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Carper: Senate Bill Will Include A National Public Plan With An Opt Out
Brian Beutler | October 22, 2009, 4:00PM
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Sen. Thomas Carper (D-DE)
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After a meeting with Democrats on the Senate Finance Committee, Sen. Tom Carper (D-DE) discussed the status of the public plan in the Senate health care bill with reporters. Here's what he said:
"I think at the end of the day there will be a national plan probably put together not by the federal government but by a non-profit board with some seed money from the federal government that states would initially participate in because of lack of affordability. The question is should there be an opportunity for states to opt out later on and if so, within a year, within two years, within three years?"
How would this plan work? "Among the things that's important," Carper said, "is, one, that this not be a government run, government funded enterprise, two, that there be a level playing field so that this non-profit entity that would be stood up would have to play by same rules basically as for-profit insurance companies--the idea that secretary of Health and Human Services [will be] running or directing the operation of this--no way.
We ought to have a non-profit board--it could be appointed by the President but a non profit board. They'd have to retain earnings, create a retained earnings pool, so that if they run into financial problems later on the financial needs of the plan could be met by the retained earnings, not by the federal government.
Carper suggested that a state's ability to opt out could be determined by the effectiveness and competitiveness of its insurance market. "There should be some standard--how do we say to a state, 'No you've got to participate in it right from day one,' and if so should there be an opportunity later on for you to say, 'Well, it's not working, we don't want to continue to be a part that,' and to opt out."
I pressed Carper on whether this entity would be accountable to taxpayers. He didn't answer directly--clearly there's some interest in de-emphasizing the government's role in the insurance market--he did sugest that the public option, though run by a non-government entity, would answer to the government.
And that would appear to bring it into line with the demands of the largest health care reform campaign in the country.
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theone718
October 22, 2009 4:17 PM
I don't think you guys understand. This is a WATERSHED moment. This means we WILL get a PO in the bill the President signs. Now it's all about pressuring what kind of PO. I really don't mind an opt-out compromise at all. It seems like it will be the HELP bill PO with an opt out. Maybe in conference if we fight hard we can get the Medicare plust 5 with an opt out.
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theone718
October 22, 2009 4:18 PM
Plus FIGHT so if there is an opt out, the PO can be in place for AS LONG AS WE CAN GET IT before a state is eligible to opt out.
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cdub
October 22, 2009 4:21 PM
sounds like a Co-op to me - not a public option
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tosh
October 22, 2009 4:29 PM in reply to cdub
Exactly. Was Brian not reading carefully, or is he buying a Co-Op called a "Public Option" to be a Public Option?
John
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tosh
October 22, 2009 4:32 PM in reply to tosh
And someone might want to tell David on the Front Page than "public plan" does not mean "public option" as the term has been used.
Come on, guys... you can't be this obtuse, right?
John
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matyra
October 22, 2009 4:43 PM in reply to tosh
So this is a triggered co-op with an opt-out? Someone needs to tell Carper that compromise means choosing, not sticking all available ideas, no matter how disparate, into one bill.
(I'm defining a "3-yr delay" as a trigger ;) )
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theone718
October 22, 2009 4:44 PM in reply to matyra
No no no he is speaking in legislative talk. The PO was ALWAYS going to have a non profit board. I don't think you guys know what the PO is lol.
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matyra
October 22, 2009 4:48 PM in reply to theone718
heh, don't let reality get in the way of my joke! (unless the reality is that the joke was really terrible.......sigh.)
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tosh
October 22, 2009 5:02 PM in reply to theone718
You're right, and I was the one being obtuse. I'm getting Conrad-speek confused with Carper's comments. :)
John
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rwc
October 22, 2009 4:52 PM in reply to cdub
exactly.
Carper siad: "I think at the end of the day there will be a national plan probably put together not by the federal government but by a non-profit board with some seed money from the federal government that states would initially participate in because of lack of affordability."
So, not only a co-op but one with a trigger, only for states with a "lack of affordability." Se we have the worst of the two worser POs.
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Lestatdelc
October 22, 2009 9:11 PM in reply to rwc
You haven't a clue as to what you are talking about. The PO was always going to be a run by a national level board with Federal seed money. The opt-out not only gets you a stronger version of the PO, but it makes it a political third-rail that will destroy any GOPers or fake Dems who vote to opt-out down-the-road in red states.
For progressive Dems (and the nation) this is a win-win scenario.
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Mateo123
October 22, 2009 5:01 PM in reply to cdub
I disagree. I think you need to understand how health care works and, in particular, why cooperatives won't do anything to lower the premiums.
Today, the large health insurers make a ton of money by gouging consumers -- and by limiting their pool of insureds to healthy people. So, the fewer the health insurers, the better the premiums are from their perspective.
If the senate bill requires insurers to actually compete with a national organization and if the senate bill prohibits insurers from excluding those with preexisting conditions, we consumers are in good shape. Why? The key to competing with Blue Cross or United is to be able to gather a critical mass of premium-paying customers.
Cooperatives won't work at the state level because cooperatives don't have enough people to compete with massive insurers. A national organization, though, that's available for everyone to enroll, will lower premiums. I'm sure of it.
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Lestatdelc
October 22, 2009 9:12 PM in reply to Mateo123
This isn't a co-op with no public plan. Opt-out and co-op are two totally separate things.
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Lestatdelc
October 22, 2009 9:06 PM in reply to cdub
Then you need to get your hearing checked.
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PeninsulaMatt
October 22, 2009 4:21 PM
It sounds weak.
As in, not good.
As in, where in the heck did this idea come from? Kent Conrad???
The insurance cartel will roll over this non-profit and it'll be useless.
Why not a state by state opt-in?
I'd love to take this fight to the state by state level; turn some red states blue!
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Ash
October 22, 2009 4:22 PM
A plan that is partially funded by the government but run by a private group, even if non-profit, is not a "public option". A public option is, by definition, one that is fully owned and administered by the federal government, just like Medicare. Anything else is unacceptable.
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The Commenter Formerly Known as NCSteve
October 22, 2009 5:32 PM in reply to Ash
Why? Why is only that one thing, exactly as you defined it, acceptable? And to whom?
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rbeats
October 22, 2009 4:26 PM
Ok, put it on the floor, vote, and lets move on.
People are dying.
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synchronicity
October 22, 2009 4:27 PM
I hope that he is completely off base and full of shit.
We need a public option that is an expansion of medicare.
And I keep hearing this rosy scenario about why an opt-out would be good and I think everyone has gone nuts!!
First of all WTF, we now have to fight this fight in every single friggin' state?!
And second, I live in CO. I don't want my health insurance to be treated like a political football getting tossed around whenever the political leadership/power changes in my state. This sounds insane to me... completely nuts. I am really pissed off about all of the tricks, gimmicks, state vs. state, triggers, etc. To me it's just being fucking lazy about getting the job done!
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mcc
October 22, 2009 4:27 PM
Okay so wait.
Carper is describing more or less precisely the "opt-in" he proposed a week or two ago.
So Carper is predicting the bill will include his own plan.
This is newsworthy in the sense that TPM was right to report it, but this isn't "news" or reliable. It is self-promotion, positioning.
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sherifffruitfly
October 22, 2009 4:28 PM
Of course it's the weakest possible structure they can call a "public option" without breaking up into laughter.
It's still an improvement: the baseline for worst-case-scenario has improved. Baby steps, folks.
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tommyo
October 22, 2009 4:31 PM
This is going to be some needlessly convoluted mess in order to appease.....who? The GOP? Olympia Snow? The blue dogs? None of these objects of appeasment are neccessary to pass this through the senate. Reid has said so. Reconciliation is the way.
Of course you can always count on the Senate Democrats to live up to the weak nature of their chosen leader Reid. They are pathetic.
If only Obama and Reid had a pair half the size of Pelosi's.
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oskieoskie
October 22, 2009 4:32 PM
We are looking for a bill that will get 60 votes in the senate to get past the filibuster and on to the conference committee.
The conference bill only needs a simple majority in each chamber to pass.
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rwc
October 22, 2009 4:57 PM in reply to oskieoskie
Adre you sure a conference bill needs only a simple majority. I think the usual Senate rules apply and 60 votes will be needed to move the question to force a vote.
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wbgonne
October 22, 2009 4:33 PM
No. This idea is shit. It is not even a government plan it damn sure isn't a public option.
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johnmccsf
October 22, 2009 4:35 PM in reply to wbgonne
That's the spirit!
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marklouis
October 22, 2009 4:34 PM
The easiest way to make the plan stronger is to mandate that all medical providers charge the same reimbursement rate to all insurers(including the public plan), and put a cap on the rate.
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Seth
October 22, 2009 4:38 PM
This is so maddening and muddled. So much crap is being thrown around and labeled “public option” that it is impossible to reclaim a true definition of the public option anymore. They have successfully watered down the concept. Carper said:
“I think at the end of the day there will be a national plan probably put together not by the federal government but by a non-profit board with some seed money from the federal government that states would initially participate in because of lack of affordability. The question is should there be an opportunity for states to opt out later on and if so, within a year, within two years, within three years?”
This combines opt-out with triggers with co-ops, all in one statement on the public option. What the hell does “not run by the federal government but by a no-profit board” mean? If it is not run by the government and funded by govt. seed money, it is not a “public option”. Rather, it sounds exactly like Conrad’s CO-OPs! But it is being called by TPM a “public option”! WTF!
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_jonny_5_
October 22, 2009 4:40 PM
Sounds a little weak, which isn't necessary the end of the world if...
1. This is the Senate Bill to be merged w/ the presumably stronger House bill.
2. the final bill has an Opt-OUT clause as opposed to an Opt-IN clause. The difference is huge.
3. If we end up w/ a final bill w/ Opt-out, then the Opt-out MUST be by referendum in the states, thus removing the "Political Football" in the various state legislators.
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wbgonne
October 22, 2009 4:48 PM in reply to _jonny_5_
No. There must be a real public option in the Senate bill. That means a national, federally funded system. The worst we can accept from the Senate is a PO with an opt-opt. But it must be a REAL public option. If they start playing word games and acting like everybody is stupid there will he hell to pay. And not for the ConservaDems alone.
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_jonny_5_
October 22, 2009 4:59 PM in reply to wbgonne
Agreed, I just don't think it's the "End of the World" provided the House bill's PO is every bit as strong as the Senate's is week.
This should make for something fairly strong to come out of conference since 50 + VP is all that's needed after conference.
But I do agreed we need a real PO I'm just suggesting this may be one of the paths to get there.
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witty1
October 22, 2009 4:48 PM
Let me see if I understand this corrrectly.
If some showboating asshole that is running my state (Sean Parnell, Governor of Alaska) wants to please his business lobby - he gives away my public option without asking me first, then I have to wait until the next election to hold him accountable for it?
WTF?
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marklouis
October 22, 2009 4:56 PM in reply to witty1
It can't be decided by the Governor. It has to be by the legislature or ballot referendum. And there should be an opt-in for states that previously opted out to return to the program.
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rwc
October 22, 2009 5:00 PM in reply to marklouis
Says who?
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witty1
October 22, 2009 5:00 PM in reply to marklouis
With what kind of timeline? If the current legislation takes 2-3 years to get put in place - and there is only a "window" for state's to opt-in or opt-out - it seems like 5-7-10 years before I get access to a public option?
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_jonny_5_
October 22, 2009 5:06 PM in reply to witty1
I hear your concern...
But we did have some ShowBoating Assh*les (Gov. Palin, In your case as well as Snaford and Perry) that tried that w/ the stimulus and where did that get them?
I would be better to tie the Opt-out to a ballot referendum. This leaves the (granted, in many cases un-informed) people in charge and if 76% (or whatever) really support it then there will be little to worry about.
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witty1
October 22, 2009 6:04 PM in reply to _jonny_5_
This is the thing about Alaskans, they tend to use public rhetoric that makes everyone else think we're rabid red staters - but then, when it comes to conservation, public health, education funding etc. (ballot measures only mind you) they turn a funny shade of blue.
This is why opinion polling never matches up to ballot/election results.
If it is tied to a ballot measure, then I guess I have some hope. Not much, just some.
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_jonny_5_
October 23, 2009 12:44 PM in reply to witty1
Well keep up the hope you can...
It's good to see that you at least still have some faith in your friends and neighbors.
Even if worse comes to worse and its up to the state legislatures that not too bad. THe state legislators in the Gov. Blowhard states still kept the stimulus(even is SC!!). There is some reason for hope...
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amabo666
October 22, 2009 5:01 PM
Opt out is a great idea. When the people see what the PO does to the US deficit they will gladly dump the idea. The only state likely to stick with the choice will probably be Illinois and maybe Hawaii.
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_jonny_5_
October 22, 2009 5:07 PM in reply to amabo666
Remember everyone... Don't engage the trolls.
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Minne sconsin
October 22, 2009 6:17 PM in reply to _jonny_5_
I don't want to engage him.
I want a sample of his DNA so I can see where he lies in the evolutionary tree. My guess is somewhere before our last common ancestor with chimpanzees. But I could be wrong, it could be earlier.
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amabo666
October 22, 2009 5:05 PM
And there will definitely be a big hit on the deficit(s) after the FRONT LOADED money runs out. By 2020 the debts of Medicare and Medicaid will look like chump change.
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amabo666
October 22, 2009 5:18 PM
Don't engage the trolls? Maybe the WH gang should take that advice... LOL.
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docrocktex
October 22, 2009 5:21 PM
Sounds like crap to me. This is why we need to stop calling it a public option. Any of these yahoos can put together a shit taco and call it the public option and most people won't know the difference. From now on, we should be campaigning for Medicare for Everyone. Get it done.
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Mr.E.
October 22, 2009 11:19 PM
The thing that pisses me off the most is this newly created sacred cow of a "level playing field." Why? Why must a playing field be level. In sports, you want a level playing field so one team doesn't have to run uphill, while the other runs downhill BECAUSE the competition itself is what people want to see. I don't give a fuck about "the competition." I want the best coverage, with the least exclusions, for the most people, for the least cost. I don't care how we get there, and I don't think most people will care what the program is, once it is in place and it saves them money and gives them security.
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