Kucinich's HR 3200, which would allow states to set up single-payer healthcare systems? Is Carper's compromise essentially a reworking of the co-op scheme, but with states running the show?
In any case, things are looking up. It's no longer a question of "if" a public option is included, the question is now "what"? That said, we still need to do a lot of work to ensure that the public option is robust and available to as many people as possible... |
