This afternoon, Health Care for America Now! director Richard Kirsch stated that there were not enough votes to pass a public option through reconciliation in the Senate.
This statement came on a conference call with supporters this afternoon. Billed as a "Finish Health Reform Right Strategy Call" with Senator Al Franken, over 3,500 people were listening in by the first fifteen minutes.
The strategy presented on the call for finishing health care reform was two-fold:
House should pass Senate bill with a pledge from the Senate to fix it in reconciliation. Senator Franken talked of "pledge and pass," which means the House needs to pass the Senate bill with a pledge from the Senate that it will be fixed in reconciliation. This is somewhat in conflict with Speaker Pelosi's statement that the Senate must actually pass a reconciliation bill before the House acts at all. A pledge alone isn't good enough for the House. Franken stated that he also thought the Senate bill needed to be improved, but that "the perfect--and we all have different ideas of what perfect is--shouldn't be the enemy of the very good."
Into the streets to create political will. The second part of the strategy is to make enough noise through protests, rallies, letters to the editor, and calls to Congress to create enough pressure for Congress to pass health care.
When asked by a caller if it was possible to include a public option during the Senate reconciliation process, HCAN director Richard Kirsch said, "I will be frank with you," and went on to say there are not enough votes. Kirsch said that perhaps this was the case back in the fall, but it is no longer the case now.
Kirsch did claim that the bill, if passed, would lead to a public option in a future health care fight. His reasoning, which seemed somewhat cryptic, was because the health care legislation currently before Congress would make the federal government more invested in health insurance than before. As private costs continued to increase, it would cost the federal government more money. Eventually, the federal government would tire of paying excessive fees to private companies, and support would build in Congress for the public option. Or something.
Last week I argued that the only reason the public option campaign went down to defeat in the Senate was because a few Senators lied to us.
I stand by that analysis, but it still leaves me with a couple of regrets about the campaign:
1. We should have been throwing everything at getting health care done through reconciliation from the start. If the only reason we lost is because a few Senators lied, then we should have been pushing just as hard for reconciliation as anything else in the fight. If there are bad-faith actors in the caucus, then the goal should have been to remove their influence over the process altogether. That would have meant conducting a whip count to reach 51 senators in favor of using reconciliation. We could have started it as soon as the budget passed with reconciliation on April 29th.
2. We should have pushed to expand Medicare availability, rather than create a new public option. As popular as the public option was in polls, Medicare is even more popular. It is also simpler to explain, and does more to build toward universal coverage through Medicare in the future.
*******
No guarantee this would have changed anything for the better. We may never have found 51 votes for reconciliation, and there may have been the same, long, slow fold on Medicare expansion as there was on the public option. Still, as we look to the future, I hope any path progressives follow on health care focuses on reconciliation and expanding existing public options, rather than creating new ones.
I've seen a few post-mortems of the public option campaign kicking around the Internets. Invariably, as more are written, some will blame the people leading the campaign for not adopting different tactics which, the authors of the post-mortems will claim, could have led to victory.
Before this line of writing becomes too widespread, we all need to remember that the only reason we didn't win the public option campaign was because a few Senators lied to us. Unless someone can think of ways to have prevented them from lying, then these post-mortems will be useless.
From that point, the only four Senators we still needed all lied to us in one form or another. Both Mary Landrieu and Blanche Lincoln signed a document stating that they supported a public option, only to reverse their positions. Blanche Lincoln's website still comically claimed she supported a public option even as she was declaring her opposition to one on the Senate floor.
Six days later, Lieberman and Nelson went on national television to engage in some more mendacity. Lieberman said he would filibuster the deal, even though he had told Reid he liked it, and even though he had recently advocated for it. Ben Nelson badmouthed the deal even though he helped forge it.
And then, when the lying was all done, Rahm Emanuel ordered the Democratic Senate caucus to do as Lieberman said. And the Democratic Senate caucus not only is ready to comply, but to do so without punishing Lieberman (or any of the other liars, for that matter).
To put it bluntly, we had won the campaign, but were lied to by a small number of Senators. In particular, we were lied to by Joe Lieberman. If you have a post-mortem that could have prevented the lying, I'd love to hear it. For, were it not for the lying, the public option campaign would have been won.
Update: Just stop yelling at each other in the comments. Just stop it. It doesn't help anything. I'll keep that in mind myself.
Update 2: Instead of yelling at each other, watch Franken shut Lieberman down. It will make you feel a little better:
Emanuel didn't just leave it to Reid to find a solution. Emanuel specifically suggested Reid give Lieberman the concessions he seeks on issues like the Medicare buy-in and triggers.
"It was all about 'do what you've got to do to get it done. Drop whatever you've got to drop to get it done," the aide said. All of Emanuel's prescriptions, the source said, were aimed at appeasing Lieberman--not twisting his arm.
I contacted a Senate aide to further confirm the story. When I asked the aide if the Huffington Post and TPMDC stories were true, the aide responded "absolutely."
Further, the aide confirmed that Joe Lieberman is lying (I'm not exaggerating the language). Immediately after the Gang of Ten struck a deal on the public option, Harry Reid contacted Lieberman to hear his thoughts. Lieberman indicated that he was liking what he was seeing, and just wanted to wait for the CBO score. For him to change without the CBO score is mendacity, pure and simple.
Finally, the aide also said that this is still about saving lives. We keep talking about cost, but this bill still saves lives. For all of its tremendous disappointments, the aide kept emphasizing that the bill saves lives. This shows, if nothing else, that Alan Grayson's messaging appears to have won the day for Democrats.
I don't really know what to think right now. Too angry to think straight. After a very long campaign, we had appeared to secure a deal that I thought was acceptable. We promptly get stabbed in the back by none other than Joe Lieberman (and the CBO, btw), and then just as promptly told by the White House to accept it all.
The cloture motion on health care reform will be filed either tomorrow or Thursday, setting up a vote two days later. With a very crowded legislative schedule, and demands from the White Hosue to pass the bill in 2009, there really isn't any other option. My bet is that Olympia Snowe will probably vote for the bill now, as will Roland Burris. All of this makes even the unlikely prospect of a no vote from Bernie Sanders on the cloture motion irrelevant. Barring further mendacity, this bill now has sixty votes.
The next step will be the conference committee, unless the White House demands that also gets thrown in the trash to appease Lieberman, or Nelson, or whoever.
A new report from the Huffington Post claims that Rahm Emanuel told Harry Reid to cave to Lieberman's double-cross, and just pass anything:
Rahm Emanuel visited Senate Majority Leader Harry Reid in his Capitol office on Sunday evening and personally urged him to cut a deal with recalcitrant Sen. Joe Lieberman, two Democratic sources familiar with the situation said.
Some readers may not accept reports from anonymous sources. However, consider that if any Senate aide put their name to a report about Rahm s/he would be fired instantly and faced an immediate end to his or her career. The White House deny the report anyway, the vast majority of die-hard Obama administrations believe the White House anyway, and the aide would have been reviled by huge numbers of rank and file Dems. In short, if an aide had been willing to attach his or her name to the report, it wouldn't have changed anything, except ruining the aide's life.
Sen. Tom Harkin (D-IA) just walked walked into the Democrats all-important caucus meeting tonight sounding defeatest about the chance that a Medicare buy-in or public option trigger will survive Sen. Joe Lieberman's (I-CT) decision to block the compromises this weekend.
Asked by a reporter if the Medicare buy-in will be pulled out, Harkin said "looks that way," before praising a Democratic health care bill without the two public option compromises.
Earlier today, Matthew Yglesias argued that Matt Taibbi's criticism of the Obama administration on financial policy is off because Congress largely has purview over that policy. Instead, the Obama administration should be criticized for those areas of policy over which it has more direct control:
If you want to complain about the Obama administration, you should complain about their conduct of issues they actually have control over. Foreign policy and the war in Afghanistan, for example.
However, these two Lieberman incidents show that the Obama administration does, in fact, have a lot of influence over many Democrats in Congress on virtually all issues.
By picking Rahm Emanuel as Chief of Staff, President Obama immediately signaled that the White House was not going to use this influence against conservative Democrats in Congress who sought to water down the Democratic agenda. Then again, as I pointed out last night, Democrats in Congress also don't seem interested in putting pressure on the more conservative members of their caucus who seek to water down the Democratic agenda. At the highest levels of the Democratic Party, no pressure ever seems to be applied to conservative Democrats who seek to water down the Democratic agenda.
Whatever pressure is applied is going to have to come from the grassroots. However, there are limits to what pressure we can apply on our own, as Matt Stoller articled in his farewell post on Open Left. Clearly, one year later, we still have a long way to go on solving the Rootsgap. Despite everything that has happened, we are still in a very difficult environment for passing progressive legislation.
There is rightly a lot of focus on how Joe Lieberman is acting in bad faith on the health care bill. He apparently had told Reid he was open to the deal, and he supported a Medicare buy-in only three months ago. However, it is wroth noting that he isn't the only one. Mary Landrieu, Blanche Lincoln, and Ben Nelson haven't exactly been consistent and forthcoming in their dealings on the public option, either.
Mary Landrieu. Landrieu has said she is a no vote on the public option for for quite some time, instead demanding a trigger:
Count Sen. Mary Landrieu (D-La.) as a "no" vote on the public insurance option.
"I am not open to a public option, however I will remain open to a compromise - a full compromise," Landrieu told reporters Tuesday. "A public option is not something I support i don't think its the right way to go."
However, not long before she said that she opposed the public option, she said that she supported it. Landrieu signed a statement with Health Care for America Now, celaring the following:
Our government's responsibility is to guarantee quality affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing...
A choice of a private insurance plan, including keeping the insurance you have if you like it, or a public insurance plan without a private insurer middleman that guarantees affordable coverage.
But hey, what do promises like that mean to Mary Landrieu, given that she is not up for re-election again until 2014?
Blanche Lincoln. On November 21st, Blanche Lincoln declared on the floor of the Senate that she would filibuster any bill with a public option:
I have already alerted the Leader, and I am promising my colleagues that I am prepared to vote against moving to the next stage of consideration as long as a government-run public option is included.
"I am concerned that it's the forerunner of single payer, the ultimate single-payer plan, maybe even more directly than the public option," he said.
This is even though Nelson himself was one of a very small group of Senators who actually developed the Medicare buy-in compromise. Nice. If you are going to strike a deal, then defend that deal.
All four of these Senators have acted on bad faith in the public option. If they were consistent, at the very least we should have 60 votes for a Medicare buy-in for the Senate bill. They all recently supported such a buy-in.
Senate Democrats are meeting at 5:30 p.m. to discuss what to do next. At least one prominent insider claims that Lieberman's continuing bad faith will renew the push for reconciliation, but I am less optimistic. Even Senators like Tom Harkin and Russ Feingold seem pretty opposed to using reconciliation for health care, which might explain why the leadership doesn't seem open to it right now.
To no one's surprise (but certainly to my disappointment), Joe Lieberman has now told Harry Reid that he will filibuster any health care bill with a Medicare buy-in or a public option (emphasis mine):
Senator Joseph Lieberman (I-Conn.) informed Senate Majority Leader Harry Reid (D-Nev.) in a face-to-face meeting on Sunday that he will vote against a health care bill that includes a public option or a provision that would expand Medicare, a Democrat Senate aide tells the Huffington Post.
The two Senators had a discussion in Reid's office shortly after Lieberman appeared on CBS's Face the Nation Sunday morning. The Connecticut Independent discussed with Reid some of his concerns about the legislation, elaborating on issues he had raised during the show. According to the source, who was briefed on the exchange, Lieberman punctuated the discussion by telling the majority leader directly that he would vote against the bill if the Medicare buy-in and public option provisions remained in it. Roll Call reports that Lieberman said he would also support a Republican filibuster of legislation that included these provisions.
This is a reversal of Lieberman's position when the deal was struck:
A Senate Democratic aide, flummoxed by Mr. Lieberman's stance, said, "It was a total flip-flop and leaves us in a predicament as to what to do."
Lieberman flip-flipped because he can. No matter what Lieberman does, the majority of the Democratic Senate caucus won't do anything about it. Here is a quick review:
When Lieberman blows up a hard-fought deal on health care legislation, the Senate Democratic leadership immediately declares that circumventing Lieberman through reconciliation is still not on the table:
The final path would be to try the reconciliation, the parliamentary procedure that would allow Democrats to pass chunks of health care reform by a simple up or down vote. There are a host of hurdles that come with going down this route, including questions over what, exactly, could be passed. And at this point both the White House and Reid's office seem hesitant to use the procedural tool, even after Lieberman's latest round of opposition.
"It is not on the table at this point," the source said. "We are still trying to go through regular order."
If it is not on the table at this point, it is hard to imagine when it ever will be.
Nothing Lieberman is doing would be possible without the ongoing support of the majority of the Democratic caucus. If Democratic Senators wanted to punish Lieberman for his consistent transgressions against the party, they could. If Democrats wanted to use reconciliation, and just circumvent him altogether, they could do that to. But they are not going to do either.
As such, Lieberman is simply taking the power that is being handed to him by the rest of the caucus. Since he knows that Senate Democrats won't ever punish him, and won't ever circumvent him, he now has free reign to dictate whatever legislation he wants, get tons of face time with the White House and Senate leadership, regularly be the top story on news outlets around the country, receive millions in campaign contributions, and appease his Republican base (at this point, most of Lieberman's supporters are Republicans). It is a great deal for Lieberman, and it would not be possible without the ongoing consent of the majority of the Democratic Senate caucus.
Since we have already defeated Lieberman in a Democratic primary, there is nothing more severe we can do as progressive activists to directly threaten Lieberman. What we need to start doing is taking action against the Democrats who enable Lieberman and his ilk. If other Senate Democrats are not going to do anything about Lieberman taking control of the entire caucus, then really, what is the difference between those other Senators and Joe Lieberman?
Never thought I would echo George W. Bush, but we have reached the point where it is time to stop differentiating between problematic Senators like Joseph Lieberman and the other Senate Democrats who enable them.
In the wake of the tentative Senate health care compromise, I am going to reiterate the case I made last night that the public option campaign was actually a real success. While it looks like we didn't get a new public option program, we have received at least:
4 million more people covered by Medicaid, which is a public option, than the July version of the House bill
1-2 million covered by a Medicare buy-in, which is also a public option, and which was entirely absent in the July version of the House bill
An increase, from 85% in the July House bill to 90% now, in the percentage of money companies receive on health insurance premiums that must be spent on health care.
These are all concessions directly made to progressives in return for dropping a Medicare +5% public option that would have covered 10 million people. Not bad.
The Progressive Caucus spent five weeks in September and October trying to round up support for health care reform with a Medicare +5% public option in the House. While they came up about 10 votes short, they knew they were doomed to fail from the start. A public option tied to Medicare rates had no chance of passing the Senate, and the CPC knew it. As near as I could tell, the point of passing a Medicare +5% public option in the House bill was improve the bargaining position for the public option in the conference committee. The hoped-for end point was a negotiated rats public option (which would have covered about six million people, but not as well as Medicare), plus concessions like the ones listed above.
At its fundamental core, the goal of the public option campaign was to get more people onto public health insurance plans. The Senate compromise will result in 16-17 million more people entering public health insurance plans than current law. This is down from 21 million in the bill that passed House committees in July, but it isn't zero. How can a campaign that was designed entirely to get more people on public health insurance be a failure if it resulted in 16-17 million more people receiving public health insurance?
Assuming for a moment that the Stupak language is defeated, the major objection I am still seeing to this bill from the left is that some people will be facing a mandate without the choice of a public option. Specifically, that means people between the age of 27 and 54 (inclusive) who do not have insurance from their employer and whose income is above 133% of poverty level. That is certainly a substantial group of people, numbering somewhere between 20 and 22 million.
Covering 16-17 million more people on public health insurance than current law, among an overall decline in the uninsured population by 30-35 million, with a cut in health insurance industry waste and profits from 30% to 10%, is, in my estimation, much better than the status quo. Public insurance rolls will be increased, lives will be saved, and industry profit margins will take a real hit. If a $95 per annum mandate penalty in 2014, and a $750 per annum mandate penalty in 2019, makes all of that too much to swallow for you, I am not going to argue with you. But there is a strong case to be made for this compromise.
I will be on Live on the Left Coast at 9:40 p.m. eastern to discuss the Medicare buy-in compromise
On its most abstract, ideological level, the fight over the public option is about moving people off private insurance and onto public insurance. And, on that level, neither the "level playing field" public option nor the negotiated rates national public option are the primary means of getting more people onto public health insurance in either the House of the Senate bills.
The CBO analysis of both the House and Senate bills projects that either one would result in another 15 million more people receiving health insurance from Medicaid and the Children's Health Insurance Program. By comparison, the CBO projection for the public option in the House bill would cover 6 million people, and the public option in the Senate bill would cover 4 million people. Kind of makes you wonder what the real public option has been all along.
Now, it looks like a deal has been struck in the Senate to replace the opt-out public option for a weak Medicare buy-in. There were reason to be interested in the Medicare buy-in, but the current deal will only be open to Americans between the ages of 55 and 64 who are uninsured:
Democratic senators say they have a tentative deal to drop a government-run insurance option from health care legislation. No further details were immediately available.
But liberals and moderates have been discussing an alternative, including a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, talks centered on opening up Medicare to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the over-65 population.
There are about 3.24 million uninsured Americans between the ages of 55 and 64 (that's 7% of a total uninsured population of 46.3 million). If, as per an earlier CBO projection, 33% of those eligible for a public option tied to Medicare rates (which, in this case, would actually be Medicare) enroll, then this public option "compromise" would only cover 1.08 million Americans, or only about 25-33% of what the opt-out public option would have done.
So, it looks as though the buy-in compromise is indeed worse than even the opt-out compromise. However, the next play should not be to fight to save the opt-out, "level playing field" public option, but rather to expand the Medicare buy-in to all Americans between the age of 55 and 64 (inclusive). Such a buy-in would cover 13 million people under public insurance, more than double the amount under the House public option. The 13 million number was derived from there being roughly 39,000,000 Americans between the age of 55-64, and the earlier CBO's estimate listed above of 33% of those eligible opting in.
Ideally, we would have the public option and the Medicare buy-in. However, if you have to choose which one to try and save during the conference committee, I am simply going with whichever plan gets more people on public insurance. And, by a long way, that is making all Americans between the ages of 55 and 64 eligible for the Medicare buy-in.
Update: There are a lot of different claims about the details of the agreement floating around right now. Very hard to know which ones are accurate. Reid won't release the details until the CBO reports on the new agreement.
What little we do know suggests that there is a triggered co-op (that will do a lot of frakking good), and the Medicare buy-in starts in 2011. I have heard wide ranging details on of the buy-in itself. Until we know the specifics, it will be impossible to tell if the buy-in will cover more people under public insurance than the opt-out level playing field would have done.
But, even if the buy-in doesn't cover more people than the opt-out, it will cover them better (with Medicare rates) and sooner (in 2011) than the opt-out would have done.
For the past five weeks, there have been only four Democratic Senators blocking the public option: Mary Landrieu, Joe Lieberman, Blanche Lincoln and Ben Nelson. Now, with a new compromise being discussed-allowing Americans to buy-in to Medicare at 55, three of those Senators appear supportive of the idea. Further, Blanche Lincoln, who has always been the most mercurial in making public statements on this topic, faces the real possibility a strong primary challenge.
Here is a quick whip count of the problem Senators on the Medicare buy-in compromise:
Landrieu said the goal is to take the pure public option out of the bill and said she might back an expansion of Medicare that would require a buy-in if it's supported by premiums paid by new enrollees.
On the Medicare buy-in--which has significant appeal among liberals--Lieberman was open, but non-committal. "I'll take a look at it," Lieberman said. "I think the good news is, however, that the current bill will, for the first time, provide people 55 and over who are not yet eligible for Medicare with subsidies to go on to the exchanges and buy, so they can buy for a lot less than it costs them in the marketplace now."
"I'm open to looking at it," Lieberman told reporters. "But I want to make sure that we're not...adding a big additional burden to the Medicare program."
Sen. Ben Nelson, D-Neb., said the idea is on the table as part of an emerging compromise under which liberals would back away from their demand for a new government health insurance plan to compete with private carriers. Instead of a so-called public plan, the compromise envisions private insurers operating under the auspices of the government agency that now manages the federal employee health plan -- the same one that covers members of Congress.
Although none of these are clear statements of support, they are all statements indicating that an OPM plus Medicare buy-in compromise appears very close. Further, Blanche Lincoln faces the very real possibility of a very strong primary challenger, giving us leverage over one of the final hurdles.
Now, the OPM plus Medicare buy-in is not necessarily a good enough trade for the opt-out public option. Since there would still be a national mandate, and the new public option provision in the bill would be limited to people between 55 and 64, weakening the mandate should now become a major goal of progressives before accepting it. Further, as Howard Dean says, this buy0in must be available from day one (which would actually be a huge improvement from the opt-out public option). Yet further, Ron Wyden's "free choice" amendment opening the insurance exchanges to all Americans, and Al Franken's amendment requiring 90% of the money spent by consumers on health insurance premiums to go to health care costs, both need to be added.
Still, lowering the age of the Medicare buy-in would be a victory in the public option campaign. If it is included in the final bill, a significant percentage of Americans will be able to buy-in to a publically-run health insurance option tied to Medicare rates. That is exactly what we have been demanding all along, with the only compromise being that all Americans won't be able to buy-in. Americans aged 27 to 54 would still be left out in the cold, and that will need to be fixed in the future.
The good news is that the logic of this compromise dictates that the way that huge donut hole would be fixed in the future would not be through the creation of a new public option that is separate from Medicare, but by opening up Medicare to all Americans. That is something that I imagine left-wing opponents health care bill would be happy to hear, as the next health care fight--which will take place in 8, 12 or 16 years-will indeed be over Medicare for all.
The path forward for the public option is grim. Here is what it faces:
Landrieu, Lieberman, Lincoln and Ben Nelson all appear to oppose cloture on a health care bill with the current version of the public option in the Senate. The new "compromise" they are working on has nothing to do with the public option at all. It isn't even the non-public (co-op), non-option (trigger) that Carper had floated for a while. It is something else entirely:
Following the meeting, Pryor declined to get too specific, but did say that a leading proposal involves increasing the ability of the Office of Personnel Management -- which oversees the federal employee health plans -- to negotiate on behalf of individuals and small businesses. Pryor told a HuffPost and an AP reporter that it was unclear how exactly it would be set up, but that it would take the place of the public option managed by the Health and Human Services Secretary.
This isn't necessarily a bad idea, but it certainly is not a public option. Then again, the co-op trigger wasn't even close to a public option either, so maybe it really doesn't matter.
Reconciliation is probably a dead end. Even though there appear to be enough votes for a public option to pass through reconciliation, few Senators are discussing reconciliation as an option right now. What's worse, a reconciliation bill would have to go through Kent Conrad's Budget Committee, which almost certainly make sure that a Social Security / Medicare "commission"be attached to any health care bill (update--commenter JasonCNJ corrects me on the process of reconciliation) be passed in exchange for a public option that went through there. Trading the public option for an undemocratic cut of Social Security and Medicare is not something I, or I bet many public option supporters, would be happy with.
Killing the bill from the left in the Senate is not going to happen. While some people think that Roland Burris and Bernie Sanders have claimed they will block a bill that lacks a public option, they really haven't. A spokesman for Burris specifically told me he has not committed to voting against cloture on such a bill, and Bernie Sanders has simply said he would be "very reluctant" to accept such a bill. Further, keep in mind that not long ago Sanders was taking the lead in trying to get all Democrats to vote for cloture on the bill. Doesn't seem to me like any Senate Democrats will filibuster the bill from the left.
At this point, reinstating some form of the public option during in conference committee is probably the best option. The conference committee would take place in January, giving us more time to pressure Lieberman, Lincoln, Landrieu and Ben Nelson (who is actually more focused on Stupak-language), to accept cloture on a bill without a public option.
However, during a conference committee, the pressure would largely fall on House Progressives to fold yet again. Fifty-eight of the sixty members of the Progressive Block already backed down from their threat to kill the bill if it lacks a public option tied to Medicare rates, making it difficult to draw a new line in the sand. Further, the current major fight in the House is actually over the Stupak amendment, which will not be in the Senate version of the bill (Ben Nelson's Stupak amendment will be defeated either later today or tomorrow). Given that there are competing blocs threatening to kill the bill in the House if the Stupak amendment is included or removed, expect that fight to take precedence.
The possible paths for the public option are all pretty poor. This has led some to start asking what Progressives would consider accepting in exchange for the public option. The only two ideas I have ever thought of are:
A trigger written by the Progressive Caucus. That gambit was already floated, and rejected, by Senators like Susan Collins. Plus, Lieberman is opposed to even the trigger.
The Franken amendment which would require 90% of all health insurance dollars go to providing health care. Currently, the House bill only requires 85%.
Overall, the best bet would be to get the Franken amendment in the Senate bill before the conference committee, and keep up the pressure for the public option in the conference committee. Then, when the conference committee is over, we review our options, and decide whether or not that final version of the bill is worth passing.
Update--Medicare buy-in compromise?: Ezra Klein reports that allowing Americans aged 55 or older (instead of the current 65) is gaining steam as a possible "compromise."
F*ck the triggered co-op. The OPM plan, plus the Franken amendment, plus lowering the age to buy into Medicare, would be a helluva a lot better.
Based on statements Senators have made, this "compromise" is apparently something that at least Ben Nelson, Mary Landrieu and Olympia Snowe support. However, even with those three Senators, that is still not enough for 60. In order for the triggered co-op plan to pass, it will also need either Blanche Lincoln or Joe Lieberman jump on board, and the support of all Senators who favor something stronger. Relating to the later, Roland Burris and Bernie Sanders have made noise about voting against a health care bill without a public option, although neither have stated they will vote against cloture.
Progressive Caucus co-chair, Raul Grijalva, calls the compromise "unacceptable," but is vague on what the Progressive Caucus will do in response:
"I think that compromise is totally unacceptable," Grijalva told The Hill. "It basically emasculates the public option."(...)
The Arizona Democrat expressed concern that a Senate bill including the compromise on which Carper is working would drag the bill to be crafted during conference with the House bill beyond what is palatable for House liberals, who'd previously threatened to vote against a bill on final passage if it did not contain a sufficiently strong public option.
Grijalva said that he had had no conversations with House leaders, however, about the prospects for such a bill.
"We've made our position clear," Grijalva added.
Stupak
Ben Nelson is saying that he will never vote for cloture, unless there is a Stupak-like amendment. Beyond the mandate, the continued inclusion of Stupak could very well be reason to actually kill the bill.
Representative Diana DeGette says that Stupak does not have the votes to pass the bill in the House, or at least that he won't:
Rep. Bart Stupak (D-Mich.) won't have the votes to block a health bill if it doesn't contain his abortion restrictions, Rep. Diana DeGette (D-Colo.) claimed Tuesday.
DeGette, the co-chairwoman of the Congressional Pro-Choice Caucus, refuted Stupak's claim that he has enough votes to fell health reform in the House if leaders strip his amendment expanding restrictions on federal funding of abortions.
"I think he won't have the votes when people explain to those members what exactly the Stupak amendment does," DeGette asserted during an appearance on ABC News's "Top Line" webcast.
DeGette is organizing the Pro-Choice Block of 41 House Democrats who vow to defeat the bill if the Stupak amendment remains in the bill after conference committee.
Process updates, and a list of amendments, can be found in the extended entry.
Health care reform must build upon what works and improve inefficiencies. Individuals should be able to choose from a range of quality health insurance plans. Options should include private plans as well as a quality, affordable public plan or non-profit plan that can accomplish the same goals of a public plan.
Blanche Lincoln is a liar. She signs a document stating that she supports the public option. Her website says that she would be fine with a public option. And then she does on the floor of the Senate, and promises to filibuster any bill with a public option.
There is still a real possibility that Lincoln could face a high-profile primary challenge next year. The challenger won't be a great progressive, but would still be an improvement over the lying Blanche Lincoln. Further, Arkansas remains a Democratic state at all but the Presidential level, and so that primary challenger might very well have a better chance in the general election than Lincoln.
Let's hope that primary challenge starts sooner, rather than later. Blanche Lincoln is a lair, and needs to be removed from office.
This is also an open thread on the health care vote tonight, which passed 60-39. Senator Voinovich of Ohio did not attend.
As part of their statements, Landrieu and Lincoln are both claiming they will filibuster a bill with the current version of the public option. Landrieu is demanding a trigger, and claims that she is working on a compromise of that sort with Senator Schumer. Lincoln did not specify a trigger as part of her demands. They join Joe Lieberman, who has been threatening to filibuster a bill with a public option for nearly a month.
It is worth noting that, several months ago, both Mary Landrieu and Blanche Lincoln singed the HCAN statement of common purpose which states:
Our government's responsibility is to guarantee quality affordable health care for everyone in America and it must play a central role in regulating, financing, and providing health coverage by establishing:
A truly inclusive and accessible health care system in which no one is left out.
A choice of a private insurance plan, including keeping the insurance you have if you like it, or a public insurance plan without a private insurer middleman that guarantees affordable coverage.
So, these Senators are just flat-out liars. Both Lincoln and Landrieu signed a document stating that it was the "government's responsibility to guarantee... a public insurance plan," and now they both claim they will filibuster a bill with a public insurance plan.
Both of them flipped on the card-check provision of EFCA, too. They are just liars. I don't even know why we deal with lying Senators like these. I certainly don't know why we give to organizations that give them money. How can we believe anything either from these two Senators, or from organizations that are funneling them money? They consistently lie to us about the most important, progressive aspects of the Democratic agenda.
It now seems quite likely that the Senate has the 60 votes necessary to force cloture on the motion to proceed with the health care bill. The final three votes Senate majority leader Harry Reid needed were Ben Nelson, Blanche Lincoln, and Mary Landrieu, but all three now appear to be ready to vote "aye." Here is a rundown of all three:
"This weekend, I will vote for the motion to proceed to bring that debate onto the Senate floor," Nelson says. "The Senate should start trying to fix a health care system that costs too much and delivers too little for Nebraskans."
Nelson indicates that this does not mean he is ready to support cloture to pass the bill, but he is willing to let debate go forward.
Earlier today, Senate #2 Dick Durbin stated that Blanche Lincoln has told Harry Reid she would vote yes. Durbin is now walking back that statement, but really, the gig is up for Lincoln.
Anyway, what was Lincoln going to do--oppose even letting the debate go forward and then ask Democrats to vote for her in 2010? Not bloody likely, especially with a prominent figure in Arkansas still considering a primary challenge. Lincoln is highly likely to be a yes.
Right-wingers are in an uproar over this, but really--I am shocked, shocked to find that there is gambling going on in this casino! A member of Congress holding out on a key vote in order to secure funding for her home state or district!? I bet that has never happened before. This is really breaking new ground on Capitol Hill!
Further, while they don't seem to realize it, the right-wing uproar over Landrieu's deal actually makes it virtually impossible for her to vote against cloture now. Due to right-wing publicity, now everyone knows Landrieu is bringing $100 million home by holding out. As such, what is Landrieu going to do--issue a statement that preventing a floor debate on health care is more important than $100 million for Louisiana? Only 9% of Louisianans think she should block the debate. I bet a lot more than that want the $100 million, especially now that everyone has heard about the $100 million.
So, it looks like Democrats have the 60 needed to move forward on debate. The truth is that Reid probably secured the 60 votes before filing the cloture motion. It is a rare day when the leadership doesn't know the outcome of a vote before scheduling it.
The vote will take place tomorrow night, at 8 p.m. eastern, following an all-day debate. Notably, in exchange for the all-day debate, Senator Coburn has dropped his demand that the entire bill be read out loud, which means there will be less droning on C-SPAN2 during Monday and Tuesday of next week.
In the comments to today's action post, some have asked why I, and other progressives, are embracing the Senate bill. Here is my blunt answer: 45,000 Americans die every year from lack of health insurance. The Senate bill reduces the number of people uninsured in this country by roughly two-thirds, thus potentially saving 30,000 lives a year. The House bill will reduce the number of uninsured by roughly 75%, thus potentially saving 36,000 lives a year.
By no means does this solve the health care problems we face in America, but this is still a real achievement. Throw in the fact that, against all odds, we managed to get a triggerless public option in the bill, and yeah, I'd vote for the Senate health care bill. And yeah, I will work to pass it.
Right now, we have 56 votes for cloture, and we need to get the last four frickin' members of the Democratic Senate caucus on board. The Adopt-a-State action is a great way to help do this. Please, join in.
The action is going well, too. By a long, long way, more members of the Open Left community are participating in this action than any non-petition action we have run since the Senate whip count campaign over the summer. Already, nearly 4,000 over 7,000 people have clicked through to SEIU's Adopt-a-State action site, just from the email blast. Many more have clicked through from the blog itself.
I'm glad that people are pissed off. I am actually glad that some are not willing to accept the bill. As I wrote earlier today, I believe we need a much larger, hardcore progressive base.
But personally, I support this bill, and I will work to get it passed. If you don't, that's fine, but if you do I hope you will take part in the Adopt-a-State action. This can save lives--a lot of lives--and we are only four frickin' senators away from pulling it off.
The Senate introduced its health care reform bill yesterday, and only four fricking members of the Democratic Senator caucus are standing in the way of passage. Joe Lieberman of Connecticut, Ben Nelson of Nebraska, Blanche Lincoln of Arkansas, and Mary Landrieu of Louisiana are the only four remaining "Democratic" Senators who have not ruled out joining with a Republican filibuster of health care reform.
What the #%@*!?!
What's worse, these four don't really give a rat's a$$ what you think, even though their vote affects you. Unless you are a resident of Arkansas, Connecticut, Louisiana or Nebraska, as far as they are concerned, you might as well live on Pluto.
Fortunately, Open Left is teaming up with SEIU to do something about it. Even if you do not live in Arkansas, Connecticut, Louisiana or Nebraska, SEIU has developed activist tools that allow you to contact voters in those four states, and tell those voters to tell their Senators to get on board with health care reform. Fight back and make a difference--sign up and tell one, or all four, of these "Democratic" Senators to pass health care reform with a public option:
All the efforts we made to retake Congress. All of the efforts we made to retake the White House. All of the efforts we made to find 51 Senators in favor of health care reform with a public option. It took us fifteen years to get to this point, and we still have to deal with four freaking Democratic Senators who might join with Republicans and filibuster health care reform? Aaarrgghhhh!
1. What's in the bill? The Senate Democratic caucus has just started their meeting on the merged senate health care bill. Wonkroom tweets, via CNN, that the bill will cost $849 billion, and reduce the deficit by $127 billion, over ten years. Via Quick Hits, it will only over 94% of Americans (31 million), which is up from 83%, but below the 96% (36 million) estimated by the CBO for the House bill. So, it actually has a higher cost per person covered than the House health care bill, with less generous subsidies to match.
Over at Fire Dog Lake, Dave Dayden breaks down what to expect in the bill. It appears that, at least for now, it will include the opt-out public option. The triggered co-op, not reconciliation, remains "Plan B.".
2. Will it get to the floor? Earlier in the day, majority leader Harry Reid gave Ben Nelson, Mary Landrieu and Blanche Lincoln a sneak peak of the bill. The only conclusion to draw from this is that these are the only three Senators who have not committed to vote in favor a motion to proceed on the bill.
Ben Nelson seems to be leaning in favor of voting yes, although he doesn't promise to support the bill in its final vote. No indication from Blanche Lincoln. May Landrieu claims to be leaning toward voting against, probably in an attempt to force concessions even before the bill hits the floor. If she does defeat the bill, it will delay the process in the Senate by at least two more weeks, and water it down even further.
3. What is the timeline and process? The motion to proceed vote is expected on Saturday, in order to give 72 hours between unveiling the bill and voting on it. Then again, I'm not sure why, given that this is the motion to proceed, rather than the vote on the actual bill. A complete description of the process required to bring the bill to the floor can be read here.
Really limping forward here. At this point, the best case scenario is that the debate and amendment process will begin on Tuesday, December 1st.
The CBO is expected to complete its analysis of the Senate health care bill today. This completes the merging of the Senate Help and Senate Fiannce committee bills, and starts the process of bringing the bill to the floor of the full Senate.
Courtesy of a Senate aide, here is a complete description of the process required to bring the health care bill to the floor of the Senate.
Health Care Process
Leader Reid moves to proceed to an HR bill, which will be the vehicle for the Senate health care bill, and files a cloture motion on the motion to proceed.
Two calendar days later, the cloture motion on the motion to proceed ripens (there has to be one intervening calendar day between the day you file cloture and the day you have the vote)
The cloture vote on the motion to proceed occurs one hour after we convene on the third day (If cloture is filed on Wednesday, the cloture vote is Friday. If cloture is filed on Thursday, the cloture vote is on Saturday, etc)
Assuming 60 Senators vote to limit debate on the motion to proceed and end the filibuster, the Senate invokes cloture on the motion to proceed
Thirty hours after cloture is invoked the Senate will proceed to vote on adoption of the motion to proceed itself (This assumes (a) consent will not be granted to yield back any post-cloture time on the motion to proceed and (b) consent will not be granted to adopt the motion to proceed itself---adoption of the motion to proceed itself is routinely agreed to by UC but Rs could force a roll call vote).
Upon adoption of the motion to proceed, the Senate will be on the Health Care bill
Leader Reid will immediately be recognized to offer the complete Senate substitute amendment to the Health Care bill
Under the rules (Rule XV, to be exact), an amendment must be read before debate can begin on an amendment. (This is routinely waived by UC (you'll often hear Senators ask consent that the reading of the amendment be dispensed with when an amendment is offered) but Dr. Coburn has threatened that he will not agree to waive the reading of the substitute amendment). Reading the entire substitute amendment would take several days.
Whether read aloud in full or not, at this point, the substitute amendment will be pending and the full amendment process will begin when we return from Thanksgiving Recess.
Democrats, in return, say they'll force Republicans to stay on the floor continuously throughout the exercise. At least one Coburn ally will have to remain on the floor to object to unanimous consent requests to dispense with the reading. Whether they'll be able to require the presence of more than one Republican, though, remains to be seen.
The long and short of it is that, starting today, the Senate health care bill will be debated in public for two weeks before debate starts on the Senate floor. The Thanksgiving holiday, and all of these procedural hoops, delay the process tremendously compared to the House. All of this is just to start debate on the health care bill on the Senate floor, and there will be many more hoops to jump through once that begins.
Determining which members of Congress would have voted against the health care reform bill if the Stupak amendment had not been included is actually pretty easy:
House Whip James Clyburn said that the Stupak amendment netted ten votes:
"It was not 40 votes that we were trying to get with this amendment it was 10 votes. And that's the fact," Clyburn said on MSNBC. "This language took us across the threshold of 218, but it was 10 people. It wasn't 40 people as has been reported."
On July 1st, 26 House Democrats sent a letter to Speaker Pelosi threatening to vote against the final bill unless the Stupak amendment was included. Of those 26, nine ended up voting for the bill:
Republican Joseph Cao also indicated he would have voted against the bill if not for the Stupak amendment.
Viola. Clyburn's ten votes are pretty easy to find.
There were 220 votes for health care reform in the House, and 218 will be required for passage on the conference report. So, in order to pass health care reform in the House without the Stupak amendment language, Democrats will need to replace as many as eight of these ten votes.
The best place to find those eight new votes would be from the 16 members of the House who voted against both the Stupak amendment and the final bill. These members thus opposed the bill for reasons that had nothing to do with the Stupak amendment:
It's a motley group that includes both conservatives from ultra-red districts (like Edwards and Minnick) and Progressives who ostensibly voted against the bill as the remnants of the Progressive Block (Kucinich and Massa). Perhaps the most notable feature of this group is that ten out of the sixteen members are in their first-term, compared to only two out of ten in the group that voted for the bill only because of the Stupak language.
These are the lists we have to work with to pass a health care bill without Stupak language, and with a public option. Off-hand, the easiest eight might be Kaptur (Progressive), Murtha (leadership), Boyd (primary challenge), Kissell (threats from donors, doesn't raise money well), Kucinich (Progressive, often faces primary challenges), Massa (Progressive), Murphy (never actually had to win a primary, still might face one) and someone.
It is a small enough group, and features enough members of either blue or purple districts, that primary challenges could potentially do the trick. I am not actually in favor of running primary challenges against people who voted against the health care bill, voted against Stupak, and co-sponsored Medicare for All, but there still should be enough blue and purple districts to get this done either way.
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