Progressive Caucus Draws a Line on Health Care

by: Chris Bowers

Thu Apr 02, 2009 at 17:31


Something unexpected just happened on Capitol Hill today--the Congressional Progressive Caucus drew a line in the sand on something. In a letter sent to Speaker Pelosi, Representatives Woolsey and Grijalva stated that most of the 77-member progressive caucus will not support a health care plan that lacks a public option with a level playing field. I like it:

Dear Madam Speaker and Majority Leader,

Regarding the upcoming health care reform debate, we believe it is important for you to know that virtually the entire 77-Member Congressional Progressive Caucus (CPC) prefers a single-payer approach to healthcare reform.  Therefore, it will come as no surprise as you work to craft comprehensive health care reform legislation, that we urge the inclusion of a public plan option, at a minimum, in the final legislation.  We have polled CPC Members and a strong majority will not support legislation that does not include a public plan option that is supported on a level playing field with private health insurance plans.

We look forward to working with you to ensure inclusion of a public plan option and the successful passage of healthcare legislation that will provide a choice of  quality healthcare for all Americans

Sincerely,
Lynn Woolsey, Co-Chair, Congressional Progressive Caucus
Raul Grijalva, Co-Chair, Congressional Progressive Caucus

As the conservodems in the Senate seem mainly fixated on cap and trade, it appears that Progressives have fired the opening shot on health care. If there is no public option, then there is no deal.

This isn't an issue where House Blue Dogs and Senate Conservodems can hide behind their "red" districts in opposition. Here is the most recent poll I could find that seemed to talk about a public option:

CBS News/New York Times Poll. Jan. 11-15, 2009. N=1,112 adults nationwide. MoE ± 3.

"Should the government in Washington provide national health insurance, or is this something that should be left only to private enterprise?"

Government 59%--32% Private Enterprise

With a margin like that, only about 20-30 of the 435 congressional districts, and only about 4-5 states, would be opposed to a public option. And even then, the opposition would be pretty narrow. However, at the same time, terms like "public option" don't really mean much to people yet. The frames and terminology that will drive public opinion on this debate have not yet been set. Drawing a line in the sand is a good first step, but now we have to brace ourselves against what will inevitably be bi-partisan talking points about socialized medicine and government intruding on families. As long as the reconciliation process is still available for health care, as long as the progressive caucus holds a line on the public option, and as long as we can control the framing of the debate, this is a winnable campaign.

Good job, Congressional Progressive Caucus!  
Chris Bowers :: Progressive Caucus Draws a Line on Health Care

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Progressive Caucus Draws a Line on Health Care | 25 comments
Yahoo! (4.00 / 9)
I hope it is the first of many.  Win or lose, at least they finally showed up.  

They're asking for another four years -- in a just world, they'd get 10 to 20. ~~ Dennis Kucinich  
The Reid Factor (4.00 / 1)
Do we know that Spineless Harry will allow health care to be introduced via reconciliation?  How about Dinosaur Bob Byrd?  Will he go for that approach?
Byrd has now said he WON'T go for it (0.00 / 0)
I just saw this article on TPM, quoting The Dinosaur as saying he's against using reconciliation to pass health care:

http://tpmdc.talkingpointsmemo...

[ Parent ]
Real reform won't get through the Senate (4.00 / 8)
I'll just say it right now. Any "reform" measure that gets through the Senate will just be some species of turd blossom. The smugness of the usual suspects in the senate is just too plainly apparent, Reid and Baucus especially.

But if the progressives are willing to make a real, substantive stand, then the people will be able to start making some stark distinctions going forward. Could make the next election cycle a lot more interesting in a good way.

I'd rather have the people see just how corrupt the Senate is than pass some bullshit healthcare Deform. That's a harsh thing to say, given how many people will suffer in the interim, but they're going to suffer anyway. Might as well suffer for something real, than this bullshit.

"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn

[ Parent ]
Are they serious? (4.00 / 7)
I know Rep. Grijalva -- he's from my state, and he's very serious -- but I don't really know what to expect from the others. I'm hopeful, but as always, I'm worried that they'll trade this away at some point. Back in Frances Perkins' day, the AMA stopped it. The insurance companies are a far more powerful lobby than the AMA ever was, perhaps more powerful now than they were in 1993.

The Caucus -- to its everlasting credit -- has now painted targets on its members' backs. You're right Chris, we have to stand behind them; I just hope that when it comes down to the wire, they'll continue to stand with us.

Time to write some thank you notes! (4.00 / 6)


"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn
[ Parent ]
Where's The list? (0.00 / 0)
Who belongs to the caucus?  Besides kudos for this new display of backbone, we might encourage our non-member Representatives to join, especially if, such as mine, they are from safe Democratic districts.
[ Parent ]
There's a list on Wikipedia (4.00 / 1)
[ Parent ]
Thanks.... (4.00 / 1)
mine is a member.  There seems to be a decent overlap with the Black Caucus.
[ Parent ]
Here's the email address and URL for the caucus (0.00 / 0)
info@congressionalprogressivecaucus.org

http://cpc.grijalva.house.gov/

They have a web form to comment on, but it just eated my message, so I don't recommend that.

"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn

[ Parent ]
Email bounced too (0.00 / 0)
I just sent a note to the email address and it bounced: "64.202.166.12 does not like recipient." So I guess we have to send a note to our individual Reps.
[ Parent ]
Good politics, good policy (4.00 / 5)
A plan without a strong public option isn't worth passing.

I wonder if this will lead Obama to actually meet with the Progressive Caucus.

I'm confident that Obama would be willing to bargain away a public option in order to pass a bill, so I guess we'll have to see if Rahm can bust enough kneecaps.


If Rahm wants to bust kneecaps (4.00 / 3)
This is probably the worst issue to do it on and we know he's been in bed with the Healthcare Denial Industry for many moons now. I haven't seen a poll with less than 60% support for single payer in many months now. As the economy continues to crumble, people lose their jobs and their healthcare... so when the Senate does it's typical, "leave us alone and shut the fuck up" whining while it caters to corporate lobbyists, the public reaction will be most sour when "reform" fails. They'll polish a turd, call it "reform" and will proclaim, "It's the best we can do." But it won't do much of anything except further enrich that industry. That's all this is really about in the Senate anyway.

Obama will probably prove weak on this issue. He doesn't want to piss off his major medical industry donors. He doesn't want to piss off the Senate leadership. He doesn't want to piss off the Republicans or the "moderates" who are all busy making major bank on the "deliberations." So he'll say, "Well, we tried and this turd polishes up real nice."

So reform will likely die a quiet death in the Senate shredding room.

All this will happen while millions of people become more desperate than they are now. If the CPC sticks to their guns, they will be staking out valuable territory when people get really pissed off. So anyone who stakes out the high ground on this will look a lot better in the next election cycle. Blue Dogs beware!



"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn

[ Parent ]
I disagree... (4.00 / 1)
Sibelius just said she wants a public option, the house wants a public option, even friggin' Baucus wants a public option...

What is MORE likely to happen is that the definition of "public option" will change...  Several house leaders are already hinting on this... Instead of a medicare-type plan, the "public option" will allow us to enroll in the federal employees and congressional health plan.  Of course that health plan is nothing but a smorgasbord of private plans that allow people to pick and choose, so I don't see what the real benefit or difference is... In defense of the move, those plans are really, friggin' good plans, with better coverage than what a medicare-type public plan would provide.  What I don't understand is how that would save anyone any money, nor does it specify how much it would cost...

I think that is what the likely end result will be... the public option will actually end up being privatized....  Something like this could be framed very well to the public and be quite popular in theory.... If the costs are reasonable for the policy holder, then they might benefit too... but, there is no way the taxpayer would... it's still a mega giveaway to the insurance industry, which is why it's extremely likely to happen.

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!

[ Parent ]
Right, which points to the real problem, or one of them... (4.00 / 2)
In the case of Baucus, what he actually said is he wants a public option solely for the purpose of keeping the feet of the insurers "to the fire." Now, to my mind and maybe I'm wrong in interpreting it this way, that's a pretty hollow position. Indeed, Baucus is also against using the reconciliation process and instead wants to let the Rethuglicans filibuster. Somehow, I don't think he's playing for our team.

What lobbyist (or massive group of lobbyists colluding on this process) would bother to take the "public option" seriously if this is the attitude of the committee chair that will put the bill to the floor? Baucus has also publicly stated that single payer is off the table, so that doesn't give him much leverage when he's already flushed the big stick down the loo. I can't really speak to Sibelius, but if this is just a matter of hollow posturing, it doesn't count for much in real terms.

Lastly, if the "public option" is in fact privatized, how is that a public option?

I agree that the corporatist model can be sold, but I also hope your scenario turns out wrong. I just don't think it will work in any appreciable way. It will just be business as usual and I think most people who have to deal with that industry will find this out rather quickly. Healthcare will still be denied, rationing by spreadsheet will continue to get worse and the only real "reform" will be the size of public subsidies of private profits (wait, where have we heard that before?). I realize I'm being pretty cynical here, but I just can't help thinking the key people in the Senate (Reid and Baucus) are vastly more cynical than I, especially after their recent STFU remarks to "whining liberals."

If the final bill ends up looking like the Massachusetts program, which is rumored at times, then look out. Individual mandates w/ obscenely high premiums, taxing employee based insurance and a declining economy with mass unemployment will not have pleasant results, methinks. Issuing fines to unemployed people for not getting insurance won't go over too well either.

Better to sink a bad bill and get people mad in time for the next election cycle than let a porcine lipstick model get onto Obama's desk. I'm happy the CPC has taken a stand. If nothing else it lays the groundwork for Reform 2.0, but maybe it can have a positive impact on Reform 1.0.  

"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn

[ Parent ]
I'm trying to figure out... (4.00 / 2)
...what the benefit of a "privatized" public option would be... how would that be any different than anything else.  

Many large companies don't pay insurance premiums for health care clams(i.e. self insured), but pay for the health care directly--they only have insurers run the administration of the plans for a fixed fee.  In most of those cases, the resulting coverage is much better than if the plan was purchased directly from the insurer 'cos the employers aren't nickle and diming their employees with denied benefits.  The insurers have no incentive to challenge claims 'cos it's not on their dime, and denying coverage and making life hell for the employees who could make them demand a different plan from their employer in the future.  So, I guess the one big benefit of such a "public option" would be that the government pays directly for all the costs with the insures only acting as an administrator.  

I do not know if that is how the federal government administers their plans, but if they are the direct payer, then, we kind of do have a public option with this setup.  Remember, that the administration of medicare is also farmed out to third parties in the private sector, so it might not be as bad as we assume...

I will get some more info...

REID: Voting against us was never part of our arrangement!
SPECTER: I am altering the deal! Pray I don't alter it any further!
REID: This deal keeps getting worse all the time!

[ Parent ]
The devil is in the details, as they say (0.00 / 0)
I don't know much of anything about the congressional healthcare thing. If they use private carriers, then it doesn't really seem to be a very public thing, except that the USG picks up the tab on a large portion of it. How it works is unknown to me.

ONe of the reasons I'm particularly strident on the health care issue is that it speaks to many of our nation's ills. Single payer would be a huge boon for the economy, creating jobs...it would also make US companies much more competitive in the global economy. It would ruin this notion of privatization, which is now and always has been a neo-liberal scam to seize the public goods and turn them over to private interests. It would also be the most democratic of all solutions and would make healthcare accountable to the people.

So I'm open to any option that makes significant steps in that direction. My own sense is that once private industry has to compete with the public option, they will be done soon enough.

"In our country, the lie has become not just a moral category but a pillar of the State" -- Alexander Solzhenitsyn

[ Parent ]
Hooray (4.00 / 3)
hopefully they'll hire a full time communications person so people achually see this and their awesome budget plan.  

John McCain: Beacuse lobbyists should have more power
I am really proud (4.00 / 2)
to have Lynn Woolsey as my congresswoman. I was happy to see this, and called her San Rafael office to thank her right after I read this.
leverage public sentiment, (0.00 / 0)
and drop the hammer.

now is the time to do it.

I'd like to see them go farther (4.00 / 1)
As stated, this gives "centrist" Dems a choice between a very liberal version of health care and no change at all.  Who thinks that so-called centrists will veer left, given that choice?

I advocate cross-issue pressures. Here's an example. Let's say that progressives believe that Obama isn't going far enough in his advocacy to sway the middle.  Maybe this fight occurs just after Ruth Bader Ginsberg has retired and the next Supreme Court term is looking at some key decisions that are likely to be split 4-4 on who is left.  Obama makes an appointment.  It could even be something historic like the first black woman on the court.  Like-minded Senate progressives should consider supporting a possible Republican filibuster and try to hold the nomination hostage until Obama changes course on health care.

That's an extreme example, but something more plausible would be to try to trade concessions on something to do with Afghanistan that progressives had previously been blocking for single payer.  Progressives should consider going so far as to find things to block that they would normally vote for (or support things they would normally vote against) in order create political commodities that can be traded for votes on health care.

Things You Don't Talk About in Polite Company: Religion, Politics, the Occasional Intersection of Both

Easiest change (4.00 / 2)
Universal coverage of children is a reasonable and inexpensive goal even for this Congress. Medical insurance for kids is relatively cheap.  Kids are by and large pretty healthy.  Many of the most expensive ailments are rare in children or come later.

The 2009 Kaiser study showed just 8.9 million children (11%) uninsured.  Twenty million were covered by Medicaid or SCHIP.  With SCHIP adding 4 million more kids, it would be easy to finish the job by including the other 5 million.  Problems?  The uninsured currently are plurality Hispanic (38%) and include a healthy share of illegals (11% of ununsured kids as of 2007).  Although primarily poor, there are some well to do kids in the mix.

Most states with a high percentage of uninsured are in the south and Mountain west.  Two odd exceptions are New Jersey and Oregon.  New Jersey makes it nearly impossible to get single coverage for self employed.  Insurance agents actually advise putting an "employee", even a fake employee on the plan just to qualify.  (NY State allows independents to get insurance through community groups including the Chamber of Commerce).  I suspect that is part of the problem.

Some (not all) NY plans are "family" coverage including an unlimited number of kids and a spouse.  Really great for a single mom or dad to have to pay more to cover a non-exisatent spouse.  Even a buy-in for kids only at a good rate would draw some coverage.  Single parent and multi generational families have much poorer coverage than two parent families according to Kaiser.

Coverage for working age adults (Kaiser says "non-elderly") is far more expensive and involves far more individuals (around 36 million then, more now).  The big step won't come, alas in this session.  The little step is easily doable.  I figured child coverage was it back in Iowa.  And I was pissed.

Nothing really to add… (4.00 / 1)
...just think both this post and the comments accompanying it are encouraging and insightful. Backbone, indeed...

"This ain't for the underground. This here is for the sun." -Saul Williams
Excellent news. (4.00 / 1)
If they want our support, there is a cost.  It's called progressive policies.

No public option, no health care reform, because it ain't really reform anyway without a publci option.  

hang on everyone (4.00 / 1)
You need to understand what "a level playing field" actually means, and I don't think you're really going to like it.

The Level Playing Field Plan. Insurers, predictably, howled that a public insurer with access to Medicare's market power would put them out of business. (Generally speaking, liberals agreed with that.) The messaging they settled on was conceptually odd but has proven pretty effective. A public insurer, they argued, would not be competing on a "level playing field." This might have caused someone to wonder when, exactly, the market had ever cared about "fair." But instead, this frame has been widely adopted, with Obama telling Chuck Grassley, "I recognize that there's that concern. I think it's a serious one and a real one. And we'll make sure that it gets addressed." In answer to this, Len Nichols proposed a public insurance plan that doesn't have access to Medicare's bargaining power, and this is the policy that CAP's paper advocates. This is not single-payer lite. It's just an insurer without shareholders or highly-paid executives. (I should note that some, like Harold Pollack, believe you could begin with this plan and end with the single-payer lite plan. I'm not convinced, but its possible.)

Such a public option would not achieve the kind of bargaining power to make it cost-effective.

Insert shameless blog promotion here.

Progressive Caucus Draws a Line on Health Care | 25 comments
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