Senate opt-out public option won't start until 2014, and won't cover abortion procedures

by: Chris Bowers

Wed Nov 18, 2009 at 20:19


The Senate health care bill is now online. It is a lot to wade through, but I can tell you a few things right off the bat:

  1. The opt-out public option in the bill will not begin until 2014.  This is one year later than even the 2013 date included in earlier versions of the bill.

  2. The opt-out mechanism is simply when states pass a law.  So, that means both state legislatures (except in Nebraska), plus a Governor's signature.  Now, even if the opt-out public option passes into law, conservatives have an extra year to try and organize against it.

  3. The penalty for individuals not purchasing health insurance will be $95, and also will not start until 2014.

  4. Also, while the Senate bill does not include Stupak language in the House bill, the public option will not cover abortion procedures.
Obviously, in a bill this large, these bullet points just scratch the surface.  Consider them appetizers.
Chris Bowers :: Senate opt-out public option won't start until 2014, and won't cover abortion procedures

Tags: , , , (All Tags)
Print Friendly View Send As Email
Senate opt-out public option won't start until 2014, and won't cover abortion procedures | 65 comments
2014 is disgraceful (4.00 / 7)
A fair-minded person could say the Dems deserve to lose elections until they actually deliver coverage & other improvements to those who need them.

The abortion exclusion is cowardly but probably inevitable.  Insurance companies (in this case the gov't) don't on average give any money for any care: that's the premium payers.

Lose to whom? (0.00 / 0)
Get a hold of yourself!
[ Parent ]
Does it really, really matter? (4.00 / 3)
Only if one believes that a) the D party has earned progressives' endorsements by bitch-slap after bitch-slap, b) the D party can be shifted to the left by continuing progressive endorsement and c) fervent support is going to get the D "base" anything that matters, which does not include token gestures and perennial platitudes.

I wonder if the D party is infiltrating blogs to support the "Whaddaya gonna do, vote Republican?" sentiment.  I notice that quite a few bloggers and commenters, especially of late, treat the D party like certain gene donors treat their spawn: let it beat the stuffing out of you while gently scolding it and then become indignant when someone suggests actually taking a hand to their tender little precious.

[ Parent ]
And I wonder (4.00 / 1)
if the R party is infiltrating blogs with people posing as progressives trying to get as many people as they can not to vote for Democrats.

I mean, since we're throwing out baseless speculation and all.

[ Parent ]
Baseless? (0.00 / 0)
Your charge has more base beneath it than mine, since the GOP apparently was caught funding Greens a while back.  But damn these self-reinforcing doctrines of learned helplessness are tough to swallow when you see them for exactly what they are, and since the D party lost (or bloody well should have) any trust the progressive movement ever had for them, it is worth considering just what the D leadership has to gain from promoting the establishment over the alternative.
[ Parent ]
Maybe I should clarify my original sentiment, now that we have suspicion of infiltrators! (0.00 / 0)
I meant what I said: Maybe Dems do not deserve to have their party name mean "Vote for me, I deserve to win," given that their 60-seat Senate majority is not in fact motivated to take bold steps for the welfare of the American people.

I want the wretched Dems to succeed and stick to their principles -- they just don't deserve what I (the battered spouse if you will) wish for them.

Now, I will vote for Dems vs. GOPers, and I will endorse them.  I just can't say with a straight face to my fellow Americans that WE (the Dems) deserve their votes because of what we're working to accomplish.  Because our pols are not in fact working so terribly hard to accomplish jack.  The ones whose constituents most need relief are the ones whose Senators are running scared towards GOP talking points and policies.

I'm secure in my ideology.  I know what policies I want.  But I know that if all I have in my persuasive repertoire is that my ideology leads to a better world, my fellow citizens can quite legitimately say, show me something real that your ideology inspires so-called Dems to do, or I'm going back to watching TV instead of voting.

(To clarify further: I could point to things the Dems have done.  But given how far those accomplishments rank below what they should have done based on caring about the American people's welfare,  I can't expect those things to have the needed persuasive oomph with my fellow citizens.)

[ Parent ]
After 8 years of Bush... (3.00 / 4)
Yes... It definitely matters.  I'd much rather be disappointed, then to be outright raped by the GOP.    Are people really that stupid that they forgot just how much shittier things were and the horrific shit passed under Bush.
[ Parent ]
The Presidency is generally unimportant (4.00 / 2)
since there are lots of people with lots of money who simply won't tolerate an executive branch to the left of Bill Clinton.  Rich financiers rabble-rousing and brandishing the weapons, just like 70 years ago, tend to put a lid on "uppity" Executives.  (A good reason to start electing single loners to public office!)

I suppose there's some solace to be taken in a President who appoints reasonable justices to SCOTUS, but a traitorous douche like Rahm more than cancels out any of that good in the short term.

[ Parent ]
Curious (4.00 / 1)
(A good reason to start electing single loners to public office!)

What exactly do you mean by this?  That they have less to lose, or what?

BTW, I think FDR was still in sum well to the left of Bill Clinton, in the context of his times, and several Presidents since, including arguably Eisenhower, Nixon, and Ford, were also to his left.  And I strenuously disagree that the Presidency is unimportant on economic matters.  I don't think that any Congress has ever been collectively to the left of FDR, as you seem to be implying?  Obviously, many individual members have been, but that's only so useful.

Still, I agree that the wealthy/business have power in this country that goes well beyond what can be explained by direct, objective sources (I don't believe that campaign contributions are near as important as some think.)  I'm not quite sure of the mechanism(s), though.

[ Parent ]
Exactly (4.00 / 1)
Less opportunity for "Nice family you got there, it would be a shame if something were to... happen to it".  It's a thought, anyway.

I haven't studied past Congresses in detail (though I probably ought to) so I can't speak to that, but with two polarized coalitions, members of a splinter group of the majority enjoy more power the closer the majority, as seen in the potency and urgency of filibuster threats.  

There are other mechanisms, to be sure.  Clearly the revolving door between the private sector and public service allows individuals to work to legislate public gains for private entities and be rewarded with a better paying job on K Street.  Somehow the "seeking better opportunities" aspect greatly outshines the "appearance of quid pro quo", and besides it's too late to do anything about it by that point.  It's also worth considering that party-building activities at the national level have fewer size limits on donations and, additionally being less visible than candidates/movements, are an excellent point where to exert influence on party platforms and direction of campaign funds.

But I'm convinced that the Beltway cocktail weenie circuit has as much or more to do with the breakdown of accoutnability to constitutents as anything: lobbyists and legislators are more like each other than like us.

[ Parent ]
Don't become confused: Goodman is a LIBERTARIAN! (4.00 / 2)
Highly unlikely that he's working for the "D-Party" to spread such an unhelpful, probably counter-productive argument. Simply ignore him.
[ Parent ]
The other half of the GOP (0.00 / 0)


"It sounds wrong...
     ...but its right."
[ Parent ]
From what I can tell (0.00 / 0)
One can purchase a policy that covers abortions with federal funds in the exchange, but that the federal funds will only cover everything in the premium and the coverage up to but exclusive of abortion. The buyer would have to contribute their own funds to meet the full purchase price.

My take on the opt-out is that states can opt-out at any time. They're not automatically in it and have to leave after a year or two of operation. That raises significantly the number of states that will indeed exercise an opt-out, perhaps as high as 15-20.

An excellent saftey mechanism (0.00 / 0)
If the politics don't translate to good policy

- which is the default assumption: entropy -

then

1. The rest of the reforms stay in place

2. The government-run debacle disappears as nearly all states opt out

3. The Dems simply give people free money to buy whatever private health insurance that suits their fancy.

Which ought to be how the welfare state works anyway.

[ Parent ]
you have to be f@(#*^& kidding (4.00 / 6)
2. The government-run debacle disappears as nearly all states opt out

No public option, no real reform. What part of that don't you get?

And how do you know it'll be a "debacle", that sounds like a rightwing talking point.

3. The Dems simply give people free money to buy whatever private health insurance that suits their fancy.

And when the insurance companies raise their rates through the roof, and the subsidies stay the same, then what? Without a public option, there's no mechanism for keeping their prices down.

[ Parent ]
Pitchforks and torches? (4.00 / 1)
Without a public option, there's no mechanism for keeping their prices down.

Tar, feathers and a rail?

"It sounds wrong...
     ...but its right."

[ Parent ]
I don't understand how (4.00 / 6)
someone can find a site like this, and say such ignorant things. Without cost containment, there is no reform for the simple reason that without cost containment, health care bankrupts the system.  
[ Parent ]
Hey, Goodman, could you pls add a sig line to your profile,... (4.00 / 1)
...something like "RON PAUL 2012" or "Libertarians 4 te win!", so that people don't become confused and mistake you for a liberal?
[ Parent ]
He's a liberal libertarian (4.00 / 2)
Whatever errors he makes, standard libertarians don't support things like the government giving people money "to buy whatever private health insurance that suits their fancy."  Or any welfare state at all, for that matter.
[ Parent ]
Yeah they do. (4.00 / 1)
"Government giving people money to buy private health insurance" = a massive give-away of public money to powerful corporations. Since Libertarianism is nothing more than apologetics for "might makes right," there is no conflict there.

Montani semper liberi
[ Parent ]
There are some genuine libertarians n/t (0.00 / 0)

[ Parent ]
re: opt-out (0.00 / 0)
My take on the opt-out is that states can opt-out at any time. They're not automatically in it and have to leave after a year or two of operation. That raises significantly the number of states that will indeed exercise an opt-out, perhaps as high as 15-20.

if the states are not in automatically that's bad

if the public option is operating for 2 years before it can be opted-out of, I seriously doubt the 15-20 number. but if it can be stopped before it starts then I could see it...

[ Parent ]
He's wrong... (0.00 / 0)
Robert's analysis is wrong.
[ Parent ]
questions (0.00 / 0)
1. Does the bill require states to wait some period of time after the PO goes into effect before opting out?  Or can they opt out right away, before the PO even gets started?

2. Can states decide on the question of opting out via popular vote/referenda, like in CA?

3. Is the $95 penalty per year?  $95 per what?  Unless that time increment is anything below month, that seems like a very low penalty - which is good, from my POV, since I think having any kind of fine, as opposed to autoenrollment or health savings accounts, is ridiculous to begin with.

4. Did any version of the PO ever cover abortion procedures?  I'm surprised that's even something worth noting.

4. (0.00 / 0)
Hyde was never in jeopardy, Obama made it clear in his State of the Union. Political reality makes it clearer.

The solace or agony that some derive from contemplating the difference between Hyde and Stupak is laughable for the following reason:

There is NO WAY the Pooh-Bahs of the Republican Party are going to stand in the way of poor people murdering their own offspring: that's just bunk for the hicks.

[ Parent ]
It's illegal to murder children. (4.00 / 4)
What are you talking about?

Montani semper liberi
[ Parent ]
You feign (2.67 / 3)
not getting it.
[ Parent ]
No, I get it very well. (4.00 / 3)
Anyone who believes in forced childbirth is not an ally.

Montani semper liberi
[ Parent ]
They can opt out any time they like (4.00 / 4)
Just by passing a state law, which means popular vote/referenda is on the table. FDL Action found the key section:

(3)STATE OPT OUT.-
(A) IN GENERAL.-A State may elect to prohibit Exchanges in such State from offering a community health insurance option if such State enacts a law to provide for such prohibition.
(B) TERMINATION OF OPT OUT.-A Statemay repeal a law described in subparagraph (A) and provide for the offering of such an option through the Exchange.

This ensures 15-20 states will opt out, and that even blue states will see expensive ballot fights funded by insurers promoting opt-outs.

[ Parent ]
Here's another good healthcare bill article on FDL that covers abortion (4.00 / 1)
http://fdlaction.firedoglake.c...

It describes the various proposals (Capps, Ellsworth, Stupak and Senate Finance Cmmtee) for handling abortion coverage. Pretty much the way you described it above.

The language dealing with abortion in the Senate Finance Committee bill is very similar to the Capps proposal. (Harry Reid is expected to include the Finance Committee's language in the merged bill.) Abortion services would need to be paid for by segregated funds. Depending on state law, every region of the exchange must have at least one plan that covers and one plan that does not cover abortion. The Senate Finance Committee bill is, of course, silent on how the public option would handle abortion because it did not contain a public option
(emphasis added)

Those who cannot remember the past are condemned to repeat it.

George Santayana, The Life of Reason, Volume 1, 1905
[ Parent ]
No... (0.00 / 0)
But thank you for spreading incorrect information.    Seriously, a high school student council member could see your interpretation is wrong.
[ Parent ]
penalty for non-coverage (4.00 / 1)
$95 for the first year, $350 for year two, but for year three it's $750 and gets indexed up with COLA automatically from there.  Still not punitive enough to force some people into the system, IMHO.
[ Parent ]
and that's a bad thing? (0.00 / 0)
without full subsidies, I'll be saving up to pay the penalties
[ Parent ]
Because you still can't afford the insurance... (0.00 / 0)
..or because you're healthy and want to take the risk??? Doesn't make much sense to me...
[ Parent ]
because I still can't afford the insurance (4.00 / 2)
but the government does not care for I have not bred
[ Parent ]
Consider it a contribution (0.00 / 0)
to the future of single-payer health care.
[ Parent ]
Isn't #2 a good thing? (0.00 / 0)
Passing a law is the hardest way to opt out of the public option, since it requires action by both houses of the state legislature plus approval of the governor (or a veto override). That's a lot better than being able to opt out by gubernatorial decree (which only requires the action of one person) or by ballot initiative (which we've seen can be easily demagogued with a well-funded campaign).

If we have to have state opt-out, the states having to pass a law to do it seems like the best option to me.

State law = ballot initiative (4.00 / 2)
A ballot initiative, at least in California and in states with similar rules, is a "state law," enacted by the people and not the legislature. Since the bill makes no distinction, that definitely means ballot initiatives are on the table.
[ Parent ]
Most states don't allow laws to be passed by ballot initiative (0.00 / 0)
I think California is an exception to that rule. Which is part of the reason the state is so screwed up, of course.
[ Parent ]
Not so. (0.00 / 0)
22 states allow that. Most of them are west of the Mississippi.
[ Parent ]
Hmm, didn't know it was so many (4.00 / 1)
So I guess we have to look elsewhere for blame for California's problems.
[ Parent ]
Diogenes would dim his lantern for that response. (4.00 / 1)

[ Parent ]
No, we don't actually... (0.00 / 0)

[ Parent ]
The problem with California (0.00 / 0)
is that 63% of the people passed Prop 13, which requires a 67% majority to raise taxes. It's the same as 51 senators deciding to uphold a filibuster rule that creates an effective majority requirement of 60.  I think we should recognize this as a principle of democracy: no majority has the right to impose a requirement of an even greater majority than themselves to approve an action.  
[ Parent ]
considering the populariry of the public option (4.00 / 2)
I'd welcome ballot intiativates.  
[ Parent ]
In Texas, for instance, I suspect it would be easy (4.00 / 2)
for the state lege to pass an opt-out and get the governor's signature. Oklahoma too, and a dozen other states.

This is a ready-made issue for the right to organize around and build a movement.

The teabaggers will take tons of money from insurers, who want to defeat the PO, and rail against how Washington wants to impose evil socialist totalitarian Obamacare on everyone in their state.

Because the right knows how to organize and the left doesn't, they have a good shot at winning in quite a few states.

The left can't even stop one Democratic Congress (with a Senate supermajority) from restricting abortion rights in the name of "reform." That's with a strong mandate to fix health care and a President Obama to drive up involvement.

What are the odds that they can win fifty battles in fifty state legislatures?

And states will have a lot of freedom to opt out. They could pass an opt-in law, but with triggers that are intended never to be pulled. This way, even legislators in strongly blue states can take insurers' money, pass the buck, and yet get the credit for doing something when in fact they have done nothing.

There's just too many ways this can go wrong.

[ Parent ]
If it's as popular as it is (4.00 / 3)
Any Republican governor/legislature who opts out will face the wrath of voters at the polls.

Oklahoma has a Democratic governor. I don't know how popular the public option is, but the Democratic candidate for Governor next year will LOVE it if it is in fact popular in Oklahoma.

This issue alone can help keep a lot of Democrats in office at the state level next year...which is important for redistricting.  

[ Parent ]
the politicians in these states (4.00 / 3)
have been voting against their constituents' interests for decades, and yet they're still returned to office time after time.

Democrats are incapable of understanding that it's not the issues that matter here, it's all about the culture wars. These conservative politicians can mobilize a constituency that votes on the basis of abortion, gay marriage, and God, and nothing else.

Neither Social Security nor Medicare were opt-out. If they had been there's no way they would have attained the critical density necessary to become sustainable.

And there was plenty of conservative opposition to Social Security at the time, plenty of wingnuts claiming it was evil socialism that would make Americans fat and lazy. It was only when they experienced its benefits that they relented in their opposition.

It will be the same with the public option. Unless the teabaggers get a direct and immediate benefit from it, they will continue to organize against it. And they will be well-funded by insurers who want to kill the PO.

[ Parent ]
Well, since the start date is the issue (0.00 / 0)
perhaps that can be a source of compromise between the Senate and House- that if the bill is to have an opt out, it must start much earlier.  
[ Parent ]
Well (4.00 / 2)
the politicians in these states (4.00 / 1)
have been voting against their constituents' interests for decades, and yet they're still returned to office time after time.

the people need to fucking wake up then. If they don't want the public option THAT badly, then what are we all getting ourselves tied in knots over? Most of the governor races where this matters are open seats. The only incumbent Republican governors running in states where this will matter are Utah, Idaho, the Dakotas, Nebraska and Arizona. Arizona will most likely have a Democratic governor next year. The rest of them are too small states to matter. Hey, maybe this issue alone will elect Democratic governors in the Dakotas.

There are, by my count, only 10 states with Republican governors and Republican legislatures...only Florida and Texas are large states. I dare Charlie Crist to sign a bill that will opt out of the public option. This issue alone will make Alex Sink, Terry Goddard, Roy Barnes governors.  

[ Parent ]
no one's going to "wake up" (4.00 / 10)
This is how it worked during FDR's presidency: the Democrats in Congress enacted a progressive policy under FDR's encouragement, and southern conservatives whined and bitched about it being an imposition of totalitarian socialism on the states, until the policy's utility became clear and it was very grudgingly accepted.

No one was given any chance to opt-out. The Democrats back then had the power, had Congress and the presidency, and they used that power. They didn't duck out of their responsibility by tossing it back into the lap of the states.

Look at all these teabaggers railing to "get the government out of my Medicare." They don't understand that Medicare is a government-run program, and they'll never understand, nor will they ever be grateful to the government for giving it to them. They will never be brought around to the idea of activist government being a force for good, and it's folly to try.

Why is it that Democrats are so fucking obsessed with trying to force irrational people to see reason?

"Our ideas are so blindingly and obviously superior, so clearly high and noble in intention, that people will automatically choose them without having their utility proven to them by direct experience." That's such a silly attitude. We won the election, we have nothing to prove, so why are we risking our policy agenda to prove a point?

There's always a contingent of people who are suspicious of anything new simply because it's new. If it's left up to them, they will bury the PO.

And unfortunately, there are a lot of states where that mentality holds sway and controls the state government. Add to that picture the immense financial power of the insurance companies, and the ease with which state legislatures are corrupted (even more so than the US Congress), and you'll have a lot of trouble getting the PO through even in some "blue" states.

[ Parent ]
there is also a lot o fmiss information (4.00 / 2)
out there deliberately designed to confuse people who do not follow politics like we do. Forgetting the crazies, we can not ignore higher information burden that progressives have when it comes to well progress. the conservative argument relies on what people "know to be true" whereas progressive arguments require that you tell people that what they "know to be true" is actually wrong. Even if the voters are open, that is a higher standard for us to meet.
[ Parent ]
Actually on a lot of economic policy (4.00 / 1)
What people "know to be true" fits rather nicely with our policy preferences.  We need to take advantage of this better.
[ Parent ]
You misunderstand the point (4.00 / 1)
they want the theory, but do not know the specifics, which will inform them whether choice a or choice b is correct.
[ Parent ]
No (4.00 / 2)
It's popular nationwide, but that is skewed by the blue states. Markos's polls have shown the PO is opposed by majorities in states like AR, KY, and NE.

Republicans in those states will face little if any wrath, certainly none that risks their careers, for exercising an opt-out.

[ Parent ]
AR? (0.00 / 0)

[ Parent ]
AR = Arkansas ... (0.00 / 0)
don't you know your two letter state postal abbreviations?   ;-)
[ Parent ]
NE yes (4.00 / 1)
but the public option is popular in Arkansas, though I'm not certain the people in Arkansas even know what the hell it is.  
[ Parent ]
The latest poll I could find shows (0.00 / 0)
that a plurality of voters in Nebraska want the public option.

QUESTION: Would you favor or oppose the government offering everyone a government administered health insurance plan -- something like the Medicare coverage that people 65 and older get -- that would compete with private health insurance plans? (Wording of NYT poll)

FAVOR 46

OPPOSE 44

NOT SURE 10

So, 46% of Nebraskans favor a public option (margin of error 4.5%).

The same poll found that Ben Nelson could face rough times back home if he opposes healthcare reform.


[ Parent ]
state laws do NOT = race to bottom! (4.00 / 1)
When I feel bad I sing "My Favorite Things" to cheer myself up!

States won't turn into a race to the bottom! not like they do on unemployment, health care, retraining, schools, roads ...

northern industries were NOT abandonded so companies could set up shop in southern backwaters with NOTHING, especially no taxes which pay for nothgin!

you're stratergerizing on what states will do is VERY wrong.

rmm.


It is too full o' the milk of human kindness To catch the nearest way

[ Parent ]
Penalty (4.00 / 1)
The penalty for individuals not purchasing health insurance will be $95, and also will not start until 2014.

Penalty is $95 in 2014, $350 in $2015, $750 in 2016, and indexed to inflation after that.

Check out more provisions of the bill here

in 2017 they'll pin down single people and kick them in the ribs (4.00 / 5)
in 2018 they'll key their cars
[ Parent ]
Procedural Question (4.00 / 1)
If a public option is in this bill, doesn't that technically mean that it should take 60 votes to remove it? At least as long as a democrat filibusters any amendment  designed to do just that.
yes (4.00 / 1)
there will likely to be an amendment to strip it on the floor...it will need 60 votes to be stripped.  
[ Parent ]
doesn't 60 means filibustering? (4.00 / 1)
will po supporters filibuster?

the republicrats will say 'hey, that's a great plan, we'll help filibustering'

see david waldman:

It would take 60 votes to add it in because Republicans would filibuster an amendment to add it. But an amendment to strip it out? What happens to that amendment?

Does a public option supporter filibuster it? Maybe. And what do Republicans say to that? OK, great! We'll help! Let's all vote no on cloture on this amendment, and then we'll all just sit and stare at each other until you guys realize that we're stuck on this amendment forever, and we never get to a vote on final passage. Fine with us.

http://www.congressmatters.com...

stupak too:

http://www.congressmatters.com...

[ Parent ]
Senate opt-out public option won't start until 2014, and won't cover abortion procedures | 65 comments
Donate to Open Left







QUICK HITS

Friends of the Earth thanks the OpenLeft community for the ideas you generate and your contributions to the progressive movement.
As an anti-spam measure, there is a 24-hour waiting period after registering before new users can comment.
blog advertising is good for you
blog advertising is good for you
LIBERAL INSTITUTIONS
STATE BLOGS
SEARCH

   

Advanced Search

Home | RSS/XML Feed | Register | Contact

  © OpenLeft 2007-2009, Powered by SoapBlox