
Senate health care leaders, and White House officials including Chief of Staff Rahm Emanuel, HHS Secretary Kathleen Sebelius, Office of Health Reform Director Nancy-Ann DeParle and Sens. Chris Dodd (D-CT), Max Baucus (D-MT), Harry Reid (D-NV), met behind closed doors for over an hour in a leadership office Monday night to discuss and negotiate the merging of two different health care bills.
A spokesman for Reid was mum about the details, except to say that the group discussed the public option, affordability and other issues at the heart of the plan to reform the nation's health care system.
The same officials are expected to huddle again Tuesday to continue the talks.
kash79
October 20, 2009 12:14 AM
I know as much about the White House agenda on this as the first person I'll see the next time I take a stroll downtown. Which means I don't much at all.
But I'm confident in making a couple of guesses:
1) I do think, the Obama administration genuinely feels PO is only a part of the gamut of issues on hand, and while they welcome a PO, they believe a bill without the PO can also be called "reform." Also, the Obama administration wants to ensure they have "something" to pass, more than the "right" thing. Because passing nothing is even more fatal and passing without a PO.
While I empathize with them, they should know by now in no uncertain terms for the hardcore base, it seems, the discussion begins and ends at PO. And I hope the base, so called "Whiners" keeping making noise, even if it gets a little uglier.
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kash79
October 20, 2009 12:15 AM in reply to kash79
"even more fatal than passing without a PO..."
"keep making noise..."
Arghhh....
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Indie Pro
October 20, 2009 10:44 AM in reply to kash79
affordability is the Herculean task when you are mandating a product.
sincerely.
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jimbomoron
October 20, 2009 10:56 AM in reply to kash79
And that's where I disagree with you. I don't share your views about the magical powers of the public option, and don't believe it's absence is worth throwing a political temper tantrum. I think the public option has the ability to lower costs 10-20 percent for more affluent customers, which is certainly nice, but for low and middle-income customers the savings from the subsidies will overtake any savings from the public option.
Here's my numerical calculation: Alan and Jane Smith have two children, and have a family income of $80K/yr. Based on the current bills, they will have to pay $8,800-$9,600 (11-12 percent premium cap) before receiving a subsidy. Now Suppose a private plan costs $14,000, which doesn't seem unreasonable with the 2:1 community rating. Do I think a public plan with the same generosity will cost under $9,600? I don't. I think it will save the taxpayers at most (and that's being wildly optimistic) $14,000 * 20%, or $2,800, which is nice, but it won't save the Smith's anything as $14,000 - $2,800 > $9,600.
In other words, based on my mathematical example, the higher the income, an the less coverage a person purchases, the more he/she will save because of the public option. This is nice. But is it's absence worth keeping the Smiths and millions of other uninsured families one illness from bankruptcy? I'm not sold on that. That's just how I feel about the legislation.
I think it would be better for progressives to turn their attention to the following issues:
1. Whether or not a family can afford the premium (individual mandate penalty, subsidies -- premium caps)
2. Whether or not a family can afford the deductibles and co-pays (individual mandate penalty, subsidies and minimum actuarial value)
3. Whether or not older adults will be able to afford the premium and cost-sharing (individual mandate, community rating)
4. Whether or not the rules on the Exchange will do enough to prevent insurance companies from cherry-picking healthy people (risk-adjustment, community rating, minimum benefits package, tier structure, individual mandate)
5. Whether or not employees of medium-sized and large companies have access to the plans on the Exchange
6. Whether or not plans on the Exchange will be affordable (risk selection of employers who drop coverage, and dump their employees on the Exchange)
These questions -- more than whether or not a public option exists in the Exchange -- will determine the bill's long-term-political fate.
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Indie Pro
October 20, 2009 11:11 AM in reply to jimbomoron
affordability and the mandate is what the progressives I know are concentrating on.
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jimbomoron
October 20, 2009 11:18 AM in reply to Indie Pro
Exactly. And the mandate makes the product more affordable. There's simply no way you can have a community rating without an individual mandate, and have health insurance be affordable.
That's why the subsidies, the minimum benefits package, and the community rating are so important. Also, what kind of population goes onto the Exchange? If you make participation in the Exchange voluntary, how do you prevent employers who have a healthier population than the average employer from continuing to offer employer-based health insurance and the employers who have trouble getting health insurance for their employees from participating in the Exchange? And how will health insurance on the Exchange be affordable if only employers having employees with much greater than average claims costs are on the Exchange? There has to be something to control the risk selection on the Exchange.
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Indie Pro
October 20, 2009 11:32 AM in reply to jimbomoron
And the mandate makes the product more affordable.
that's questionable, if by product you mean premiums. No one, I've seen is claiming that the mandate will bring premiums down, only that you need a mandate to offset the costs of insuring people usually denied covereage.
I'm eagerly awaiting this:
“patient, consumer and labor groups are crafting a proposal they plan to shop to key senators to make health coverage more affordable than it would be under legislation approved by the Senate Finance Committee, hoping to influence a final Senate version of healthcare overhaul.”
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magster
October 20, 2009 1:12 AM
Boy, seeing those 4 determining the fate of this bill does not inspire confidence.
At least Dodd and Reid are in the fight of their political lives next year, and might be feeling the pressure.
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Tanjaoui
October 20, 2009 6:10 AM
SO: call your Senator, and any progressive Senator, and tell them to tell Reid, quietly: no strong public option, no cloture. They don't even have to show up for the vote.
You're right, the WH wants to pass any bill, and is ready to give the po. If they think there's a risk it won't pass because it has no po, they will get behind it, I'm pretty sure.
In fact, if you're right and they're willing to compromise on the po to pass anything: they're not so smart. With unemployment at 10%, you're leaving millions to the tender mercies of the insurance industry. And giving them millions through a mandate. And they lose their base, or a substantial chunk of it. That's if you're right. You're also spot on about not knowing how hard they are working to pass the po, or whether they're hoping it will go away. Impossible to say. That's very frustrating, as a voter. But I understand the secrecy. Secrecy may not be in our interests, but it's the way things get done.
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Angellight
October 20, 2009 7:53 AM
There is a statement that there is no higher religion than truth and that only Truth will set us free! It is right for the Obama Administration to speak truth and to call Fox News exactly what it is, to severe the bonds of untruth and misconception they infuse into the consciousness of humanity in order to "muddy the waters".... for selfish reason -- to maintain the power of the rich!
GOP politicians and operatives continue to dishonestly and deceptively say that they cannot support a public option, they claim, because they want to keep costs down for the American people! Really? They claim this all the while knowing a public option, therebycompetition is the only way to bring about true reform and to put a Halt to the “out of control” medical costs and premiums crippling people and Employers today, making it harder and harder for everyone to realize the American Dream. One must ask themselves, If you happen to lose your job today or tomorrow during this time when we do not have healthcare reform for all, who will pay you or your family's health care bills, that is if you are lucky enough to be able to see a doctor without insurance? This American Dream, which has slowly been slipping away, is in the last throes of dying, if we do not forge a new path ahead on toward inclusion and cooperation for all. This dream of America will die to be replaced with just another third world country -- becoming another failed experiment and promise, only to go by the wayside.
There is a reason that GOP always say Gov’t is the problem. They know that when you have a party of men and women in power who do Nothing for Main Street but say no or complain, to reform, then goverment is a problem! And so it becomes a self-fulfilling prophecy. As long as the GOP were in power or in control, the government has been a do nothing, problematic government for Average Americans and a big Boom and Bonus for the Rich and well connected. We must remember, this is Bush & the GOP’s recession. They had the power for 8 years and did nothing to uplift this country, only to rape it from Main Street, to add it to Wall Street. The GOP does not even like to raise the Minimum Wage! They care nothing if you are making it. People we must wake up now! Because look around you at the mess the United States is in and ask yourself over the last 10 years of GOP rule, what have they accomplised and what have they done for you lately? Or this country? Do you like what the United States has become? And ask yourself this, if we let them regain power again, how much more further will this country be destroyed until the United States will no longer be. That is a very frightening thought!
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The Commenter Formerly Known as NCSteve
October 20, 2009 8:57 AM
I think maybe some people missed the most important story about the public option yesterday vis a vis Reid: 52 of the 60 members of the Democratic Caucus are strongly in favor of a public option.
Think about why that might be significant. It has something to do with the fact that he's elected to his leadership spot by a vote of the Democratic Caucus.
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SleepinJeezus
October 20, 2009 9:27 AM in reply to The Commenter Formerly Known as NCSteve
And it only requires 51 votes to be approved if it is included in the bill that is presented out of conference.
I get so damned mad listening to all this bullshit about 60 votes being needed. It will take 60 votes to achieve cloture if the GOP decides to filibuster. Big deal.
The Dems have 60 votes. This therefore really becomes a matter of party discipline, nothing more. If Reid allows himself to be held hostage by ANY member OF HIS OWN PARTY on a PROCEDURAL VOTE for cloture, he has no business being in leadership. Period.
As for Lieberman, that is a case that should be handled by Obama/Emanuel. In this case I think Emanuel could be ruthless to good effect, and Lieberman definitely owes Obama the loyalty inherent in voting for cloture, regardless of what his ultimate vote on the bill might be. Failing that, Lieberman needs to be dealt with harshly - and he needs to know beforehand in no uncertain terms just how harsh the consequences will be if he tries to cut the rug out from under Obama and the Dems. (He's got a low tolerance for pain. Make it work for you.)
I can't imagine a Democrat voting to uphold a filibuster against his own leadership and a Dem President. Has this ever happened before?
The media talks on and on like it is conventional wisdom that the blue dogs would vote to sustain the filibuster. I think they're nuts and show little understanding of even Civics 101.
Imagine a junior Dem Senator from, say, Nebraska telling Lyndon Johnson that "I need to vote to sustain a filibuster against your Civil Rights Act." I mean, just think about it, fer chrissakes. Has Washington really gone this crazy?
I could go on and on about this. It just drives me fucking crazy!
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mld678
October 20, 2009 4:53 PM
This is an emotional issue for many Americans. This so-called “public option” in Government run health care presents serious challenges for us. As Consumers we should be able to compare the cost and quality of health care services. How much is a specific surgery at one hospital, as compared with another? http://www.friendsoftheuschamber.com/media/
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