Time to pick a side on the health reform bill, but odds for passage dwindling

by: Chris Bowers

Thu Mar 11, 2010 at 17:15


The House of Representatives is deep in the midst of drafting their reconciliation "fix" to the Senate health reform bill.  Some of the language of the bill had been sent to the CBO as long ago as last week, and House members are already able to provide an estimated length of the bill (100 pages).  The CBO score of the White House draft proposal on reconciliation could be out as early as tonight.

This is important, because the reconciliation bill represents the last stage of negotiations on health reform.  Due both to their desire not to blow up deals on votes, and to prevent Republicans from using a filibuster by amendment strategy to kill the bill, there will not be strengthening amendments to the bill on the floor in either the House or the Senate (or, at least, they won't be allowed to pass, as per Roll Call's article on the public option today).  The deal that emerges will already be written into the reconciliation bill itself, with the possible exception of a separate deal to capitulate to the Stupak bloc.

With the reconciliation bill nearly written, and with no strengthening amendments to the reconciliation bill on offer, the time for negotiating improvement to the bill has virtually ended.  There might be another couple of days of agitation available, but not much time and only for marginal aspects of the bill.  We are very close to the time when you simply have to decide whether you want to pass it or defeat it.  I am on the support side, but that is something everyone has to decide for themselves.

No matter which side you are on, the odds for passage do not appear very good right now.  The Hill sums up the difficulties facing the Democratic leadership pretty well:

The 25 opposed include firm "no" votes and members who are likely "no" votes. Most Democrats on The Hill's whip list are definitely going to vote no, but others, such as Reps. Lincoln Davis (Tenn.) and Harry Teague (N.M.), could vote yes.

However, The Hill has not yet put Democrats who are insisting on Rep. Bart Stupak's (D-Mich.) language on abortion in the "no" category. Stupak has said there are 12 Democrats who supported the House bill in November who will vote no unless his measure blocking federal funding of abortions is melded into the final bill.(...)

Assuming every member votes, Democratic leaders could not afford more than 37 defectors, which would lead to a 216-215 tally.

Democrats can afford 37 defections.  Already 25 members are either solid or "lean" no's, according to public statements.  Further, that does not include many other groups making demands on the bill, most notably the roughly 12 members of Bart Stupak's bloc.  And, it looks like Dems have given up on Stupak anyway:

House leaders have concluded they cannot change a divisive abortion provision in President Barack Obama's health care bill and will try to pass the sweeping legislation without the support of ardent anti-abortion Democrats.

A break on abortion would remove a major obstacle for Democratic leaders in the final throes of a yearlong effort to change health care in the United States. But it sets up a risky strategy of trying to round up enough Democrats to overcome, not appease, a small but possibly decisive group of Democratic lawmakers in the House.

So, with the Stupak group done, House leaders are either already at, or very close to, 37 defections.  This means meaning Democrats need to round up all of the roughly 70 other, non-Stupak undecided votes.

That is an extremely tall order.  While Democratic leaders continue to express confidence in the passage of health reform, public vote counts indicate that defeat of the bill has become the more likely outcome.  For example, David Dayen's latest puts the count at 189 in favor, and 202 opposed.  

Chris Bowers :: Time to pick a side on the health reform bill, but odds for passage dwindling

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Without meaning to disagree with you (0.00 / 0)
and without getting into at all whether passage is good or bad, I just want to note that TPM has an opposite assessment of the likelihood of passage now.  Care to comment?

sTiVo's rule: Just because YOU "wouldn't put it past 'em" doesn't prove that THEY did it.

From TPM front page (4.00 / 1)
After Much-Hyped Meeting, House Dems No Closer To HCR Deal

So its almost done, and no closer...

Chris seems to be able to put a sentence together that doesnt contradict itself. Would that more political writers were so competent.

--

The government has a defect: it's potentially democratic. Corporations have no defect: they're pure tyrannies. -Chomsky


[ Parent ]
Whip counts (4.00 / 4)
Hard for me to believe all the no's will stay that way if push comes to shove. Some people get passes to vote no if it doesn't matter, but it's going to be very difficult for those folks to hang on if HCR is going down by a few votes. So public whip counts like this are great for figuring out whom to target, but I'm not sure they're really predictive. I guess we'll see soon.

Not really (0.00 / 0)
If they are in a conservative leaning district, voting no probably looks pretty safe  right now.

[ Parent ]
Exactly (4.00 / 1)
This is the vicious circle which follows from the Baucus Caucus locust months last year:

The further we get from post-election euphoria, the closer we get to a mid-term election in which a majority presidential party is expected to slump.

And, with a Dem prez, the greater the likely slump, the keener conservative Dems will be to vote (what they think is) their district, not their prez.


[ Parent ]
Talk about a downer (0.00 / 0)
As previous commenter says, those No votes aren't written in stone. For instance, I can't believe that Arcuri, Adler, and Matheson will vote against the bill if it means it dies.

Plus, you are assuming that Stupak's bloc is a big as he says it is. We've already seen a few potential bloc members peel away. I'd guess his bloc is more likely 8 or so (not counting Cao, who's a lost cause).


I generally believe Stupak (0.00 / 0)
He said before that he had the votes for his amendment, and he did.  He's more credible than most politicians who say they have the votes for something.

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

[ Parent ]
Rachel Maddow's staff says Stupak has 4 or 5 NO's.. (0.00 / 0)
Maxine Waters was just on The Ed Show and had one bad piece of news, and 1 very bad piece of new.
First, Pelosi doesn't have the votes yet.  Secondly, they won't be finished before the recess
Following Chris's earlier numbers, minus 4 from Stupak, it seems we're close - about 211-220.

9 votes short, approximately. If we can't find 10 votes before the recess, and we won't unless the PO is in the reconciliation bill, the whole party is over literally.

And if Obama doesn't come out now to agree with and push the PO among the wavering few- it's he who failed the country and his own party.

Nationalism is not the same thing as terrorism, and an adversary is not the same thing as an enemy.


[ Parent ]
Evidence please... (0.00 / 0)
9 votes short, approximately. If we can't find 10 votes before the recess, and we won't unless the PO is in the reconciliation bill, the whole party is over literally.

And if Obama doesn't come out now to agree with and push the PO among the wavering few- it's he who failed the country and his own party.

I'm skeptical.  Show me the votes.  Who is voting against it because there is no PO?  Who do we pick up from adding it?

First bill passed 220-215.  We are down 3 yeas, and they're down 1 nay from retirements, and Cao flipping is one more yea to nay.  That gives us 216-215.  This is before we even get to Stupak.  Even if he only speaks for himself that is enough to defeat the bill.

The only path to passing the bill is to get some blue dog/conservadem votes for the bill, and they won't accept PO.  I want it as much as anyone, but don't see how the votes are there...

We PTDB! Now, let's pass Grayson's Public Option Act!


[ Parent ]
I don't believe it (4.00 / 3)
My view is that ALL public discussions of vote counts should be taken with a HUGE grain of salt.

I consider it more telling that the leadership is going full steam ahead.  If passage were really unlikely, I don't believe Pelosi would be talking up a vote right now.


This seems on the money. (4.00 / 1)
So, its close, but they have some confidence.

--

The government has a defect: it's potentially democratic. Corporations have no defect: they're pure tyrannies. -Chomsky


[ Parent ]
I'm with Dennis. (4.00 / 7)
As Obama repeatedly says, the insurance companies are the problem. Their practices are offensive, but their biggest problem is they can't negotiate effectively with providers. The solution is NOT to force everyone to buy their product. You've got to get have an alternative to private insurance for reform to succeed. There are a number of ways to do it, including a robust public option, Medicare buy-in, state single payer, etc. I support Dennis for refusing to vote for bogus reform. It is not a first step. It's a foundation made of sand.

Lighthouses are built on sand sometimes. (0.00 / 0)


[ Parent ]
Not for long (4.00 / 2)
They make a lovely mess when built on sand alone.

[ Parent ]
Do you have any words of comfort... (0.00 / 0)
...for the people who will suffer and/or die if this bill containing paid coverage for millions of uninsured people fails? One can imaging the platitudes towards Dennis' principled stand they'll be offering from their death beds...

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

[ Parent ]
I might tell them that the current bill will help no one for years. (4.00 / 2)
And that a principled stand could result in real reform sooner by not taking the issue off the table.

I might then mention Alan Grayson and the Medicare Buy-in for All and note that Medicare was implemented from scratch in one year.


[ Parent ]
"Could?" (0.00 / 0)
You're betting their lives on "could." When they're dying I'm sure they'll appreciate your wagering with their lives.

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

[ Parent ]
Yes. "Could." Which is much better than "Definitely not for about five years." (4.00 / 2)
Portraying this bill as some emergency measure to save lives is both inaccurate and a bit below the belt.

Nobody criticizing this bill from the left wants people to die.  Moreover, this bill simply doesn't save them.  As has repeated ad nauseum Obama's bill does nothing significant to help people till 2014.

If you wish to hide behind the skirts of those who will die from no insurance without this bill, then you should at least take responsibility for the over one hundred thousand people who will die from no insurance because of this bill.


[ Parent ]
Do you have any words of comfort (4.00 / 3)
for the people who will die as a result of insurance company malfeasance, after the government forces them to buy the insurance companies' junk policies?

One can imagine the platitudes about "the most progressive legislation in half a century" ringing in their ears as they lie in their death beds.


[ Parent ]
Nicely put (0.00 / 0)
Every side has two coins (or something like that...)

[ Parent ]
And those insurance policies will be worse how? (4.00 / 1)
Than they would be if we do nothing? And they wouldn't be on their death beds if they had no policy at all? That's what your alternative contemplates.

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

[ Parent ]
Grayson's bill is a great argument... (4.00 / 2)
...for passing reform now.

This doesn't have to be the end of reform, but if we fail to pass a comprehensive bill, it will be.

The Public Option/Medicare buy-in is a worthy policy that can stand on its own.  Why force it into this particular bill if it is only going to complicate passage?

We PTDB! Now, let's pass Grayson's Public Option Act!


[ Parent ]
Stands on own (4.00 / 2)
The Public Option/Medicare buy-in is a worthy policy that can stand on its own.

Note this is only true if the current bill passes.  Without that framework Grayson's bill would lead to huge problems of Medicare sucking in all the sick people, etc.  It is only with the new framework that handles problems like adverse selection and pre-existing conditions that this is viable.


[ Parent ]
But it also provides concrete cost controls (4.00 / 1)
Once the insurance companies raise the premiums too much for profit, healthy people would choose to opt into Medicare for pure economic reasons.  Hence, solid cost controls on insurance mark ups.

With a mandate alone, you get the opposite (Private monopolies are not well known for providing great value to their customers.)


[ Parent ]
Together, yes (0.00 / 0)
But it would provide no cost control at all by itself, without changing the underlining system.

[ Parent ]
Isn't there a way for them to handle adverse selection without a mandate? (4.00 / 1)
How do public insurance programs like Medicaid or SCHIP handle customers now?  Do they deny people for preexisting conditions or "waiting too long" to get insurance?

Not to mention there's a huge difference between charging someone a little more (say for back premiums) and an insurance company's total rejection of someone because they flat out don't want to pay for that person's illness.


[ Parent ]
I might tell them that the current bill will help no one for years. (4.00 / 3)
And that a principled stand could result in real reform sooner by not taking the issue off the table.

I might then mention Alan Grayson and the Medicare Buy-in for All and note that Medicare was implemented from scratch in one year.


[ Parent ]
I'll copy from my earlier reply (4.00 / 1)
I think it comes down to how much you trust the insurance cartel

here's the key part of your post:

the Senate HCR w/Rec fixes that will give coverage to millions who don't have it

if I had your confidence that "the Senate HCR w/Rec fixes...will give coverage to millions who don't have it" I'd support it. honestly. I mean the money that would be spend, if not spend on health-care it'd be spent on some other corporate outlet like a military program, tax-break or farm subsidy. I don't give a damn about those. I prefer to spend it on health-care.

but I don't think the insurance cartel will do what you say. look at the current situation. the insurance companies' mission is to make the most money possible. they don't care if that means letting people die. now, would their mission change in your scenario? no. would they become not-for profit companies? no. so, why do you trust them that they will give people health-care? isn't your assumption naive?


[ Parent ]
Medicaid expansion (0.00 / 0)
100% government program and millions will be added into it. Doesn't rely on "insurance cartels" at all.

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

[ Parent ]
really steve? (4.00 / 1)
is your argument down to 'you must be lose most of your assets if you want to get health-care'?

anyway, we're discussing how much do you trust the insurance cartel

I'm OK with the medicaid expansion, no argument there
but what you want isn't only medicaid expansion


[ Parent ]
No... (0.00 / 0)
...we weren't discussing insurance cartels. We were discussing two options -- One where millions who don't have it get paid health care coverage, many of whom will be added to Medicaid, a 100% government program vs. Two - Failing and doing nothing.

Now, you responded by saying you don't trust the insurance cartel to hold up their end and therefore question that coverage really will get expanded. My reply was that independent of the insurance cartel, millions will be added to Medicaid. Therefore, my contention that millions will get health care holds. That's all I was saying.

Now, w/r/t whether insurance cartels will hold up their end so that newly subsidized insureds through them actually get paid care provided, I'd first ask: How many of those people will get paid care if they continue as they are now with no subsidies and no insurance at all?

Beyond that basic question, HCR repeals the anti-trust exemption and implements medical loss ratios, eliminates pre-existing conditions as a reason not to pay etc. Those are important reforms that cannot be done via reconciliation. Grayson's Medicare-buy-in-for-all just becomes a dumping ground for the least healthy without these reforms. This is our one shot for insurance reforms -- unlike a PO or Medicare buy-in, they get no possible second chances through reconciliation later. It's now or never.

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


[ Parent ]
re: (4.00 / 1)
...we weren't discussing insurance cartels. We were discussing two options -- One where millions who don't have it get paid health care coverage, many of whom will be added to Medicaid, a 100% government program vs. Two - Failing and doing nothing.

I never said I want nothing! I even want to cover more than you. I told you a po/buy-in amendment won't derail the bill.

Now, you responded by saying you don't trust the insurance cartel to hold up their end and therefore question that coverage really will get expanded. My reply was that independent of the insurance cartel, millions will be added to Medicaid. Therefore, my contention that millions will get health care holds. That's all I was saying.

ok, if the "millions" refer to medicaid only I understand you. I was refereing to the millions that will be send to the ahip sharks.

Now, w/r/t whether insurance cartels will hold up their end so that newly subsidized insureds through them actually get paid care provided, I'd first ask: How many of those people will get paid care if they continue as they are now with no subsidies and no insurance at all?

see above. I don't want no plan.

Beyond that basic question, HCR repeals the anti-trust exemption and implements medical loss ratios, eliminates pre-existing conditions as a reason not to pay etc. Those are important reforms that cannot be done via reconciliation.

I don't trust them. I also don't trust the enforcement.

Grayson's Medicare-buy-in-for-all just becomes a dumping ground for the least healthy without these reforms.

did I argue for a buy-in and nothing else?

This is our one shot for insurance reforms -- unlike a PO or Medicare buy-in, they get no possible second chances through reconciliation later. It's now or never.

amendment steve, amendment


[ Parent ]
I didn't (0.00 / 0)
I never said I want nothing! I even want to cover more than you. I told you a po/buy-in amendment won't derail the bill.

I didn't say you wanted nothing. If you go back to the post you were originally responding to I was arguing a point that assumed a PO amendment is not added (either not voted on or voted down). I'm just carrying that assumption forward. Likewise here, the Kucinich position we're discussing assumes no PO is in the final bill. It was not a comment on your position.

I don't want no plan [from the ahip sharks].

Well, ok. Uninsured people w/o their policies aren't any better off.

amendment steve, amendment

Can't do the insurance reforms by amendment unless you have 60 votes in the Senate.  

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


[ Parent ]
re: mandate (4.00 / 1)
I didn't say you wanted nothing. If you go back to the post you were originally responding to I was arguing a point that assumed a PO amendment is not added (either not voted on or voted down). I'm just carrying that assumption forward. Likewise here, the Kucinich position we're discussing assumes no PO is in the final bill. It was not a comment on your position.

I responded to this:

One where millions who don't have it get paid health care coverage, many of whom will be added to Medicaid, a 100% government program vs. Two - Failing and doing nothing.

I can't keep track of everything on ol!

Well, ok. Uninsured people w/o their policies aren't any better off.

I think not being mandated to write a $1,000/month check to big health is better than being mandated to.

Can't do the insurance reforms by amendment unless you have 60 votes in the Senate.

do the reforms. the amendment I'm talking about is a po/buy-in in reconciliation.


[ Parent ]
Cripes... (0.00 / 0)
$150,000 a year. That's how much you have to make to be "mandated" to pay $1,000 a month for insurance. $1,000 is 8% of $12,500 (x12 = $150k).

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

[ Parent ]
ok, say it is $500 (0.00 / 0)
the point is the same:

I think not being mandated to write a $500/month check to big health is better than being mandated to.  


[ Parent ]
$75,000 a year income required for mandate (0.00 / 0)
And my response would be the same.

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

[ Parent ]
use whatever number you like (0.00 / 0)
the point remains the same

you said:

Uninsured people w/o their [ahip] policies aren't any better off.

well, whatever is the amount you arfe required to pay that you wouldn't if you're not subject to the ahip mandate is makes you "better off"

the $1,000 a month number came from a QH that listed a $12,000 yearly maximum for a $80,000 income. you say it isn't $1,000 but $xxx. ok, it doesn't change my point.


[ Parent ]
Honestly... (0.00 / 0)
I don't know what your point is.

Also, to be clear, "any better off" refers to access to health care -- that was clearly the comparison being made in the full context of the comment.  

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


[ Parent ]
re: point (0.00 / 0)
the point is that people won't be better off paying the ahip penalty

[ Parent ]
Somebody's going to pay (0.00 / 0)
People have accidents. People get cancer. Etc. Are you saying these people will be better off without insurance? Are you saying there's exactly zero expected benefit from an insurance policy? Someone's going to pay for these people. Who? Are they better off?

Look, millions of people get paid treatment through ahip insurance. Ahip does not pocket 100% of premiums collected, so you simply cannot claim that people absolutely won't benefit from private insurance. (Yes, insurance MLR's are too low, but they're not zero).

Now, you could reasonably argue that a $500 policy really should only have to cost $400 if ahip wasn't skimming profits. But that's a real $400 cost that has to be borne by somebody -- it doesn't magically disappear just because insurance is private. The question is should someone who should be able to afford $500/mth ($75,000 annual income required) be responsible for that real cost or not. If not, who should? Why?

Finally, you're missing the logic behind the 8% of income requirement. Ahip only gets their mandate if they keep premiums under 8% of people's income. Otherwise there is no mandate -- while the pre-existing condition changes are permanent for all. That 8% requirement is a downward pressure on premiums.

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


[ Parent ]
Now that I have a bit more time... (0.00 / 0)
Two things:

Nothing in this...

One where millions who don't have it get paid health care coverage, many of whom will be added to Medicaid, a 100% government program vs. Two - Failing and doing nothing.

...states what you think. Your response was I was claiming something about you or your position that I wasn't.

Re $150k/yr income, $1,000/mth policy -- anyone making that kind of money probably has assets they want to protect and would want insurance to protect them. Furthermore, they may even desire a high-deductible policy, since they likely have the ability to pay the deductibles and other out-of-pocket expenses. Finally, IMHO anyone making that income annually who affirmatively decides to transfer their health care risk to the taxpaying public is a f-ing douchebag. That, in effect, is just another 'tax break' for the rich and/or subsidy of the rich paid for by all taxpayers.

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


[ Parent ]
re: nothing (0.00 / 0)
Your response was I was claiming something about you or your position that I wasn't.

I assumed the "Two - Failing and doing nothing." was directed at me. since it wasn't directed to me, I take it back.


[ Parent ]
Ok, it's all good (0.00 / 0)
It was directed at Jane and later Dennis -- they're the one's saying 'do nothing' if they don't get their PO/pony.

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

[ Parent ]
re: time (0.00 / 0)
It was directed at Jane and later Dennis -- they're the one's saying 'do nothing' if they don't get their PO/pony.

wait for the end of the process. if they defeat the 'non-0 help' plan, then start your blame


[ Parent ]
Positions/votes matter (0.00 / 0)
First, they're a statement of held principles. Additionally, they affect the scope of what's possible. Look at it from the other side -- I assume you won't give the oil industry a pass for all of their lobbying just because their efforts to open ANWR fail.

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

[ Parent ]
re: positions (0.00 / 0)
so you want them to say 'we want a po but we will vote yes po or not'?

that's brilliant steve


[ Parent ]
I want them to not... (0.00 / 0)
...actively work to keep millions of lower income people w/o HC from getting 100% government paid HC just because they didn't get their pet pony. Sorry, but that's a life or death decision for some of those people. It's a moral decision. I don't think much of people who play politics with other people's lives.

...Adding, as a matter of political tactics it's unwise to make threats you don't intend to carry out. If I take them at their word, then the moral argument above holds. If they're just BSing, then that's another level of stupid altogether.

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


[ Parent ]
re: work (0.00 / 0)
I want them to not actively work to keep millions of lower income people w/o HC from getting 100% government paid HC just because they didn't get their pet pony.

so you don't want them to say 'we will not vote yes if we don't get a po.' so, how do we get a PO? ask nicely the good people at DC?

also, you think the senate bill alone is ok if you don't get a PO. others disagree. I do too. for us the PO is not a pony.

but I think if there's a vote on a po/buy-in amendment it will pass. so, I'm willing to support the bill if there's a vote on the PO, no matter the outcome of the amendment vote.


[ Parent ]
Don't make threats... (0.00 / 0)
...You're not willing to carry out. If you want to play hardball to get a PO vote, threaten to withhold on something else that's vital or threaten to be a general pain in the ass etc. But whatever you threaten be prepared to carry it out.

The only threat you want to consider effectively boils down to this: Give us a PO vote or the people who could get health care under your bill are screwed (and some will die). I have a moral objection with playing politics with other people's lives. Bottom line -- that's what you're doing if you threaten to vote no if you don't get a PO vote.

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


[ Parent ]
re: threat (0.00 / 0)
the bill makes the situation worse. so I don't see how threatening to vote no on a bill you think makes health-care worse is morally bad. I agree it would be morally bad if you thought it will help people and wanted to vote no. on the other hand, you don't think the bill would be more bad than good. ok.

[ Parent ]
Sigh.... (0.00 / 0)
the bill makes the situation worse.

Or should I say 'sheesh' or 'oy'... Either you're now just unserious or we're entering what Atrios calls the ageless debate of "stupid vs. lying."

It won't make things worse for the millions who have no insurance now, who will have 100% government funded/provided care in Medicaid. Apparently, that and those people matter not at all to you. For you to write that this deep into our back-and-forth leads me to no other conclusion.

Setting those millions of lives you don't care about aside, even then it's just unserious or stupid or lying to claim a private insurance world with regulation on pre-existing conditions, MLRs, w/anti-trust exemption etc. is "worse" than a private insurance world without them.

I'm sorry to be so harsh. We've had a civil discussion. However, your last response is so entirely unserious (or worse) that continuing here is not worth the time.

If you have something thoughtful to say, I'll consider it. Otherwise, we're done here.

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


[ Parent ]
re: situation (0.00 / 0)
the bill makes the situation worse.

that's my opinion.

but I'm stupid.


[ Parent ]
words of comfort... (4.00 / 2)
The health industry has run out of paying customers. For years, they have been peddling the "grand bargain" of guaranteed issue in exchange for an individual mandate. That deal is always on the table. Obamacare helps 1-2 million sick uninsured (many of whom qualify for existing programs) while indenturing everyone else to the private insurance industry. It's similar to bills introduced by Republicans from Mike Enzi to Mitt Romney. Dennis believes we can do better.

[ Parent ]
Try 12-14 million, not 1-2 million (4.00 / 1)
That's how many added to Medicaid under the Obama proposal. Dennis doesn't give a rat's ass about them...

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

[ Parent ]
Even when the bill HAD an alternative (0.00 / 0)
Dennis still voted no.  

[ Parent ]
damn women, why aren't they ok with coathanger abortions (4.00 / 2)
the nerve...

[ Parent ]
What happens if..... (0.00 / 0)
...if if if!  So many scenarios as to make your head spin.

My question though, what IF this health care bill fails?  What do we here on Open Left take as the next step toward:

A) some other health care reform

B) short term political goals like retaining the House and/or Senate and

C) long term progressive goals like EFCA, ending Iraq and Afghanistan, Environmental challenges.

Anyone? Anyone? Bueller?


I l;aughed at Bueller, I always do. (4.00 / 2)
If we fail here we have to build and organize. I would say with Unions is a good start.

--

The government has a defect: it's potentially democratic. Corporations have no defect: they're pure tyrannies. -Chomsky


[ Parent ]
Wait and see .. (4.00 / 1)
How many Democrats are "wait and sees"?

Many will calculate that if it going to fail, the advantage for them is to vote against, but not to be seen as the crucial vote that brought it down. So it will suit them to wait until the last possible moment, and there might be a lost-minute rush to the "No" camp if it looks as if the majority is less than solid.

On the other hand, if the majority looks solid, the pressure is on individual members NOT to change their vote & swim with the tide. If the bill passes, it will clearly not be too advantageous to be caught on the losing side.

This is where whips earn their corn. I imagine there is a serious amount of bluffing, posturing and poker playing. God knows how it will end.


Exactly (0.00 / 0)
It's also very good for many of these members to be "undecided" for as long as possible. They're all of course waiting on the "reconciliation fix." Yeah right--most are just delaying as long as possible so it looks like they're deliberate in their thinking. Most of the "undecideds" are going to vote "yes" if needed. They just hope they're not personally needed.  

Demockracy.com


[ Parent ]
30 out of 35/40 Needed (4.00 / 1)
FDL link seems to indicate 35/40 undecided votes. About half of the "virtually all of 70" Chris cites. If you trust the FDL whip count, Dems need 30 more votes. They seem to indicate 40 undecided votes out there. If you consider the "5 less possible" as not very likely, then that leaves you with needing 30 out of the 35 undecideds. (This does not count stupak, who are already listed as no.) Therefore, Pelosi can afford 5/10 defections from this more narrow list.

19 potential Democratic No-Yes flip votes:

14 possible:
Jason Altmire, Bart Gordon, Glenn Nye, Brian Baird, John Tanner, Rick Boucher, Allen Boyd, John Boccieri, Suzanne Kosmas, Betsy Markey, John Adler, Scott Murphy, Lincoln Davis, Jim Matheson.

5 less possible:
Travis Childers, Harry Teague, Heath Shuler (severe lean no), John Barrow, Tim Holden, Ben Chandler.

21 potential Yes-No flip votes:

4 additional Stupak bloc (rumored):
Charlie Wilson, Brad Ellsworth, Marcy Kaptur, Jerry Costello.

17 other wary Democrats:
Mike Arcuri, Zack Space, Chris Carney, Mike Doyle, Paul Kanjorski, Ann Kirkpatrick, Alan Mollohan, Nick Rahall, Dan Maffei, Bill Owens, John Spratt, Dennis Cardoza, James Oberstar, Baron Hill, Solomon Ortiz, Gabrielle Giffords, Earl Pomeroy.  

Demockracy.com


Nancy Pelosi has never brought a bill to the floor.... (4.00 / 1)
....that failed.  She won't do it now.  If she doesn't have the votes, there will be no vote.

So far, it looks like there will be a vote!

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!


If I recall correctly... (4.00 / 1)
Didn't the original bailout in 2008 fail (somewhat surprisingly)?

[ Parent ]
She had the D votes she needed. The R's lied to her about how many (4.00 / 2)
they would deliver.

At least this time, she's counting on 0 R's, so if she brings it to a vote, she's sure of her D count.


[ Parent ]
Grayson's bill (4.00 / 2)
Rep Alan Grayson is calling on Nancy Pelosi for a vote on his bill to allow all Americans to buy into Medicare. Sign the petition for a real public option that people want and understand!  http://www.wewantmedicare.com

Signed (0.00 / 0)
and done a few days back.  Fingers crossed.

[ Parent ]
Who could have foreseen this bill failing? (0.00 / 0)
As I wrote a few weeks back when Obama unveiled his "final" bill, we should have been mentally preparing for our next step after this one fails.  There are just too many pitfalls, poison pills, and convoluted pieces for this to have been reliable.  This will play out over another 3 weeks, if you waste that time hoping and praying for this bill alone you will likely be crushed.  If you start shifting your mind (and acting) to a plan B then you'll make out OK.

Grayson is laying the groundwork for a Medicare for All push immediately following the failure (or immediately preceding the success?) of this bill.  For all the "how do you explain to sick people that they can't have insurance" folks here on Open Left, understand that to not support this movement is to throw any uninsured to the wolves wholescale.  Can Grayson's bill pass?  I don't know, but this effort isn't dead until we capitulate.

This bill might pass and if so, good for anyone it helps.  But if it does not pass, if you are caught flat footed and give up - don't blame anyone else for your apathy or lack of insight.  I'm telling you now what you can do (today!) to get HCR passed, do you have the stomach to push real reform and get it done?  Call your congressmen every day until they make the commitment?  March in the streets?

Everyone laments that if this fails, we'll lose the Congress.  In my mind, that makes an immediate push for Medicare all the better.  If we let them know our votes are contingent on passage of that bill, you might be surprised how much can happen in an election year.

Or you can give up, hate someone else, and curl up to weep.


I support Grayson's bill. (4.00 / 1)
And at this stage I think it is the appropriate vehicle for the public option.  This is something that I think Grayson understands very well, and part of the reason he is making this move at this critical juncture.

At this point, the public option fight needs to be decoupled from the fight to pass comprehensive reform.  PO is popular, but the conservadems whose votes we need for final passage of HCR will not vote for it.

If PO is truly popular, which by all indications it is, the movement promoting it will not go away.

The time to pass comprehensive Health Care Reform is now.  Let's not jeopardize that.

We PTDB! Now, let's pass Grayson's Public Option Act!


[ Parent ]
I don't know if Grayson's bill can pass the House if it's stand-alone (0.00 / 0)
Remember, the Medicare+5 PO as part of a larger bill was 8-10 shy of 218, and that was only for a relatively few uninsured.  Grayson's plan is a stand-alone Medicare+0 PO for everyone.

[ Parent ]
A fair point. (0.00 / 0)
However, I feel much freer to strive for something that is just out of reach, so long as it doesn't jeopardize the passage of comprehensive reform.

Grayson's bill could end up being compromised down, but it is extremely valuable as a starting point for debate because it is clear, easy to understand, and likely quite popular among the public.

We PTDB! Now, let's pass Grayson's Public Option Act!


[ Parent ]
It makes a great plan B (or as a plus to plan A) (0.00 / 0)
Regardless of what happens with the bill in reconciliation now, having a hard push for a strong PO or Medicare for all can only be good going into the 11th hour.  

The most important thing is for progressives to not get complacent and decide the job is done (in success or failure.)  


[ Parent ]
I disagree because "Medicare buy in for anyone who wants" (0.00 / 0)
is a lot more popular than "public option" in this country.  Not using the Medicare brand as part of this was part of the grand strategic error of 2009.

[ Parent ]
P.S. I also didn't think Grayson's bill is aiming at a post-FAILURE (4.00 / 1)
situation, but a post-SUCCESS situation.  In fact, without the exchanges and insurance regulations of the HCR bill, there is no viable way to offer the Medicare buy in.

This is what I got from Ezra Klein, who wrote,

A lot of these reforms become easier to implement when there's a place to put them, and incentives you can offer to encourage their adoption. The exchanges are a big step forward in that regard. The public option is a good example. If we passed a public option now, how would you get it, exactly? Call the government? And how would you handle the adverse selection problem, where sicker people who were rejected by private insurers would use the government's offering as a last resort?


[ Parent ]
Like I wrote above, the whole adverse selection thing is overblown (0.00 / 0)
There is a huge HUGE difference between a government insurance program saying sorry, we can't cover you cuz you waited too damn long, or whatever, or offering to cover in exchange for paying back-premiums (and offering an easy and accommodating installment plan - why not?), and a private insurance company flat out saying, we will NEVER cover you because you're gonna cost us too much money, and if we covered you we'd only be able to pay for 10 yachts and 8 private islands instead of 20 and 16.

This whole fear of people abusing the system is itself being abused to say that passing this crap individual mandate is absolutely necessary for any kind of expansion of government health insurance.

Hey, I got an idea for health care reform.  Make anyone who is ever denied for a preexisting condition automatically eligible for Medicare - not Medicare buy-in, actual Medicare.  How's that sound?


[ Parent ]
I agree, but what I was saying was that it's not popular enough in the House, not in the country (4.00 / 1)
Like I said, Medicare+5 PO in a must-pass health care bill couldn't even get 218.  Too many rural members of Congress are unsatisfied with Medicare's reimbursement rates.  Figure out a solution and the path is (more) clear.

[ Parent ]
Ah, another excuse not to pass it (0.00 / 0)
When is there going to be some arm twisting ie "If you vote No then no more earmarks..." "If you vote no then no campaign support next cycle..."

sigh


re: pay (0.00 / 0)
Somebody's going to pay

yes.

People have accidents. People get cancer. Etc. Are you saying these people will be better off without insurance?

no, I say they'll be better off with a PO.

Look, millions of people get paid treatment through ahip insurance. Ahip does not pocket 100% of premiums collected, so you simply cannot claim that people absolutely won't benefit from private insurance.

did I do that? I claimed the net benefit is negative.

(Yes, insurance MLR's are too low, but they're not zero).

mlr's have to be enforced. someone has to say 'no ahip, you can't classify overhead costs as treatment.'

Now, you could reasonably argue that a $500 policy really should only have to cost $400 if ahip wasn't skimming profits. But that's a real $400 cost that has to be borne by somebody -- it doesn't magically disappear just because insurance is private. The question is should someone who should be able to afford $500/mth ($75,000 annual income required) be responsible for that real cost or not. If not, who should? Why?

the gov't should collect and pay. one payer.


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