Yesterday, I argued that it is possible to pass a public option in health insurance reform legislation now if Democrats wanted to do so. Today, in a blockbuster story at TPMDC, Brian Beutler quotes an expert source who make the case that, due to the nature of the reconciliation process, it is actually much easier to pass a public option through reconciliation the stronger that public option is. From the story:
According to Martin Paone, a legislative expert who's helping Democrats map out legislative strategy, a more robust public option--one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers--would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies "will have to be offset and if [the health care plan] loses money beyond 2014...it will have to be sunsetted."
And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black--and thus prevent it from expiring. But though that may solve the procedural problems, conservative Democrats have balked at the idea creating such a momentous government program, and if they defected in great numbers, they could imperil the entire reform package.
Bottom line: because reconciliation requires a new government program to not lose money, a health care plan that is more likely to keep down health insurance costs will be easier to pass through reconciliation. Even opponents of health care reform admit that a the public option is the way to do this, given the constant conservative fretting about the inability of private insurers to compete with lower-cost public health insurance.
With this in mind, here is the updated choice facing the Democratic Congressional leadership and Obama administration:
- Democrats could pass a public option through reconciliation that is strong enough to keep down the cost of health care. This has the benefit of being more likely to pass procedural muster, which in turn means that there is no need to break the Progressive Block, face backlash from the progressive grassroots, find 60 votes in the Senate, or use the "nuclear option" to ignore the Parliamentarian. It will also have the advantages of covering more insured people, and keeping health insurance premiums lower.
The negatives of this approach are that the Democratic leadership and Obama administration will face ideological opposition from conservative Democrats, severe financial and electoral targeting repercussions from industry groups, and they will look less bipartisan.
- The Democratic Congressional leadership could decide not to try and pass a strong public option. This has the exact opposite advantages and disadvantages of option #1.
This is turning into a real "whose side are you on" decision. One the one hand, you can side with conservative Democrats, industry groups, the status quo, and the Village process fetish. On the other hand, you can side with Congressional Progressives, the grassroots groups, actually passing legislation, insuring more people, and reducing health care costs.
And, as I said yesterday, this is a choice, not something the Democratic leadership and Obama administration are forced to do one way or the other. Let's see which side they choose.
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