The story of the day on the health care beat belongs to Sens. Chuck Schumer (D-NY) and Tom Carper (D-DE). Their new proposal to devise a national public option in such a way that states could choose not to participate quickly overtook yesterday's news from the CBO that the Senate Finance Committee bill would save billions of dollars. But is it the long-sought solution to the public option conundrum?
The short answer is: it's way too early to tell.
"The amount of ink and media attention being spilled on this issue bears little relationship to where it is in the process," said one leadership aide.
Conversations with a number of Senate aides from across the Democratic spectrum all touched on the same theme: The idea may be decent on the merits, and appealing to some key conservative Democrats. But all 60? Or 59 plus Olympia Snowe? That's hard to answer when the concept hasn't even been fully fleshed out. And yet, it's almost certain that, as an amendment to the bill that ultimately reaches the Senate floor, it would need 60 one way or another.
Then there are House liberals, who remain extremely focused on a Medicare-like public option, available everywhere. They're not saying much about this idea just yet, but from initial conversations with House aides, it's unlikely that they're going to drop their campaign for a robust public option and get on the "opt-out" bandwagon. Whether they would ultimately settle for such a compromise if it came out of a conference committee is a question whose answer enters the realm of multiple levels of speculation. There's no denying that the initial reception by both liberal and conservative Democrats has been generally positive. But as the quote above indicates, we're getting a bit ahead of ourselves.

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bvd
October 8, 2009 6:32 PM
Er, Brian, Chuck Grassley is, how shall I put this, definitely not a Democrat from New York.
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hunter
October 8, 2009 6:55 PM
Pretty sure you meant Schumer.
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CN
October 8, 2009 7:05 PM
I have an idea: instead of plan where states can opt in or opt out of a public option, let's have a plain in which individual Americans can decide whether they want to participate in a public option. It's brilliant! Free choice for all Americans! What a compromise!
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Jim H
October 8, 2009 7:52 PM in reply to CN
so, you mean, like, make the public option optional???
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Tanjaoui
October 8, 2009 7:53 PM in reply to CN
It's a problem that would require a Constitutional Convention to solve: a Senator from Maine (or Montana) can really fuck it up for everyone else. We wouldn't need to make stupid compromises like this if people were represented proportionally. Typically, the House is way ahead of the Senate, which, again, typically, is being held hostage by a few Senators from sparsely populated States. So the solution is to cut our losses and say: OK, you win. You don't like a public option on some principle? You can opt out...And hopefully, this is a temporary solution. The people whose lives and health have been compromised by their elected representatives will in turn vote those elected representatives out of office and replace them with better ones. That's all if this public option is well designed, providing good benefits for little money. And with a big pool it should do just that. Still...I share your frustration. Better yet, why couldn't we just have single payer and forget about policies and bills and health networks and deductibles and all the rest of it? I just want health care, like most people, and wouldn't mind paying more in taxes for it. Makes my head ache.
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Minne sconsin
October 8, 2009 8:27 PM in reply to Tanjaoui
Exactomundo. And rig it so that the tax load is spread through the whole country, not just those states that participate.
Then when dicks like Timmeh Pawlenty say, "we're not going to participate in (program name)", everyone knows just what that means - and they throw the ftards out.
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jdb316
October 8, 2009 8:33 PM in reply to Tanjaoui
[b][i]It's a problem that would require a Constitutional Convention to solve: a Senator from Maine (or Montana) can really fuck it up for everyone else. We wouldn't need to make stupid compromises like this if people were represented proportionally. [/b][/i]
This is why we have both the Senate AND the House of Representatives. The former has equal representation, benefitting the smaller states. The latter has proportional representation, benefitting the larger states. This way both get something.
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Tanjaoui
October 8, 2009 8:53 PM in reply to jdb316
Huh? It's about people, not States. There's every reason for Montana to have less influence than California - it's got fewer people in it. Senators and Congressmen are there representing you and me, not land mass.
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BillMcD
October 9, 2009 1:41 AM in reply to Tanjaoui
No, Senators are actually there representing the interests of each State's government. That's why they were originally appointed by the Governors.
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Tanjaoui
October 9, 2009 5:03 AM in reply to BillMcD
But the State government is there to represent the people of that State. I understand their genesis. It's an archaic system that's creating real problems today. Represented proportionally, we'd have a much fairer system of government.
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lexicon
October 8, 2009 8:24 PM
Writing from Ohio, I see huge problems with allowing states to "opt-out." Ohio is already one of the states that allows ins. companies to refuse -- flat out refuse -- to sell insurance to an individual at any price. If you have Type II diabetes, for instance, you are literally uninsurable in Ohio, and every insurance broker will tell you that. The chance that, given a choice, Ohio would participate in true public option is less than zero. The Governor is a Democrat, but the legislature is solidly Repub. and utterly corrupt.
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jdb316
October 8, 2009 8:55 PM in reply to lexicon
If the people of Ohio want a public option and their legislators decide to opt out, they can vote said legislators out of office. That's why we have elections.
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CJ
October 8, 2009 9:44 PM in reply to jdb316
Yes, that's true. And if the people of Mississippi wanted civil rights in the 1960's, then they should have voted their legislators out of office. That's why they have elections. States' rights and all that.
A stretch? Quality, affordable health care is an issue of life or death. It is a moral issue on par with civil rights.
Democrats in all states, whether or not they could deliver the electoral college from their state, worked, contributed, canvassed, made long distance phone calls and wrote letters to deliver a Democratic president and a Democratic Congress on a platform of quality, affordable health care for ALL, not just quality affordable health care for people in solid blue states.
jbd316 just flipped off liberals, progressives, the poor and elderly and disenfranchised in purple/red states. Nice.
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jdb316
October 8, 2009 10:37 PM in reply to CJ
I'm not flipping them off. If support for a public option is as large as you claim (and it may very well be), then the state legislators will have to keep their state in the plan or they'll lose their jobs.
Yes, it would be great if both chambers of Congress could easily pass a straight public option. But for various reasons which have been mentioned here many times, that doesn't look like it is going to happen. It sounds like this plan gives enough Senators the political cover they need to make sure a public option gets through without being filibustered or defeated outright. It's definitely better than the co-op or trigger ideas being thrown out before.
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Stroszek
October 9, 2009 12:24 AM in reply to jdb316
Don't take it personally. This is typical of FDL's tactics. When they can't make the policy argument, they resort to inapt analogies and heated invective.
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Elizabeth2
October 8, 2009 11:01 PM in reply to CJ
also, hate to sat it but good quality health care has a lot more "what's in it for me" ooomph for the individual red-stater than civil rights had for the individual Southerner back then ...... it was, quite frankly, hard to imagine what a non-segregated world would look like in GA or MS. It isn't nearly so hard to imagine what impact it would have on one's own life ...... esp. if your friend or relative in the next state is enjoying that. If all the states won't go for it right away, the very quickest way to get the benefit for the opting-out states is to have the others demonstrating that it works and is better. Then either the legislators will wake up and smell the coffee -- or they can be voted out of office. A benefit that is real, tangible, personal, and very easy to believe in is a big motivator. Not nearly so complex as the civil rights issue.
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CJ
October 8, 2009 11:38 PM in reply to Elizabeth2
I'm not claiming that the public option has support in these states. It doesn't have any more support than abolition did, or women's suffrage, or school integration (Brown v. Board of Education), or the voting rights for African-Americans, or Medicaid, or Medicare, or any of the rest.
There's no support for the public option among the majority in, for example, South Carolina, Georgia, Florida, Mississippi, Alabama, Louisiana and Texas.
There will be no waking up and smelling of coffee; nobody getting voted out of office. There's no reasoning. There's no pragmatism.
The red states will opt out, and millions who don't have the votes to throw the state-level whores out will be screwed by progressives who are content to have theirs, even if others can't.
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Stroszek
October 9, 2009 12:19 AM in reply to CJ
Alabama and Louisiana have Democratic legislatures.
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Stroszek
October 9, 2009 12:22 AM in reply to CJ
Also, you need a polling data to back up those extravagant claims.
My take is that the FDL crowd reflexively opposes this because they've made a strategic decision to support a national PO and trash anything else. That's their right, but I haven't really heard a convincing policy argument for why this wouldn't work, just a lot of heated rhetoric about abandoning people who would be doubly abandoned if there is no bill (but the FDL'ers never view that as a problem). I think it's hilarious how quickly a lot of commenters over at kos flip-flopped when the purity popes told them they couldn't keep their progressive cred if they liked this idea.
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CJ
October 9, 2009 8:33 AM in reply to Stroszek
I don't have polling data. I'm speculating, and so are you. But unlike you, if I'm wrong, nobody dies. You're gambling with other people's lives.
You absolutely lose your progressive cred if you like this idea. Progressives look out of others; conservatives look out for themselves. You can't call yourself a progressive while supporting a plan that could UNNECESSARILY leave millions out (the votes are there for the HELP version and could easily pass through reconciliation).
One man is going to sell the land he planned on retiring on in Georgia? Why? He'll have access to Medicare.
Another from Chicago is going to movie from Boise back to Chicago?
My wife and I should quit our jobs, sell our house, leave our elderly parents, leave the place we've lived our entire lives, and move our family to another state? For health insurance? What kind of shit is that?
Millions of poor, elderly, and yes, middle class, don't have the resources, the networks, the means, the will. It's ludicrous to suggest it, just as it would have been ludicrous to suggest that blacks should move out of the south in the 1960s.
You don't agree? Fine.
You can't argue with this. The left was together on the public option two days ago. Today, the left is divided. If an opt-out bill passes, that's going to play out nicely in 2010 and beyond. Like you said, hilarious.
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MarylandBlue
October 9, 2009 1:01 AM in reply to CJ
I live in Maryland but own retirement land in Georgia which I was planning to use before age 65. If the opt-out plan goes through and Georgia decides not to participate, I will most likely sell the Georgia land and purchase new land in a state that does participate.
How many other people do you think will start making the same types of calculations? How long will it take before opt-out states tax revenues decline, industries move out, real estate prices plunge?
The "compromise" is a clever interim step. It will unleash dynamics that bring everyone under universal care. Republicans will see the opt-out plan for what it is -- a taste test that citizens won't be able to resist -- but will have a hard time countering the plan's simplicity and pseudo-homage to states rights.
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CyberDuckie
October 9, 2009 2:32 AM in reply to MarylandBlue
My thoughts exactly.
I'm a transplanted Chicago native living in Boise, ID. In Illinois, about 75% of the population lives in the Chicagoland area, which is extremely blue. This is why a state made up of lots of farmland is still considered democratic.
Boise also happens to be quite blue, surprisingly. But the Boise metro area only contains about 39% of the population and Idaho is arguably the reddest state in the nation. I'm pretty positive this state will opt out of the public option if the choice is given. And I don't see that changing quickly simply due to the mentality of many of the people living here.
If that happens, my personal choice becomes much easier - I will leave. If Washington or Oregon or California offer a better standard of life because of their health care options, then it's a no-brainer. And I know I won't be the only one.
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slb
October 9, 2009 2:49 AM in reply to jdb316
That's more easily said than done. Thanks to gerrymandering, the vast majority of legislative seats are not competitive; certainly they are not in this state.
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Tanjaoui
October 8, 2009 8:58 PM in reply to lexicon
Wait a minute: if they accepted bailout money, I'm pretty sure they'll go with the default option and stay put. It would be electoral suicide for them to opt out. Especially with the high unemployment rates in OH. People saw a neighboring States benefiting from good coverage at reasonable rates, out come the pitchforks and torches. Those State legislators that voted to opt out are out on their sorry asses, that's certain.
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Rich in NJ
October 8, 2009 9:29 PM
It's early in the process. We get it.
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ellhalt
October 8, 2009 10:28 PM
I can accept policy differences among members of congress, and to that end: it is understandable if "blue dogs", and other centrist dems, are against public options.
What I can't accept are democrats, any democrats, who would support a filibuster against their own party's, their own president's initiative.
Why can't blue dogs against public options join the 60 for cloiture and then vote against the bill on the floor. How can Harry Reid let fellow democrats even threaten this behavior?
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Ricky
October 8, 2009 11:07 PM
the democrats are weak , unorganized.. and the a compromising with themselves.. because the REPUBLICANS ARE AGAINST ANY AND EVERYTHING THAT HAVE TO DO WITH REFORM..
WHAT A BUNCH OF BAFOONS.. well that not fair.. the democrats are a bunch of prostitutes.. they are bought and paid for by the corporations.. all this is trying to appease the insurance industry.
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slb
October 9, 2009 2:35 AM
Typically, the House is way ahead of the Senate, which, again, typically, is being held hostage by a few Senators from sparsely populated States.
It depends on what you mean by "ahead." When the House changed hands in 1994, I suppose you could say that it was ahead of the Senate in trying to go back a generation. It was the Senate that held the line on the House's radical conservatism until it finally changed hands and was taken over by the Republicans, and I was very glad to have the Senate slow things down in those years.
That is not to say that I don't think some changes need to be made in the representation in the Senate. There's a much wider gap between the most populous states and the least populous ones than there was in 1789, and I would like to see some changes made that would allow for maybe the ten largest states to have an extra Senator apiece.
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slb
October 9, 2009 2:38 AM in reply to slb
Well, shoot. That was, of course, meant as a reply to Tanjaoui. :-(
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Tanjaoui
October 9, 2009 5:28 AM in reply to slb
Generally, I'd rather have something closer to a parliamentary system. The government that is voted in is voted in on issues, to get results, and the probable means to get there. True, you have to take the good with the bad, but we do anyway: we're involved in two wars which use my tax money to finance.
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bmull
October 9, 2009 4:33 AM
First of all, let's be clear that this "opt out" is level playing field public option. As far as I know we already have at least 51 votes for Schumer's 50 state level playing field option--so why do we need this compromise? Are we negotiating with ourselves again?
The only justification is if you could get to 60 votes--but Lieberman is on record against any government run health plan in defiance of polls in Connecticut, one of which shows 68% support. It's hard to believe this plan gets him on board. And there are others...
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Andreams
October 9, 2009 8:57 AM
The idea definitely shows promise but it won't pass because it makes sense.
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BTJ46
October 9, 2009 9:48 AM
Moving power to the states to determine, ultimately, who gets health care could be called the 'empower Bobby Jindal, Mark Sanford, and Tim Pawlenty' act. On the other hand moving such high stakes decisions and the accompanying lobbyists to state legislatures and governor's mansions, just call that "F..ing Golden."
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Tanjaoui
October 9, 2009 1:59 PM in reply to BTJ46
We need to get a strong po into law first. The better it is, the more compelling it will make itself. Those guys won't last long if they decide to opt out of a well designed public option. This could be - could - the camel's nose under the tent for single payer, as Judd Gregg fears. Here's hoping!
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