Lots of happenings on the health reform front. In the extended entry, you can find details on the White House draft health reform bill, the Senate whip count, the use of reconciliation to finish health reform, and the ongoing public option campaign.
Health reform state of play in the extended entry.
|White House releases health reform bill
The White House has released a draft health reform bill 72-hours in advance of Thursday's bipartisan health reform summit. Some highlights:
Many more specifics can be found here. The White House is referring to this bill as an "initial offer."
- Written to be passed as a sidecar "fix" to the Senate health reform bill through reconciliation (more on reconciliation below);
- Does not include a public option of any sort (more on that below);
- Is closer to the Senate health bill than the House health bill;
- Increase penalty for employers who do not provide health insurance to employees;
- Slightly increases subsidies for people purchasing insurance on the insurance exchange;
- Removes special deals to Louisiana and Nebraska;
- Keeps excise tax, but does not implement it until 2018. Labor is still studying the proposal, and has not endorsed it yet;
- Expands "high-income Medicare taxes to include investment income" to replace funding from excise tax;
- Not scored by the CBO.
Reconciliation appears to be a go
The draft bill released by the White House is designed to be passed through the budget reconciliation process. This signals strong support for that procedural path for finishing health reform.
Senate Majority Leader Reid Harry has also declared that the Senate will use the reconciliation process to finish health reform "in the next 60 days." That declaration was made on February 19, making April 11th the 60th day.
Speaker Nancy Pelosi had previously stated that passing health reform would be impossible without using the budget reconciliation process to fix the Senate bill.
This means that the entire Democratic leadership is now on board with the reconciliation process. While out whip count still only shows 34 clear Senate supporters of reconciliation, and as many as 39 possible supporters when "maybes" are included," it seems clear at this point that at least an attempt at reconciliation will be made. We can play a big role in making that happen by providing a public list of 50 Senators in favor of using reconciliation to pass health reform ASAP.
The public option has regained a lot of momentum over the past week. In addition to 22 Senators stating that they would like to pass a public option during the reconciliation process, and an additional 9 others currently listed as "maybes" (see whip count here), Senate Majority leader Harry Reid has stated that he will work to include a vote on the public option during the reconciliation process:
If a decision is made to use reconciliation to advance health care, Senator Reid will work with the White House, the House, and members of his caucus in an effort to craft a public option that can overcome procedural obstacles and secure enough votes.
If I may, allow me to suggest a Medicare buy-in as the best public option to include in reconciliation. Such a buy-in has the following advantages:
After the Lieberman backstab in December, my two regrets on the public option campaign were not whipping on reconciliation (which we are doing now), and not pushing for a Medicare buy-in instead of a new, fourth public option (three current public options: Medicare, Medicaid, and CHIP).
- More support: As of December, it had the support of 57 Senators who are still in the Senate (everyone in the old 60 except Kirk, Lieberman and Ben Nelson), compared to only 50 for Chuck Schumer's level playing field public option.
- No procedural obstacles. Unlike a public option, there is no doubt that a Medicare buy-in could pass the procedural hurdles for budget reconciliation in the Senate.
- It's better. A public option that is tied to Medicare--or, rather, that actually is Medicare--is superior to the level-playing field public option (which is worse than the one that passed the House). We always wanted a public option tied to Medicare rates, and I can't imagine anything better than Medicare itself.
Since we have been given a chance to re-do the public option campaign, I don't intend to make either of those mistakes again. The Medicare buy-in is the preferred public option. I would like to see us start pushing for everyone to buy-in to Medicare, or at least for people 45 and older to be able to do so.