I am still in a haze over the deal struck last night on the public option, not helped by the fact that they are keeping the details close while CBO scores the bill. As anyone who has read my past blog posts knows, I think the "details" on all these deals are incredibly important, and I don't believe in rushing to judgment until we have had a chance to analyze them. Clearly, though, there is both a lot of bad news in the reports coming out so far, and some good news as well.
The worst of the news (obviously, from my perspective) is the demise of the public option. Without knowing the details, it is hard to assess just how bleak things are, but the early reports make it sound like they have come close to killing it for everyone under 55, and above 150% of the poverty line. The one thing that could still salvage something decent is the nature is the trigger language, but I'm not hearing encouraging things about how good it is. And I am not going to sugarcoat this for you: this is a bitter disappointment. The result is a deeply flawed bill that will not control costs or provide a check on insurance company power the way it could or should have. I also think the politics of this are going to be very tough for the Democratic Party in both 2010 and 2012: people mandated to buy insurance without a public option they can go to will result in a lot of heartache for Democrats with middle class voters, and the disappointment the base feels on this issue will mean it will be much tougher for Democrats to recruit volunteers, raise money online, and turn out the base vote. They have just screwed themselves politically with this deal. Joe Lieberman, the conservative Democrat who absolutely refused to compromise or bargain in good faith, has just leveled a tough blow to his entire party.
However, there is some good news in reports of the compromise (again, waiting on the details):
- opening up Medicare to people under 65 for the first time would be an important substantive and symbolic victory, and would allow progressives a wedge to keep pushing in years to come to open it up even further.
- forcing insurers to pay out at least 90% of their revenue out in benefits (compared to the 82% on average they pay out now) is a very big and important victory, stopping the private insurance race to the bottom in terms of providing benefits that has been plaguing us for the last couple of decades.
- forcing insurance companies to offer more choices, similar to what federal employees get now, is actually a significant victory even though there is no public choice. Members of Congress are always going to make sure there is decent competition for themselves, and if getting a package like theirs means we get more competition for everyone, that helps.
I will be writing more on this in the coming days. The loss of a public option is a bitter pill to swallow, but there is still plenty of good in this package. As details emerge, we will know more.