
New CBO numbers may have sealed the deal. Speaker Nancy Pelosi is preparing to move ahead with a "robust" public option--one that reimburses hospitals and providers at Medicare rates, plus five percent--in the House's health care bill. She is briefing her caucus about the plan's savings tonight, and, pending the approval of a sufficient majority of members, will adopt the measure as part of the complete reform package.
The analysis finds the reconstituted House proposal to be deficit neutral, and require less than $900 billion (reportedly around $870 billion) in new spending, over ten years.
The bill remains nominally more expensive than the Senate Finance Committee proposal, but would cover 96 percent of all Americans, providing greater bang for each federal dollar spent. And, aides note, the bill that comes to the floor of the Senate will be a hybrid of the Finance and more expensive HELP Committee bills, so the price is expected to rise.
The move is sure to make progressives ecstatic, and puts Senate leaders, who have been unable to reach any decisions about their preferences for a public option in their own bill, in an uncomfortable position.
In recent days, Pelosi has insisted that she intends to send House negotiators to a health care conference committee with the maximum possible leverage for the public option. And House health care principals have been working doggedly to keep the price of reform down with the help of the public option--so in a sense, the news of this final push comes as little surprise: Pelosi is, as expected, using the fiscal responsibility of the robust public option to win over enough skeptics in her caucus to pass it. And she is, reportedly, very close to doing that.
By tying reimbursement rates to Medicare, the government would be able to spend less money per individual on subsidies in the health insurance exchanges. One of the major critiques of the Senate Finance bill is that the spending totals are kept low by denying subsidies to middle income Americans, and without providing a systemic corrective to insurance industry waste and abuse. In the House bill, greater subsidies, and the public option address that issue.
Edited for clarity
theone718
October 20, 2009 8:28 PM
AHHHHHHH, this week is going to be very interesting indeed.
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theone718
October 20, 2009 8:31 PM
96% of all Americans! Under 900 billion with a robust public option. My mouth, it can't stop watering.
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mikedrevguy
October 21, 2009 1:15 AM in reply to theone718
so, what about the other 4%? are they covered under medicade? are they just out of luck?
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slb
October 21, 2009 4:47 PM in reply to mikedrevguy
96% of a loaf is better than no bread.
Nobody said we stop there, but that would make for a good first pass. You set it up, you get it working reliably in the main, and then you can evaluate what has to be done to get the remaining 4% under the umbrella.
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CVille Dem
October 20, 2009 8:38 PM
Do we dare hope? Go, Nancy, GO!!!!!
Harry, take a lesson!
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Jim H
October 20, 2009 8:46 PM
Anyone know if the House bill is going to have a version of the Wyden Free Choice Amendment? Is anyone pushing that concept in the House?
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theone718
October 20, 2009 9:21 PM in reply to Jim H
I heard they thought it was a pretty good idea but they haven't moved on it much. I think it's as important if not more important than the PO. Good thing Wyden won't stop pushing for it, we need it in this bill.
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NobleCommentDecider
October 20, 2009 8:52 PM
But will Senator Jon Kyl (R-AZ) have to indirectly pay for a poor woman's maternity care?
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THobbes
October 20, 2009 10:19 PM in reply to NobleCommentDecider
She already pays for Kyl's Viagra.
Seriously ... uninsured taxpayers already subsidize health benefits for wealthy people through the tax exemption for employer-based health insurance.
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slb
October 21, 2009 4:49 PM in reply to THobbes
And also through the higher fees they have to pay for medicine and medical treatment when they get it.
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cdub
October 20, 2009 8:52 PM
Oh Pelosi - I never thought you'd make my heard go pitter patter...
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cdub
October 20, 2009 8:53 PM in reply to cdub
heart!
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Bruce Webb
October 20, 2009 10:37 PM in reply to cdub
Oh my!
Read Oedipus Rex, take a cold shower, and forget you ever knew the name Jocasta!
I mean I have a thing for Maria Cantwell but at least we are the same age. And as far as I know single.
Please no versions of "heard" plus or minus a letter are appropriate here. Leave all that to the Palin starburst boys (who apparently can't differntiate between Xena and autobiographer Sarah Virginia Wolff-Killer)
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jollyroger
October 21, 2009 12:08 AM in reply to Bruce Webb
forget you ever knew the name Jocasta!
What, no dick for granny? Might you be an ageist?
I'll have you to know that I am shortly being taken off the DL, and beginning a rehab tour of nursing homes...those grabbin grannies are brutal, brutal I tells ya.
Moreover, Nancy is my very own representative, and she can have my, uh, support, any time.
Two more words: Jane Fonda
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jollyroger
October 21, 2009 12:21 AM in reply to Bruce Webb
at least we are the same age
Just to preempt any riposte potentially founded in the stated principle, permit me to inform you that I am 19 years old, and yet I declare my admiration for Janey without blushing.
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pinson
October 20, 2009 8:58 PM
Go Nancy. She's got them by the short and curlies now. I'm interested to hear the "moderate" argument about how spending more taxpayer money on a non-P.O. inclusive plan just... makes more sense...
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agio
October 20, 2009 8:58 PM
Smart to put the strongest bill forward while the Senate dithers, and claim the middle ground.
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Stroszek
October 20, 2009 9:30 PM
Pelosi rules.
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Ethan
October 20, 2009 9:36 PM
Happy day! =D
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W T F
October 20, 2009 11:13 PM
Make sure the final bill includes an opt-out option. We most certainly want to give local officials the opportunity to have a voice in the final decision - just in time for the 2010 election cycle.
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Joshua the Teacher
October 21, 2009 12:21 AM
Another hatchet job "study" paid by AHIP in 3, 2, 1...
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parodyandson
October 21, 2009 12:34 AM
It’s time to stop talking about healthcare reform and start SINGING about it!! See “Healthcare Fighting (King Fu Mix)” at http://www.youtube.com/watch?v=8nc1VwJOb9Y
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PaulV
October 21, 2009 3:32 AM
NO TAXATION WITHOUT.....
I was talking with one of my English friend. I said, how nice it would be if we allowed the states to opt out of public option. This would be a tax on red states for being red. He said that's what I was thinking. You yanks got rid of us for a silly little tax on tea. Now look what you missed. We have a far more efficient health care system. Americans pay about 10 percent of GNP as extra tax for not having the health care that the mother country enjoys (or their less rebellious cousins up north do!). No tax on tea -- only on sympathy!
Good luck Nancy. Go for it!
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willia451
October 21, 2009 5:36 AM
Once again, Pelosi proves she is way ahead of the curve on this issue than anyone else.
Putting working Americans first, over the profit interests of the health insurance industry and their corruption, is what Americans WANT their Congress to be doing.
Great work Nancy.
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cfarnham
October 21, 2009 8:10 AM
GREAT, GREAT NEWS! My prayers are with you Pelosi!
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Indie Pro
October 21, 2009 9:50 AM
Nancy is the leader of the people, coming out head and shoulders above all others.
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Indie Pro
October 21, 2009 9:51 AM in reply to Indie Pro
of course, the details will be important.
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JEP07
October 21, 2009 11:44 AM
Leaps and bounds? Not baby steps?
Maybe the Dems at the top of the ladder finally woke up and realized they're now bigger and stronger than that old blowhard bully who has been picking on them for so many years.
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Mr.E.
October 21, 2009 12:23 PM
I like to see Pelosi sticking to her guns, but this is nothing new. It has been obvious to anyone following the strategy and procedures that the Senate finance committee was not going to include a PO, then it would be merged with the HELP bill, with either no or only a watered-down PO, THEN it would have to be reconciled with a House bill with a robust PO. The only real drama will begin with what the reconciliation bill looks like. What Pelosi's bill is really doing is laying the foundation for a bifurcation or an opt-out clause. The bifurcation option would involve an initial bill that set up more strict regulation of the insurance industry, prohibiting exclusions and payment caps, and requiring portability, but without a PO. Then, a second bill would immediately be submitted offering ONLY a PO, and that one could be rammed through on 50 votes in the Senate, because it's only purpose would be budgetary, to save the fed hundreds of billions over time.
The opt-out option might be a way to force wavering Senate Dems to support a robust PO, by giving them cover.
Of course, the third possibility (and the one I fear is supported by at least Rahm Emanuel) is to pass only the first part of the bifurcated process, then kill the second part by 1000 blows and attrition.
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slb
October 21, 2009 4:45 PM
Go Nancy! The lady knows how the bargaining process works: you start by asking for everything, and then you negotiate down only if you have to, and then only as far as you need to go to seal the deal. Mr. President, please take note.
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jollyroger
October 22, 2009 6:49 AM in reply to slb
Mr. President, please take note.
I know Sipowitz was always the bad cop, and I think Jimmy Smits was one of the rotating good cops, but anyway, do you remember how the "good cop" used to fool the perp, and you'd say, man, that perp is stupid to believe that good cop act...?
Just because Dub was stupid enough to want to be the bad cop so his dick would occasionally get hard, that doesn't make it smart theatre.
Just like you, I want to see Prez kicking ass and taking names, but that is not the model for successfully overturning the encrusted chains of 300 years of white/male/rich/het privelege.
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