Medicare buy-in dropped, 90% medical loss ratio next on chopping block

by: Chris Bowers

Mon Dec 14, 2009 at 19:56

First, Senate Democrats struck a deal on the public option that included a Medicare buy-in and a requirement that 90% of the money insurance companies received from premiums be spent on health care.  The agreement was directly negotiated by three of the four Senate Democrats who said they would filibuster health care reform with a public option: Blanche Lincoln, Mary Landrieu, and Ben Nelson.  Joe Lieberman had also been vocally supportive of the Medicare buy-in.

Next, Joe Lieberman stabs everyone in the back, and declares he is opposed to the compromise, and will filibuster it.

Shortly thereafter, Rahm Emanuel meets with Harry Reid, and tells him to cave to Lieberman.

Now, Senate Democrats have done just that.  The Medicare-buy-in compromise is gone (hat-tip: Political Wire):

Senate Democrats emerged from a special caucus meeting Monday night determined to pass a health-care bill by Christmas -- but without the Medicare buy-in plan that liberals had sought as an alternative to a government insurance option.

It is likely that nothing will happen to Lieberman as a result of this.

But wait--it gets worse!  The CBO has declared that if Congress passes a law stating that insurance companies must spend 90% of the money they receive on premiums on actual health care, then it is the same thing as nationalizing the entire industry.  This means they would score a bill with a 90% medical loss ratio in the several trillion dollar range, thus killing the bill politically.

The Senate will not pass a public option.  It will not pass a Medicare buy-in.  It will not mandate a 90% medical loss ratio.  Ugh.  This deal keeps getting worse all the time.

Chris Bowers :: Medicare buy-in dropped, 90% medical loss ratio next on chopping block

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It's time to kill the bill (4.00 / 14)

 And it should be the PROGRESSIVES who kill it.


 Obama's a complete disaster. For the sake of progressivism's future, we need to PUBLICLY distance ourselves from this flaccid, ineffectual corporatist as visibly as possible.


"We judge ourselves by our ideals; others by their actions. It is a great convenience." -- Howard Zinn

CBO (4.00 / 4)
They are a complete, partisan disaster as they continually kill off progressive pieces of HCR by taking nonsensical stands.  Orzag and company are very bad medicine.  They ought to be dumped along with Bernanke and Geithner and Gates. And Petraeus and McChrystal.

[ Parent ]
Like all the warning voices said at the end of last year... (4.00 / 4)
...all those effing centrists and business insiders at influencial positions all over the administration are out to screw us! Damn, I feel so dumb for ever giving that manipulating sellout Obama the benefit of the doubt...

[ Parent ]
This one isn't on Orzag... (4.00 / 4)
Elmendorf was recommended by Kent Conrad... no suruprise...

Their interpretation has to be the most bizarre accounting interpretation in the history of the profession.  It's an incredible reach by a conservative...

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 ]
Is Doug any relation to Steve Elmendorf, (0.00 / 0)
the head of the PR firm that hosted that healthcare dinner fundraise for Pelosi?

[ Parent ]
According to Wikipedia (0.00 / 0)
Steve is from New Jersey and Doug is from upstate New York, so at a minimum, they are probably not brothers.

The fact that I can't find a reference to any relationship between the CBO director and a prominent lobbyist, gay activist, and former Democratic campaign operative and Congressional staffer suggests that a relationship, if any exists, is probably not close.

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

[ Parent ]
That CBO reading sets off my tinfoil hat (4.00 / 4)
It's beyond insane. The CBO is blatantly spewing nonsense acting to stop a worthwhile political action. There really has to  be a cloak-and-dagger conspiracy behind this. Amongst many other problems, this totally destroys the CBO's credibility. If they'll do this when it's obvious they're spouting nonsense, how can you trust their numerical analyses where nonsense is hard to detect?  

[ Parent ]
It doesn't matter ... (0.00 / 0)
both Elmendorf and Orzag ... come from the Hamilton Project ... the Pete Peterson boondoggle(for the rich) that Obama is so in love with

[ Parent ]
Time to for Progressives to make a break (4.00 / 4)
Progressives need to demarcate themselves from the rest of the corporate democratic party in a much more distinct way.  Perhaps, they could stop caucusing with the rest of the party, and create a quasi-parliamentary type coalition with Democrats.  Clearly progressives only serve to enable the passage of the corporate democratic agenda, which is only marginally, imperceptibly left of center of the republicans.  Regardless, this is a huge defeat today-one from which the democratic party will not recover for years.  Thank you Obama for your cowardice.  We should have given more weight last year to your pathetic record of compromising/placating/appeasing all political differences into amorphous platitudinal redundant lawmaking in the Illinois state Senate.  

Making a symbolic break or refusing to caucus (4.00 / 6)
are just gestures, they would have no impact.  The problems are institutional (not individual) and the solutions must be institutional as well. This is not a case where Congress performed well and the White House did not - there is plenty of failure to go around.

The Democratic Party's response to this is not determined by these events - if we can reduce the Rootsgap, we can recover.

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

[ Parent ]
Why even bother with the D brand? (4.00 / 2)
Progressive/leftist organizations need to stop fretting about Palin -- if she doesn't know lone gunmen are relatively cheap if you're rich, the rich will be sure to let her know long before the inauguration -- and cut off the D party entirely.  Let the Annette Bening wing of the D party own this shit.

Does the Conservative Progressive Party sound like a good idea yet?

[ Parent ]
"Does the Conservative Progressive Party sound like a good idea yet?" (0.00 / 0)
Not really. That would probably be the worst of both worlds. Horrible right wing politics without a spine? What's the point?

[ Parent ]
Could you please explain a few things? (0.00 / 0)
I'm serious, not snarking -- your stuff is interesting and provocative, even if I don't always agree.  As it stands, I can guess at what your points mean, but I'm not sure.


if she doesn't know lone gunmen are relatively cheap if you're rich, the rich will be sure to let her know long before the inauguration

I gather this means they'll threaten her.  But how is she a threat to the rich, and even if she is, does she threaten them in the same way that she threatens progressives?  Will their threats make her non-dangerous (to us and the general public)?  And more importantly, if this is how things work, what does it matter who we elect?

2. Why call it the "Conservative Progressive Party"?  I get that "conservative" is a good brand with the majority of the public.  Is that it?  I can see problems, but maybe.

3. Finally, what makes you think the "Conservative Progressives" would be a better vehicle for progressive victories than the Democrats (accounting for primaries)?

[ Parent ]
Messaging check time (4.00 / 12)
Is there any reason left to call this "health insurance reform" and not "the insurance bailout bill"?

If the bill analysis is true (4.00 / 1)
even this bill is very worthwhile. The average American's insurance rates would drop 50%. HOWEVER - the analysis was done by - the CBO, of the "mild profit limitation equals nationalization" rule. That does make it suspect.

[ Parent ]
"average American's insurance rates would drop 50%" Why? (4.00 / 2)
I can't see any valid reason why such a huge drop should be possible. What's still in the bill that would lead to cost reduction? Doesn't make any sense to me.

[ Parent ]
You are WRONG (4.00 / 2)
Nothing in this bill is about cutting the costs of private medical - did you pull the 50 percent our of your colon?

I don't know if you are just uniformed or lying, but can see why you use "economist" in your handle.

[ Parent ]
From Paul Krugman (4.00 / 4)

A family of four making 60K would have premiums drop from $9,880 to $5,240. This is mostly via subsidies, although there are also benefits from reduced overhead.

Don't you think you should at least read some preliminary analyses of a bill before you accuse people reporting on it of scatological activities?

[ Parent ]
Not the average American (4.00 / 1)
Most families of four with an income of $60,000 have insurance through work, and wouldn't save a cent on premiums (from the same Krugman post).

Plus, this is the first time I've seen these details.  $5,240 is still an insanely large amount for a family of four with an income of $60,000 to spend on insurance.  Maybe more possible than $9,880, but still a huge sacrifice.  And the amounts for lower income families are at least as bad.  Reading this makes me more rather than less likely to want to kill the bill.  Maybe an emotional reaction, maybe most families in this position would be happy, but I dunno.

[ Parent ]
bullshit (4.00 / 2)
it hides the cost. that's not hte same as savings. it is a con man's trick.  

[ Parent ]
If "via subsidies" (4.00 / 1)
it isn't actually a premium drop, is it - and without anything that is actually going to lower premium, you and I both know that those subsidies are going to end up on the chopping block.

[ Parent ]
Also, is this CBBO report about the latest version of the bill? (0.00 / 0)
I don't think so. It's about the bill they discussed at the end of November. It only has become worse since that time.

[ Parent ]
"This deal keeps getting worse all the time." Deja vu? (4.00 / 1)
Didn't you already say that? Like, some weeks ago?
If this wasn't such a tragedy, it would be the greatest comedy on earth!

I think it's a star wars quote n/t (4.00 / 2)

[ Parent ]
Hmmm, I guess we may as well just nationalize the industry then. (4.00 / 6)
Thanks, CBO. I agree.

Don't kill it, just yank the mandate (4.00 / 1)
At least we will get some droppings.

?????????????? (4.00 / 2)
So what is good in the crap left?  Nothing takes effect for years - after 2012 - why let the dems run on a faux success and prevent another dialog about this for at least a generation?

Why not let it fail - hit everyone hard in 2010 and try to get a more progressive bill with an EARLIER effective date anyhow?

Make those that have subverted the process stand and be held accountable - THE PUBLIC OVERWHELMINGLY SUPPORT A MEANINGFUL PUBLIC OPTION and those figures will only go UP!

[ Parent ]
Hold the parties accountable (0.00 / 0)
This melodrama wouldn't be happening if that weren't what they wanted.

[ Parent ]
Controlling Medicare Advantage and expanding Medical (0.00 / 0)
and maybe getting pre-existing conditions and lifetime caps.

[ Parent ]
"Democrats are not going to let the American people down." (4.00 / 8)
Harry Reid after tonight capitulation caucus.

Words fail...

Self-refuting Christine O'Donnell is proof monkeys are still evolving into humans

That's rich. (4.00 / 1)
Damn, is he able to sleep at night after voicing such monstrous lies?

[ Parent ]
he can go fuck himself (4.00 / 4)
or he can go to reconciliation

but why go to reconciliation when all the "progressives" will vote for whatever lieberman wants?

progressives my ass...

[ Parent ]
If only we had imaginative Dem leadership (4.00 / 4)
Couldn't they pull the public option and Medicare buy-in, vote on it, send it directly to the House and then to the President, and then turn right around and use reconciliation to pass a full 18-65 Medicare buy-in option? The centrists screwed the leadership by negotiating in bad faith - why can't we have leadership that sees turnabout as fair play?

We have "imaginative Dem leadership"! Imagine all the donations... (0.00 / 0)
...from the insurance companies that will go into their coffins.

[ Parent ]
It Took A Lot Of Imagination (0.00 / 0)
to conjure up the "yes we can" meme and endlessly lie about change.

The problem isn't the dems imagination - its their REALITY ORIENTATION.

[ Parent ]
so, will there be anything for liberals in the new compromise? (4.00 / 4)

Yup (4.00 / 2)
A big wet kiss with joe LIE-berman's tongue down your throat.  Thanks obama!

Don't kid yourself - this is not actually on rahm.

[ Parent ]
There will be a bumper sticker for every liberal (4.00 / 3)
"I'm so happy about the big healthcare reform of 2009!"

[ Parent ]
I'm eagerly awaiting the Mike Lux post on this topic (4.00 / 2)
which is to say, NOW can we acknowledge that we've all been hoodwinked?

AGREE (0.00 / 0)
Would be nice to have a thread by another voice - not like anyone here has ALL the answers (even if they proclaim they do).

[ Parent ]
Any Democrat that votes for this piece of crap (4.00 / 4)
deserves to be on a progressive hit list.  It's time to draw a line in the sand.  A bill with no government competitive measure (public option, expanded Medicare, whatever) is worse than the status quo when you give insurance companies billions of federal dollars and hand them over a brand new base of mandated customers.

For example, if this gets to the point of voting, I will call Senator Gillibrand's office and let her know that I'll be voting for Jon Tasini if she votes for this bill (and if she votes for cloture too, time to play the same game that Blue Dogs play).  I will then go on The Albany Project and tell others to do the same.  I'll go on Open Left and Daily Kos and blog about it.  I'll go on facebook and share it and recommend others do the same.  

Heads need to start rolling for this nonsense.  

To me, this is simple.... (4.00 / 3)
Find an alternative to Obama for 2012 or accept a Republican Presidency in either 2012 or 2016.

If he's unwilling to lead, we need a new leader.

If the four stealth Republican Senators are allowed to destroy a reasonable path towards expanded health care in America and, as a result, give the country back to the Republicans, then we need new leadership at all levels.

And that includes the Presidency.

I'm increasingly skeptical there are just 4 bad apples (4.00 / 7)
if they were really progressives they'd threaten to vote no

no, this is what they really want

remember EFCA? when they knew it wouldn't pass, every dem was for it

when the situation changed, the votes started changing

[ Parent ]
Oooh Yes! (4.00 / 2)
Oh, yes, the light bulb does go on at some point doesn't it?  I mean, you can't really keep believing that it's all Lieberman and a few Blue Dogs can you?  Where are the rest of them?  Watching them come on to MSNBC tonight like re-programmed zombies is something to behold.  They've seen the light.  They've fallen in line.  Their former statements are now inoperative.  They no longer stand for what they stood for last week and tomorrow they won't stand for what they stood for today.  

[ Parent ]
That was never a condition of our arrangement! (4.00 / 1)
Nor was giving the American people over to those insurance companies!

I'm sure soon enough, our deal will look like this

Thank You (0.00 / 0)
That video perfectly expresses the tenor of the times.

Can we start calling Joe Lieberman 'Darth'?

Would that make Obama Lando or is that Reid?  Or just the Democratic party in general?

Figuring out how to be a progressive college graduate transplant to Ohio:

[ Parent ]
re: darth (4.00 / 1)
Can we start calling Joe Lieberman 'Darth'?

no, he is emperor palpatine

[ Parent ]
This is Ridiculous (4.00 / 2)
I'm hoping Burris actually sticks to his guns. This bill is the death knell of the party. I can't stand the Democrats anymore. It's fitting that Obama's favorite game is poker. HE only seems to know how to fold.

Rachel Maddow is talking about (4.00 / 1)
ending the filibuster, including Harkin's bill to end it, with Steve Benen.

Sadly, I think Benen is wrong on the number of votes it will take to kill it (he's talking about 2/3).

She should have called Bowers!

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

Steve Benen? Of the Washington Monthly? (0.00 / 0)
Why did he get the nuke option wrong? He's a smart guy, his news roundups and many of his blog postings are excellent. He can't possibly be that uninformed???

[ Parent ]
Yes, that Steve (4.00 / 1)
He said you need 2/3 to change the Senate rules, which I think (feel free to correct me) is true. But he seemed to say that a rule change was the only way to kill the filibuster, which is not.

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

[ Parent ]
Oops, sry, Harkin's bill has to go the regular way, I guess. (4.00 / 1)
So, it has to pass the 60 vote hurdle. If they don't nuke the filibuster first, and then reinstate it, in Harkin's way. But that would be a bit too hypocrtical, imho.

However, if Benen said, 2/3, that has to be wrong.

[ Parent ]
Damn, I'm starting to write nonsense. (4.00 / 1)
Senate rules, ok, that may be different. I better go to bed, early morning here. G'night, everybody!

[ Parent ]
Is It Just Me (4.00 / 3)
Or is the entire problem here that conservatives are willing to destroy things that have even a hint of 'progressive' about them while progressives won't destroy things that have ONLY a hint of 'progressive' about them?

Figuring out how to be a progressive college graduate transplant to Ohio:

It's the Solomon baby story (4.00 / 2)
Where one genuinely wants the baby dead. It's a big problem - but we really do want the baby alive.  

[ Parent ]
Yeah (0.00 / 0)
They have nothing to lose by embracing destruction, we have base improvements to scrabble for.

Man, entrenched power sucks.

Figuring out how to be a progressive college graduate transplant to Ohio:

[ Parent ]
It is time to kill this POS and break it up into parts and (4.00 / 1)
pass the parts.  

We are going to get our asses kicked in 2010 and 2012.  At least 'dems' are - I am hopeful that some Progressive candidates can break through for the next 'Real Progressive Cycle'.  We have lost the health care argument and eventual bill to the Conservadems, Repugs, and Corporate Whores.  We are going to lose the 'immigration battle' - shit the Repugs and Conservadems fought like hell on health care and that dealt with little old white people - they don't give a shit about the 'brown folks'.  

So imagine this an election cycle with diminished voters in the following groups: (1) new or re-energized 2008 voters, (2) LGBT voters, (3) Latino Voters, (4) Union Voters, and (5) Health Care Focused Voters.  

I suspect we will have 1/4 to 1/3 less voter turnout in 2010 and 2012.  

Polls also show a huge drop of African American voters... (4.00 / 1) 2010, maybe bcaus they were only intrested in voting for Obama. Sry, don't wanna google a link now, I'm off to bed.

[ Parent ]
Time to stick a fork in it (4.00 / 5)
There will be no meaningful health care reform this year or next. Whatever passes as such will basically be a continuation of the Medicare "reform" bill of Bush's 1st term, and TARP.

I.e. a massive giveaway to corporate interests, at the expense of everyday Americans, wrapped up to look like real "reform".

And only fools still believe that this wasn't the intention all along.

My sig line. Originally targeted at Jefferson, applies just as well to The One.

He's not a coward. He's not a bipartisan fetishist. He's not even a sellout.


"Those who stand for nothing fall for anything...Mankind are forever destined to be the dupes of bold & cunning imposture" -- Alexander Hamilton


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