Health care state of play, January 14th

by: Chris Bowers

Thu Jan 14, 2010 at 15:10


Here is where things stand on the health care endgame this afternoon:

  1. Breakthrough on excise tax.  Labor and the White house appear to have reached a deal on the excise tax.  Some details:

    Under the outline currently being discussed, which the sources stressed is still fluid, the threshold for the tax on insurance plans would be raised above what passed the Senate - which was a tax on insurance plans costing $23,000 and up for families.

    In addition, health care policies for state and local workers and health care policies negotiated by labor unions would not be subject to the excise tax until 2017.

    The sources also say a working idea is to remove dental and vision plans from the calculation.

    One of the sources familiar with negotiations said that in addition to protecting health plans negotiated under collective bargain agreements, labor leaders are pushing to expand the deal to exempt health plans for all Americans making under $200,000 a year.

  2. Regulatory reform.  Reportedly, the White House is backing the House of Representatives on including a national exchange instead of a state by state exchange, and on repealing the anti-trust exemption for the health care industry.  However, those discussions remain in flux, and deal has been reached yet.  No guarantee either way, right now.

  3. Reproductive rights?  No word on whether the final bill will contain the Stupak amendment (which would create a national ban on abortion procedures in insurance), or Ben Nelson's state opt-out language.  Pro-choice House members have been pushing for Nelson's language.

  4. Subsidies. The level of subsidies will be somewhere between the House and Senate bills.  Higher than the Senate ($871 billion in subsidies), but lower than the House ($1,052 billion in subsidies). Estimated at around $930 to $950 billion.

  5. Overall deal now imminent--Friday or Saturday. The excise tax was one of the largest remaining obstacles to a final deal between the House and the Senate.  The timeline for such a deal appears to be either tomorrow or Saturday, at which time the bill would be sent to the CBO for review.

  6. Timeline. The House will likely send a bill to the CBO on Friday or Saturday.  The CBO will reportedly take between 10 to 13 days to return a score on the bill.  From that point, it will take the House between one day and three days to pass the bill, and the Senate another three days.  All told, this means the final bill will be passed by the Senate as late as early as January 29th, and as late as February 4th.  The State of the Union address is on February 2nd.

  7. Coakley loss blows whole thing up--or does it?. With the Massachusetts Senate election on January 19th, and the Senate voting on the bill on January 29th at the earliest, it seems entirely possible that a victory by Republican Scott Brown would sink the whole deal...

    ...or would it?  As David Waldman writes, the Massachusetts special election would not be certified until February 20th, and Senate rules require certification to swear in a new member.  Republicans delayed Al Franken from taking his Senate seat for six months because of this, and Democrats could simply do the same to Republicans in order to pass the bill.

    Also, as noted by multiple people in the comments, the House could theoretically just pass the bill that the Senate already passed, verbatim, and send that to the President.  That is one possibility, but I doubt the House has the votes for the Senate bill.  Some Progressives could be lost, and some conservative Dems would be scared off by a by a Brown win.  Republican Joseph Cao would probably be lost, too.  Stupak, and some of his acolytes, might also vote against it.  All in all, with only a three-vote margin, the Senate bill might not be able to pass the House.

    Anyway, as I wrote earlier today, Coakley still has a 91% chance of winning.

Lots of drama in the health care endgame.  What did I miss?
Chris Bowers :: Health care state of play, January 14th

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Health care state of play, January 14th | 26 comments
Big labor (0.00 / 0)
labor leaders are pushing to expand the deal to exempt health plans for all Americans making under $200,000 a year.

So labor leaders are fighting for the working class - by nixing taxes on people making 6-figure salaries? What the hell?

Senior Union Staff (4.00 / 3)
That's likely a combined compensation number. Senior manufacturing plant staff can easily make 6-figure salaries, (esp after overtime). Same for Cops and Firemen who've been on the job for 20 years in many places.

Me | My Work | Future Majority
[ Parent ]
That makes them some of the most privileged people in the country (4.00 / 1)
Whether they're in unions or not, I don't think the foundational aims of the labor movement were to protect people in the top 5% of personal income.

Labor needs to work to improve the lot of the poor and working class, not just their own parochial interests.

[ Parent ]
Labor has been pushing (0.00 / 0)
for a broader, more protective health care bill from the beginning. Labor supports a major jobs bill, which is the AFl-CIO's next big item on the legislative agenda. Labor opposes cuts in Medicare or Social Security.  The idea that refusing to support one particular tax, as opposed to many other ones that would actually increase progressivity in the tax code, is somehow a grand sell out of working people is just nonsense.


Who are the best keepers of the people's liberties? The people themselves. The sacred trust can be no where so safe as in the hands most interested in preserving it.
James Madison
[ Parent ]
Did I say it was a grand sell out of working people? (4.00 / 1)
I didn't say they were rotten to the core; I criticized a thing they're doing that I don't agree with. That's straightforward enough, isn't it?
[ Parent ]
Unions need to protect their own members (0.00 / 0)
Otherwise there won't be any unions.

Sure, they also need to look out for the interests of others and they certainly need to recruit aggressively, but at the end of the day they exist to improve the lot of their members. They're an interest group, not a charity.

Forgotten Countries - a foreign policy-focused blog

[ Parent ]
The excise tax is bullshit (0.00 / 0)
If they have to go for an exemption that covers most anyone, rather than striking the bullshit excise tax entirely, how is that not good?
[ Parent ]
Because the excise tax is not bullshit. (4.00 / 1)
It's sensible to tax the portion of income that is taken up by health insurance; to do otherwise is to let the rest of us subsidize the health care plans of the reasonably well off. Also it will help with cost containment over the long term.
[ Parent ]
No, It's Bullshit (0.00 / 0)
If I recall, the money was going to come from taxing people making over $250,000/year, not the working class.
[ Parent ]
sigh. look, taxing plans of people who make less than $200K (0.00 / 0)
is a stinking lousy idea. i've said elsewhere, what about people who are cash-poor, but insurance "rich," like my grandmother? taxing her plan is literally taking food out of her mouth, as she's on a fixed income and that barely covers her non-insurance expenses.

as a liberal, i'm insulted that this idea has made it this far, promoted by "democrats." the House had the right idea, for all the Senate seemingly exists to prevent rich people from ever paying any new tax ever again.

taxing the working and middle class at a time like this is a stupid, stupid idea and the dems are going to find out very soon.  

[ Parent ]
really the Baucus version? (4.00 / 1)
Assuming that Snowe would want the Baucus bill or worse, make House Progressives swallow the Baucus bill, which they say won't happen.

The Senate already passed a bill, which is at least a little better than the Baucus bill. Couldn't the House just pass exactly the same bill and send it on to the President?

I'm not saying that's acceptable, but it means Snowe is irrelevant - no need to alter what's already been passed to get Snowe's vote and make it even less palatable to the House.

If Brown wins (0.00 / 0)
If Brown wins, they have to go through Snowe. She voted against the bill the Senate passed, but voted for the Baucus bill.
[ Parent ]
This doesnt answer the question (4.00 / 1)
If the House passes the Senate Bill, passed already, then the bill hass passed both houses.

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.
[ Parent ]
This does seem like a good point. (0.00 / 0)
Why ask the Senate to pass anything new, if they can't pass it again at 60 votes.
They already passed a bill, any new bill without the 60th vote would be worse, so the Bill passed by the Senate is the bottom, the fall back bill.

But then I'd like to see them filibuster health reform.

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.

[ Parent ]
OK, I see your point (0.00 / 0)
Yeah, they could do that. If they had the votes for the Senate bill, that is. Which I don't think they would after a Brown victory.
[ Parent ]
Not quite. (0.00 / 0)
It was passed in the Senate. But the house passed a different version, as is almost always true. As is almost always true, that means that some process is used to pass a Bill that reflects both bills, as a bill has to pass both houses.

However, if the House just passes the original Senate version, then the constitutional requirement that a Bill pass both houses has been met. Therefor the absolute minimum the Bill will be will be the version of the Bill already passed by the Senate.

(This is in the event that the Senate, because of only having 59 of 100 votes isn't enough to pass legislation, which to my mind, is a pinstripe coup d'etat.)

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.

[ Parent ]
Maybe a bit outside the box, but... (0.00 / 0)
...assuming they can overcome the political gut punch of a Brown win (a big if, considering it 'don't take much to get their balls tucked up'), could the changes contemplated to be made now via amendment to the Senate bill be done instead via a second bill under reconciliation? Passing the Senate bill unchanged would be a lot more palatable with a more progressive, reconciliation-passed companion bill.

Jello Jay: "So we didn't get anything."
If we're doing that (4.00 / 3)
why not just pass a public option under reconciliation?
[ Parent ]
Of course (4.00 / 1)
I've suggested some time ago, just after the Lieberman debacle, that the House should dispense with ever going back to the Senate for 60 votes on health care. Instead, demand a second HCR bill under reconciliation including a public option and whatever fixes can be made. Then the House would pass both bills -- the just passed Senate bill as is and the second reconciliation bill. I'm wondering whether a Brown victory might prod this outcome.

Jello Jay: "So we didn't get anything."
[ Parent ]
And if the vote is really close (0.00 / 0)
who knows how many months it would take for a certification?

Jeff Wegerson
abortion language and exchanges (4.00 / 1)
doesn't Nelson's language require the state-level exchanges, in order for a state to be able to "opt out" of health care for women?

not everything worth doing is profitable. not everything profitable is worth doing.
I've thought of this too (0.00 / 0)
and haven't seen it concretely addressed anywhere, though it seems like an obvious point.

However, even the House's national exchange plan allows states to opt out and make their own state exchange instead, and I assume (merely guessing) that's how it would work.

[ Parent ]
A national exchange and repealing (0.00 / 0)
the anti-trust exemption makes perfect sense because, with only state regulation, a removal of the anti-trust exemption may result in a race to the bottom, ala banks/credit card companies and Delaware. But its good to see that the WH is actually with the House on the structure of the exchange, the repeal of the anti-trust exemptions, and the subsidy levels.  
Lieberman and Nelson (4.00 / 2)
This is still a very bad bill and Rahm and Obama have shown an instant ability to cave whenever Lieberman and/or Ben Nelson decide it is time for more sell outs.

Time to screw Nebraska and screw then forever.  They have had enough of pushing the country around.  Close SAC in Omaha and move it to Michigan.  Boycott Cabela's and Mutual of Omaha.  Maybe worse yet get the recruits to play football for Texas and Oklahoma instead.

I don't know about punishing a state for the uncontrollable excesses of its Senator (4.00 / 2)
I think we should focus on punishing Nelson himself.  As in, goodbye all his committee assignments and subcommittee chairmanships.  And in 2012, when he's staring down the barrel of some badass Republican, he's on his own.
[ Parent ]
No, this is a good idea. (4.00 / 1)
For a very long time the right has ploughed America's stimulus money (military) into right-0wing states, who then demnad that no other stimulus money be spent. It is merely fair that stimulus spending opponents not get stimulus spending, or at the very least get no more than any other county, village or state.

Newt Gingrich's old electoral district is completely against using federal money to alter economic levels, but is the single largest recipient of federal funds in the country, if my memory serves me correctly.

Change
"We must break up the banks and never again let them get so big that they distort our politics and take down the economy.

[ Parent ]
Health care state of play, January 14th | 26 comments
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