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.
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.
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.
Update (Adam): An amazing thank you to those who have chipped in so far. I am always heartened by everyone's support to keep us going.
If folks are on Twitter, Raven Brooks, Executive Director of Netroots Nation, pledged to donate $2 for each retweet of this tweet (up to $100) over the next 24 hours. Let's empty Raven's wallet by retweeting, and thanks Raven! :)
RT @ravenb Support Open Left! http://bit.ly/3TbUXw Pledging $40 and an additional $2 every time this gets RT'ed next 24 hrs up to $100 #p2
Six months ago, Open Left held a fundraiser to keep us from shutting down operations. Because of your incredible support at that time, we were not only able to keep going, but to expand our capabilities and make a real impact on the legislative process.
In particular, with the assistance of over 35,000 members of the Open Left community, we played a major role in pulling together enough votes to pass a public option through the Senate. Proving there were over 50 votes for the public option in the Senate, and helping to educate the grassroots on both Senate process and the progress of the campaign, were essential to Harry Reid including a public option in the Senate bill.
Now, against the predictions of virtually all pundits, a health care bill with a public option will reach the Senate floor next week. This is a monumental achievement, and through your financial support of Open Left, as well as your activist participation in whipping Senators, you helped make it happen.
In order for Open Left to keep operating and make an even bigger impact over the next six months, we once again need your support. If you value the information we provide, the activist campaigns in which we engage, and the strategic analysis that we offer, then please, join our fight for a progressive governing majority, and contribute today.
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With your help, we are going to keep working to bring the public option over the finish line, to engage the fight for marriage equality wherever it is being waged, and to prevent conservative Democrats from instituting new, sweeping restrictions on reproductive rights. Down the road, we are going to keep pushing the progressive envelope with efforts to end the filibuster in the Senate, to institute a new millionaire's tax in next year's budget, and to turn remaining bailout funds into a second stimulus for the rest of America.
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Even as he is bringing a health care bill with an opt-out public option to the Senate floor next week, Harry Reid is making it clear that he is open to a triggered co-op if he is unable to find 60 votes for cloture:
Even as Senate Majority Leader Reid seeks votes for a healthcare bill with a public option that states can opt-out of, Reid has allowed Sen. Thomas Carper, D-Del., to work on what one aide called a "Plan B" if Reid cannot line up 60 votes for cloture.
Carper said he and some other senators, whom he declined to name, are working on an alternative public option if the opt-out falls short.
In states where private insurers fail to offer affordable coverage, Carper said the alternative would permit them to set up a non-profit board, likely appointed by the president, to offer insurance.
Yikes! A triggered co-op!
If there is any bright side to this, it lets us all know what is at stake in the Senate fight over the next few weeks. Either we round-up the five problem Senators--Evan Bayh, Mary Landrieu, Joe Lieberman, Blanche Lincoln and Ben Nelson--to vote for cloture, or else the Senate will bring a triggered co-op to the conference committee. Those are pretty high stakes.
In addition to applying pressure on the five problem Senators, one move we need to make is to push for reconciliation, not a triggered co-op, as the fallback plan. Right up until the end of the process, the bill can still be split into two parts: one with the new regulations that requires 60 votes to reach cloture, and one with the public option and subsidies that can be included in the budgetary process and which cannot be filibustered.
Senate Majority Leader Harry Reid will send a health care bill with an opt-out public option, and without Stupak amendment language, to the floor of the Senate next week. From The Hill:
Senate Majority Leader Harry Reid (D-Nev.) late Tuesday laid the groundwork for the Senate's healthcare reform debate to start next Tuesday.
Reid filed a motion to introduce the bill on Monday, Nov. 16. Anticipating a Republican objection, the bill would be pushed onto the Senate calendar.
"A motion to proceed to the bill would be in order the next legislative day," said Reid spokesman Jim Manley.
Given the 60-vote culture in the Senate, it will take 60 votes either to remove the public option from the bill, or to add the Stupak language to the bill. This makes either pretty unlikely (especially the addition of the Stupak language).
This does not mean Reid has secured the votes to pass a public option. It does mean that Reid has likely secured the votes to start the amendment and debate process on the health care bill.
Unless the Senate uses the reconciliation process, or unless it uses the nuclear option (which it won't), it will have to pass three, 60-vote threshold, cloture votes on the health care.
The first will be to start debate. The second will be to end debate and proceed to a simple majority vote on the bill. The third and final vote will happen after the conference committee with the House, to end debate on the bill once again and proceed to one last simple majority vote. TNR summarizes the process here.
It is likely that Reid has secured the votes to start the debate and amendment process on the floor of the Senate. There was always minimal opposition to starting debate, even among the five "problem" Senators on health care: Evan Bayh, Mary Landrieu, Joe Lieberman, Blanch Lincoln, and Ben Nelson.
The significance of this is not that Reid has secured the votes to start the amendment and debate process so much as it pushes the timeline for passage of the overall bill forward. If Reid had not filed a motion to introduce the bill this week, then the earliest floor debate would have started in the Senate would have been the Tuesday after Thanksgiving. This ups the process by at least two weeks, and gives real hope that the bill will be passed into law by the end of the year.
After two weeks where most health care attention has been on the House, we now return to Senate. Here's where things stand:
Five Problem Democrats The only barriers to health care reform at this point are Senators Evan Bayh, Mary Landrieu, Joe Lieberman, Blanche Lincoln, and Ben Nelson. There are fifty-one Senators who support health care reform with a public option, and four--Max Baucus, Mark Begich, Kent Conrad, and Mark Pryor--who have made absolutely no threats to filibuster. The same cannot be said of the five "problem" Senators listed above.
Three cloture votes--threats are on the second and third There are three votes where the problem Senators could potentially join with Republicans to block the bill. First, on the cloture vote to bring the bill to the floor for debate and amendment. Second, on the cloture vote to end that debate and bring up a floor vote on the overall bill. Third, on the cloture vote to end debate and bring up a floor vote on the overall health care bill after the health care bill is returned from conference.
Right now, most of the threats to block the bill are on the second of these votes. Evan Bayh and Joe Lieberman have said they are likely to allow the floor debate. Ben Nelson has not said he will bock the floor debate, and Mary Landrieu senses a compromise is close. Blanche Lincoln recently had a one-on-one with President Obama.
So, a floor debate will likely go forward. However, that will not mean the five problem Senators have been forced into line.
Timeline The current, vague timeline for the Senate is "the end of the year."
Since Harry Reid announced that the merged Senate bill would contain a public option, the process in the Senate has slowed to a crawl. The hold-up appears to be that Reid is waiting for CBO estimates which will not be completed until the end of this week.
This means, at the earliest, floor debate and amendments will start for the health care bill one week from tomorrow. If it does not start next week, then it will start the week after Thanksgiving.
Harry Reid is also telling Senators to get ready for Saturday sessions in December.
Stupak moves to the Senate(more in the extended entry)
As you have probably heard by now, Bart Stupak's amendment to prevent any insurance plan in the health care exchanges from covering abortion procedures is set to get a floor vote tonight. If it passes as part of the bill, this would be a significant step backward for reproductive rights, even under a broad Democratic trifecta. Here is what I know:
No Progressive Block, apparently due to Obama reassurance. To my knowledge, no pro-choice Democrats have threatened to vote against the bill as a result of this. Apparently, this is because of a rumor going around Congress that President Obama promised Henry Waxman that he will "personally" work to remove the language in conference. I feel so reassured.
No other amendments. No other amendments (Medicare +5% public option, single-payer) will be voted on. Just the Stupak amendment. Apparently, the leadership felt it needed to placate Stupak, but not single-payer or robust public option supporters. Once again, the Regressives play hardball better than the Progressives.
Did the leadership get played?: Stupak claims that the bill will pass no matter what happens to his amendment. If that is true, then he really played the leadership on this, since they appear to have only allowed his amendment in order to get the votes for passage of the overall bill.
Timeline: The Stupak amendment will be voted on after the debate is over. This means around 7:15 p.m. eastern. A final vote on the overall bill will take place at around 9 p.m.
In order for it to pass, Stupak needs 41, plus all Republicans.
Take Action: Bart Stupak has claimed that Roll Call 553 was a test run for this amendment. As such, I have provided a list of Democrats who did not vote with Stupak on that occasion, but who are listed as potential votes for his bill this time around. they are the most likely targets, as they have defied Stupak before. I have also added Tom Perriello, was actually endorsed by Open Left (how embarrassing), and Frank Kratovil, who is listed by NARAL as pro-choice.
Update: Top targets moved to the top of the post.
Loretta Sanchez is a no: According to art3 in the comments, Loretta Sanchez is a no on the Stupak amendment. One down, give to go. Keep calling.
Walt Minnick is a no: Walt Minnick is also a no now. We need five more.
Spratt is a yes: Looks like we just lost John Spratt, who had previously defied Stupak. Now Stupak needs 7 more, we need 5 more.
Kratovil also seems to be a no: Per the comments, Kratovil seems to be a no.
I have refined the target list in an attempt to narrow our calls and make them more effective. If you would like to call someone else, I have kept a broader list in the extended entry, along with the number for the Congressional switchboard.
The House Committee on Rules has set the mark-up of the House health care reform bill for 2 p.m., this Friday. Having posted the manager's amendment (aka, final changes to the bill) last night, this means that a vote is likely to take place on Saturday evening. This is because the Committee on Rules must pass the bill before it goes to the floor, and also because the Speaker had promised 72 hours between posting the final version of the bill and the vote on the bill.
An aide to House Speaker Nancy Pelosi (D-Calif.) said Wednesday that a vote could happen at 6 p.m. on Saturday, a schedule House Rules Committee Chairwoman Louise Slaughter (D-N.Y.) suggested in reports Wednesday afternoon.
"It could happen at 6 p.m. on Saturday, but no final decisions have been made," said Nadeam Elshami, a spokesman for Pelosi.
The only possible way that a vote won't go forward this weekend is if Representative Bart Stupak is able to round-up enough votes to block the bill from going to the floor on the "motion to recommit" vote. Given that virtually no Republicans will oppose the bill, that Stupak has as many as 30 Democrats backing him, and that a few other Democratic members might oppose the bill for other reasons, it is possible that Stupak could still prevent the vote from taking place this weekend.
The Congressional Quad-Caucus (Black Caucus, Hispanic Caucus, Asian Pacific-American Caucus, and Progressive Caucus) sent a letter to Speaker Pelosi asking for improvement to the bill before it is passed by the House. However, it is unlikely there will be a chance for them to address their concerns via floor amendments, given that the Committee on Rules has not given a deadline for members to submit amendments. This means there will not be any amendments offered to the bill on the floor--no single-payer, no strengthening amendments of any kind--expect a single, Republican substitute amendment for the entire bill. That substitute amendment will be handily defeated.
This is a broken promise from the leadership, which had originally agreed to allow a single-payer substitute amendment. However, Stupak unfortunately left them with no choice. If members had been allowed to submit amendments, then Stupak's amendment would probably have passed through the Rule Committee, probably passed on the floor, and then probably have defeated the entire bill because it would have caused dozens of pro-choice votes to defect. So, in the end, the floor vote on single-payer was another casualty in Bart Stupak's war on reproductive rights.
As I noted yesterday, the House Committee on Rules still has not scheduled a time for a mark-up on the health care reform bill. They have to pass the bill before it goes to floor for debate, and the leadership won't send a bill to the floor until they believe they have the votes for passage. So, this delay means they are not yet convinced they have the votes.
The reason for this, unsurprisingly, remains Bart Stupak. He is, as Natasha described this morning, working to block the entire bill unless none of the insurance options in the new health care exchanges cover abortion procedures. This is even though there is already a ban on federal funding for abortion in the bill, and in pre-existing federal law. Using an alliance of Republicans, anti-choice Democrats, and Democrats who oppose the health care bill for other reasons, Stupak is claiming that he has enough votes to block the bill for reaching the floor (though the necessary "motion to recommit" vote), unless his demands are met.
As Natasha also mentioned this morning, the Democratic leadership does not actually know if Stupak has the votes or not, since no formal whip question around Stupak's demands has been completed. However, a Capitol Hill source confirmed to Natasha that they are suspicious that he has the votes. As such, they are currently whipping to see if a new compromise, which appears to re-ban something that was already banned, has enough votes to reach the floor:
Democratic House leaders have developed a compromise they hope will resolve an intra-caucus dispute about whether the health bill allows tax dollars to subsidize abortions, and they're surveying abortion opponents in the caucus to gauge support.
The language is not yet publicly available, but lawmakers familiar with it say it strengthens an existing provision intended to prevent abortion from getting any federal dollars.(...)
Leaders are hoping to start debate Friday or Saturday, and say there will definitely be a vote before Nov. 11, Veterans Day.
Lawmakers have said the abortion compromise may not be included in the final version of the bill to be released as soon as today, called the "managers amendment." Instead it may be included in the "rule" which is done the day before the vote. House Majority Leader Steny Hoyer (D-Md.) said today he did not consider that a violation of his pledge to have the bill language available for three days before a vote.
Even though the whip is ongoing, a list I have obtained indicates that there are only 29 Democrats who are with Stupak, 28 of whom are men:
This list only makes 30 (including Stupak himself), and 39 Democrats are required to join with every Republican to block the bill from reaching the floor. As such, Stupak does not have the votes to stop the bill on his own. Then again, it is possible there are enough Progressives--and other Democratic members--upset with the bill for other reasons prevent debate from going forward. At this point, it would only take nine such Democrats to join with Republicans and with this group, and block the whole thing.
There is a very narrow margin for the health care bill in the House. However, while most national news stories continue to focus on the cost of the bill or on the public option, the major sticking point for conservative Democrats is actually reproductive rights. Even under the widest Democratic majority in three decades, they are still attempting--and close to succeeding--in actually pushing reproductive rights backward.
Update: Debcoop confirms with McMahon's office that he is not supporting Stupak's amendment, although she did not ask McMahon's office about the motion to recommit.
Last week, Senator Majority Leader Harry Reid introduced a merged health care bill including an opt-out public option. The next day, Senator Joe Lieberman threatened to vote against cloture on any health care bill with a public option. The same day, Reid promptly brushed off the threat, saying that "Joe Lieberman is the least of Harry Reid's problems."
Now, sources claim the two Senators have reached a "private understanding" to let the bill go forward:
Sen. Joe Lieberman has reached a private understanding with Majority Leader Harry Reid that he will not block a final vote on healthcare reform, according to two sources briefed on the matter.
Um, OK I guess. There are good reasons to be wary, but I'll take it for now.
Anyone want to guess what the "private understanding" is?
Update: Now, both Reid and Lieberman are denying this to multiple sources. Of course they are. Either there is a private understanding, and saying so in public would make them sound ridiculous, or there is no private understanding, and saying there is would make them sound ridiculous.
In short, stating publicly that you have a private understanding sounds bad.
Before a piece of legislation can be sent to the House floor for debate and amendments, it must be cleared through the House Rules committee. This is important, because as of this writing, the committee has still not scheduled a markup for H.R. 3962--aka, the health care reform bill.
This calls into question reports that the House will be voting on the health care bill as early as Thursday. Given that the Speaker has promised House members 72 hours to read the bill before a vote, and give that Wednesday is now the earliest the Committee on Rules could finish with the health care bill, then the earliest that the House could possibly vote on health care reform is now Saturday.
The holdup is likely due to continued negotiations over what amendments, if any, will be allowed on the floor of the House. These fights include, but are not limited to, the following:
Representative Stupak (D-MI) is trying to get a vote on an amendment to disallow any health care plans in the new insurance exchange from covering abortion procedures. The Democratic leadership does not want this amendment to come to a vote, because they believe it would pass. Further, if it passes, it would likely kill the entire bill, as numerous pro-choice Representatives would vote against it. Given that the leadership is already struggling to find 218, they afford any further defections.
Since Stupak knows the leadership will never allow such an amendment freely, he is attempting to round-up enough Democrats to vote against the "motion to recommit" on the health care bill unless the amendment is allowed a vote.
"You know, there's a lot of pressure right now--take one for the team, take one for the administration--and I think that pressure will come to bear, and they'll probably end up with 218. I'm not sure how I'm gonna vote," Grijalva said. "I'm leaning no, and that's a direction--I'm not ready to jump on the bandwagon."
However, last Thursday, Speaker Pelosi told me that it is not possible to have a piece of legislation voted on unless it was scored by the CBO, and H.R. 676 has not been scored by the CBO. So, it doesn't look like this promise is going to be kept.
Given Grijalva's new tone, Stupak is now the main delay in the legislation. It is important to remember that his coalition to block the bill includes not only anti-choice Democrats, but also the entire Republican House caucus, and a couple dozen Democrats who are opposed to the bill for reasons that have nothing to do with abortion. Stupak appears to be the final hurdle for the leadership to clear, and at this point we can assume any delay is because the leadership has not yet removed his roadblock.
Last night in Quick Hits, art3 alerted the Open Left community to the ugly repercussions of the defeat of the Medicare +5% public option. Now, it appears quite possible that even if the negotiated rates public option passes as a part of the final health care bill, it will not cost any less than private health insurance plans. From the CBO analysis of the House bill (page six, PDF):
Roughly one-fifth of the people purchasing coverage through the exchanges would enroll in the public plan, meaning that total enrollment in that plan would be about 6 million.
That estimate of enrollment reflects CBO's assessment that a public plan paying negotiated rates would attract a broad network of providers but would typically have premiums that are somewhat higher than the average premiums for the private plans in the exchanges. The rates the public plan pays to providers would, on average, probably be comparable to the rates paid by private insurers participating in the exchanges. The public plan would have lower administrative costs than those private plans but would probably engage in less management of utilization by its enrollees and attract a less healthy pool of enrollees. (The effects of that "adverse selection" on the public plan's premiums would be only partially offset by the "risk adjustment" procedures that would apply to all plans operating in the exchanges.)
Ouch. That is pretty awful. In plain English, it means that the public health insurance option won't cost less than private health insurance options because, on average, the people purchasing it will be sicker and less well-off. So, even though it will save on administrative costs, its risk pool will force it to charge rates very similar, and possibly even higher, than private insurance companies.
After such a loss of momentum, at this point the public option campaign is just about getting a legislative architecture in place that will allow the public option to be improved later on with only 50 votes in the Senate. Unfortunately, however, any such improvement will be dicey, given that we apparently lack simple majorities for a stronger public option in both the House and Senate. So, in addition to still struggling just to get the public option in place, we are going to have to struggle down the road to get a better group of people elected to both the House and the Senate.
In this bleak environment, yesterday the House Tri-Caucus (Congressional Black Caucs, Congressional Hispanic Caucus, Asian Pacific American Caucus) and the Congressional Progressive Caucus all met with President Obama to voice their frustration. The White House simply described the meeting as productive:
It was a productive meeting that lasted for about an hour. The President congratulated the members on working so hard to get a meaningful reform bill put together in the House.
In a post-meeting interview with Democracy Now!, Progressive Caucus co-chair Raul Grijalva used much stronger language:
[We] basically brought out that now that we're in this stage of having to deal with this negotiated rates that came out of the House, and something much worse coming out of the Senate, on a public option, that we felt-set some parameters of what we felt very strongly about, that the bill still needed to be strengthened; that there had to be cost controls on the private insurance companies, especially with negotiated rates, because they get to set the rates and we have to chase those rates with taxpayers' dollar; and no triggers and no opt-outs, that we feel those are detrimental to the public interest and certainly to constituencies that have lacked the ability to access healthcare in this country for so many years.
That is just for starters, as Grijalva also criticized the White House for catering to Olympia Snowe, and not being a strong enough advocate of the public option. Grijalva also indicated that he would not work to defeat the bill, given that he criticized Senators who have threatened to do the same:
We're facing the most historic vote that any of us are going to take in our careers. And for procedural reasons or for other reasons, to threaten to filibuster, to threaten to scuttle, whether it is Senator Bayh, Senator Snowe, Senator Lieberman, I think they're missing their opportunity with history, and I think the White House and leadership shouldn't allow them to be absent in this fight.
This may be a tough bill to swallow, but with language like this, it sure doesn't sound like Grijalva is looking to round-up Progressives to vote against it anymore.
This bill may very well provide a lot more people with coverage, we may well still get some sort of public option passed, and the Progressive Caucus does appear to have increased its influence. However, the cost of premiums will continue to rise beyond what are already unacceptable levels, and even without the filibuster we apparently still do not have a good enough Congress to pass transformative legislation. It is a hard pill to swallow, and a very frustrating day.
Tomorrow at 10 a.m., the House Democratic leadership unveil their health care bill. It is highly likely that it will include a public option with negotiated rates, rather than the more robust public option tied to Medicare (+5%) rates. There are many other details of the plan to discuss, but for now I will wait until the bill is actually unveiled to discuss them.
The remaining barriers to passage of the health care bill in the House are two-fold:
Bart Stupak's Regressive Block. Representative Bart Stupak is still looking to round-up forty votes to prevent he bill from going to the floor unless abortions are not covered under all health care plans that receive subsidies in the new insurance exchanges.
The leadership is convinced that if Stupak is able to offer an amendment to that affect on the House floor, that it will pass. If the amendment passes, it will kill the entire bill, because dozens of pro-choice Democratic votes would be lost. As such, the leadership will not allow any amendments to the health care bill on the floor. This means that once the bill hits the floor, that is the bill that will go to conference committee.
The Tri-Caucus Progressive Block. For months, the Progressive Caucus, the Black Caucus and Hispanic Caucus (and, I think, the Asian-American Caucus) have been trying to round up House Democrats who would vote against a health care bill unless it included the Medicare +5% option. Now that the bill will not include the Medicare +5% public option, the tri-caucus is sounding noncommittal about the bill. They are also meeting with President Obama tomorrow:
Some liberals were prepared to accept the negotiated rate structure. Others were still withholding support, even while pointing to Reid's inclusion of a government insurance plan in the Senate bill as a victory in itself.
"We were laughed at in August. Who would have thought that the Senate bill would have a public option?" said Rep. Lynn Woolsey, D-Calif., a co-chair of the Congressional Progressive Caucus.
Woolsey was noncommittal about whether progressives would accept the negotiated rates. "This is not walkaway time and it is not acceptance time," Woolsey said.
Members of the progressive caucus, along with lawmakers from the black and Hispanic caucuses, were scheduled to meet with Obama at the White House on Thursday, she said.
The Tri-Caucus does not appear to have won this time, but they do seem to have improved at playing the influence game. Threaten to vote against a must-pass bill, withhold your support even after a deal is apparently reached, and viola! You end up with a meeting at the White House. Not bad for a caucus that was the last to meet with President Obama at the start of his term.
Given both the Progressive and Regressive blocs, the passage of any bill will be by a narrow margin. No matter the disproportionate attention the Senate has received, there has always been just as much drama in the House.
It is time to start seriously asking whether the House of Representatives can pass any health care bill whatsoever.
First, while the final meeting deciding the fate of the robust public option is taking place as I type this, the likely outcome is that a public option with negotiated rates will be included in the bill:
In the end, Pelosi, D-Calif., and other House leaders were unable to round up the necessary votes for their preferred version of the government insurance plan -- one that would base payment rates to providers on rates paid by Medicare. Instead, the health and human services secretary would be allowed to negotiate rates with providers and the program would be optional for states, the approach preferred by moderates and the one that will be featured in the Senate's version.
This is going to anger quite a few members of the Congressional Progressive Caucus. Some of them might not vote for passage now, because they consider the public option too weak.
This matters because there are around 18-25 Democrats who will vote against the bill from the right, pretty much no matter what at this point. With every Republican likely to vote against the bill, this means that opposition from 15-22 Progressives would sink the entire bill.
Even though all eyes are on the Senate, the House is far from decided. Right now, it simply is not guaranteed that there will be enough votes to pass any health care bill through the House of Representatives, due to opposition from both flanks of the Democratic Party.
House Leaders Ready to Unveil Moderate-Favored Health Plan
By Tory Newmyer
Roll Call Staff
Oct. 28, 2009, 12 a.m.
House Democratic leaders are preparing to unveil a health care overhaul including a version of the public insurance option favored by moderates that would allow the federal government to negotiate rates with doctors and hospitals, top Democratic aides said.
This is simply wrong. No decision has been made yet. A decision is close, but it has not been made.
The leadership is meeting at 2:45 p.m. today to review the count. If, before that time, we can demonstrate that the "robust" Medicare +5% public option is not the dealbreaker for 218 members who are currently not in firm opposition to the overall bill, then we still have a chance of the robust public option being included in the overall bill. It is a longshot, but it is possible.
Right now, behind the scenes, we are engaging in a last-ditch whip count effort to get the votes for the Medicare +5% public option. To do this, I need volunteers who can spend the next hour making media calls to a couple dozen members of Congress. If you can help out in this effort, please email me at Christopher_j_bowers@yahoo.com.
A second fire has started on the public option fight, this time in the House.
Greg Sargent is reporting that House Whip James Clyburn has told the Congressional Progressive Caucus that he does not currently have the votes for the "robust" (that is, Medicare +5%, in current lingo) public option.
Clyburn told the assembled members at the meeting that the leadership does not have the votes to pass the robust public option, according to a House progressive familiar with the meeting. That sparked aggressive pushback from liberals, who argued that leadership - and the White House - should be working harder to win over the remaining votes the bill needs.
The document shows that 47 House Dems are committed No votes, and eight are Leaning No, for a total of 56. That means of 256 House Dems, only 200 remain, and a dozen of those are listed as undecided. The bill needs 218 votes for passage.
House progressives argue that the document should light a fire under Dem leaders. One House progressive tells me he's convinced that most of the undecideds, and a number of the No votes, can be won over with the right mix of pressure and incentives - which only the House leadership and the White House can provide.
I have seen the document myself. Sargent is reporting the numbers accurately, although 47 plus 8 is 55.
However, a source I know close to the process (yeah, take anonymous sources as you will) is disputing those numbers. Specifically, the source claims:
All of the 12 undecideds, except one (Representative Ann Kirkpatrick), are actually "yes" votes. That brings the total to 200.
Further, two of the "no" votes listed on the document, Eric Massa and Artur Davis, are actually "yes" votes. That makes 202.
Also, after November 3rd, at least one new supporter of the public option will be sworn into the House (the winner of the CA-10 special election). That makes 203.
Yet further, six of the "lean no" votes are actually "lean yes" votes, and four of the members listed as "no" votes are actually "lean yes" votes. Those 10 "lean yes" votes are Representatives Giffords, Klein, Maffei, Nye, Sanchez, Scott, Lipinski, Scott Murphy, Costa, Cardozza. That would make 213.
Finally, the source argues to me that if the whip count was conducted differently, then the Progressives could probably get over the top. Specifically, instead of asking members if they will vote for a health care bill with Medicare +5% public option, the whip should be asking if a Medicare +5% public option is a dealbreaker for members.
Given all of this, tomorrow I will be joining with a few other bloggers to engage in a snap crowdsourcing action to try and conduct exactly the sort of whip count described in the last bullet point. Even though Lieberman is causing problems right now, the House is more time-sensitive because the leadership will decide what to do with the public option in the House by mid-Thursday. Really, it is tomorrow or never to pull off a Medicare +5% public option in the House.
Stay tuned. Names, phone numbers, instructions and more coming. Tomorrow is going to be a big action day.
Before today, sources had told me that Lieberman was not considered to be one of the top threats to vote against cloture on a health care bill with a public option. Now, even despite Lieberman's threat to vote against cloture today, from the way Harry Reid is talking, it seems like the Senate leadership still doesn't consider Lieberman to be one of the main problems:
"Joe Lieberman is the least of Harry Reid's problems," Reid told reporters at his weekly press conference.
During a Q&A session with reporters, Reid offered a fairly spirited defense of Lieberman, signaling perhaps that he doesn't believe Lieberman will ultimately be an obstacle--or at least that he doesn't want to tip his hat: "I don't have anyone that I've worked harder with, have more respect for, in the Senate than Joe Lieberman. As you know, he's my friend. There are a lot of senators--Democrat and Republicans--who don't like [parts of this bill]... Sen. Lieberman will let us get on the bill, and he'll be involved in the amendment process."(...)
"We'll get it on the floor, we'll have an amendment process, and that's what we do," Reid said. "We haven't been doing a lot of it because we've had 81 objections so far this year by the Republicans."
I can think of three possibilities here:
There is a deal with Reid and Lieberman to change the bill via amendments that is already in place.
Reid is disappointed, but believes he can get Lieberman to fall in line by the time of the final cloture vote.
Reid has been blindsided by Lieberman, but he is sticking to talking points that reflect the earlier estimate that Lieberman was not one of the main problems.
This is all very speculative, of course. One thing that is not speculative is that we are going to have to find a way to pressure Lieberman hard as a result of this statement. Any suggestions?
Sen. Joe Lieberman (I-Conn.) said Tuesday that he'd back a GOP filibuster of Senate Majority Leader Harry Reid's health care reform bill.(...)
Lieberman did say he's "strongly inclined" to vote to proceed to the debate, but that he'll ultimately vote to block a floor vote on the bill if it isn't changed first.
"I've told Sen. Reid that if the bill stays as it is now I will vote against cloture," he said.
"I can't see a way in which I could vote for cloture on any bill that contained a creation of a government-operated-run insurance company," Lieberman added. "It's just asking for trouble - in the end, the taxpayers are going to pay and probably all people will have health insurance are going to see their premiums go up because there's going to be cost shifting as there has been for Medicare and Medicaid."
One of the main criticisms progressives had of Lieberman leading up to the 2006 primary was that he often joined with Republicans on prominent issues (Clinton impeachment, Iraq war) in order to garner huge media attention for himself. Again, that pattern holds.
Lieberman works to undermine Democrats on major issues in order to increase his personal media profile. It is a good thing we did whatever it takes to keep someone like that in the Democratic caucus.
Update: I completely agree with the commenters who say that Reid should call this bluff. Let's see Lieberman actually casts a vote against sending this bill to conference committee, or against final passage afterward. And then, if he does, let's see what happens back in Connecticut.
Update 2: To clarify, it appears Lieberman is threatening to vote for cloture on the motion to proceed with the floor debate, but against the vote for cloture on final passage. TPMDC:
"I told Senator Reid that I'm strongly inclined--i haven't totally decided, but I'm strongly inclined--to vote to proceed to the health care debate, even though I don't support the bill that he's bringing together because it's important that we start the debate on health care reform because I want to vote for health care reform this year. But I also told him that if the bill remains what it is now, I will not be able to support a cloture motion before final passage. Therefore I will try to stop the passage of the bill."
Looks like Lieberman is making one final push to become President.
Update 3: Lieberman pledged support for universal health care back in 2006 debate:
