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Will Health Care Reform All Come Down To Ben Nelson?
Sen. Ben Nelson (D-NE), Sen. Joe Lieberman (I-CT), and Sen. Olympia Snowe (R-MA)
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Half a day later, we know a lot more about where the key players who will determine the fate of health care reform stand on a burgeoning public option compromise. Unfortunately, there's still a substantial lack of clarity about where we go from here.
The long and short of it is this: It is possible that Democrats will reach a consensus on a plan to trade the public option for several concessions, including a plan, supported by progressives, to allow people age 55-64 to buy into Medicare. That could be the grand bargain that allows health care to pass the Senate. But not a single Republican--including Sen. Olympia Snowe (R-ME)--seems to support the ideas on offer. And with Democrats unable to lose a single vote, one of them--Sen. Ben Nelson (D-NE)--could defect over the issue of abortion.
As I reported this afternoon, Snowe (R-ME) says she's not a fan of the ideas coming out of series of meetings between Democrats seeking accord on the public option. Snowe didn't explicitly say she'd filibuster the health care bill if that compromise emerges, but she has told Senate Majority Leader Harry Reid she doesn't support the idea.
That makes it seem quite likely that Reid needs all 60 of his members to support whatever compromise comes out of the negotiations. Sen. Joe Lieberman (I-CT) made no promises, but seemed open to the trade-off on the table. Optimistically, that makes 59.
That leaves Nelson. Nelson is threatening to filibuster over a different issue: abortion. He wants the health care bill to prevent the millions of people who would be receiving federal insurance subsidies from buying policies that cover abortion. His amendment, codifying that idea, is not expected to pass.
Reid says he's happy to continue negotiating with Nelson if his abortion measure goes down in smoke. And perhaps Nelson will take a second crack at a compromise, or will relent on his filibuster threat. But we likely won't know until after his amendment goes down.
At his weekly press conference today, I asked Reid what his next move is if Nelson defects. Reid suggested more compromise is the only option. "The purpose of legislation is to build consensus," Reid said. "It's not often that you have a piece of legislation that is perfect. But we can not let the perfect be the enemy of the good."
Sen. Jay Rockefeller (D-WV) was a bit more dramatic "I'm unafraid of everything, and afraid of everything. I'm exactly where I should be.... we have no votes to lose."
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Indie Pro
December 8, 2009 3:25 PM
more compromise is the only option
perhaps they could offer the insurance industry some tax breaks, freedom from any prosecution ever, and everyone's first born.
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rbeats
December 8, 2009 3:38 PM
The contempt for the welfare of the American citizenry is disgusting.
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Andreams
December 8, 2009 3:41 PM
Add a Viagra rider to Nelson's amendment and I'd vote for it if congress had to comply. Wonder how many in congress would vote for that?
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SilvestriWoman
December 8, 2009 4:21 PM in reply to Andreams
In a compromise, I'd insist that Nelson's amendment include the following provisions:
(1) Free contraception to all low-income Americans.
(2) A major national campaign behind said contraception, reminiscent of anti-AIDS/condom usage, targeted to men as well as women. (Women aren't solely responsible for unwanted pregnancies.)
(3) Funding of healthcare and childcare for low-income women - those most likely to be unable to afford that abortion.
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Cool Blue Reason
December 8, 2009 4:30 PM in reply to SilvestriWoman
No deal.
Let me list the things they are not interested in, in order of increasing lack of interest:
1. Abortion
2. Women's health and contraception
3. Being called out on their bullshit
Their aversion to #2 exceeds #1, precisely because it leads inexorably to #3.
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cwnidog
December 8, 2009 3:48 PM
I would favor putting his balls in a vise and turning the screw. Political or physical balls, or both - I don't really have a preference.
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VictorLH
December 8, 2009 3:49 PM in reply to cwnidog
Reid doesn't know what balls are.
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masanf
December 8, 2009 4:41 PM in reply to VictorLH
Yeah he does, because Nelson's are on his chin.
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VictorLH
December 8, 2009 3:48 PM
How many different excuses has Nelson had to oppose this bill. I think this is number 6. All he's looking for is attention.
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Indie Pro
December 8, 2009 4:02 PM in reply to VictorLH
the consevative democrats have given nothing, and are getting everything, why would they change their tactics now.
Getting rid of the PO is a huge win for the industry.
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AlphaLiberal
December 8, 2009 4:17 PM in reply to Indie Pro
Well said. They're being rewarded for being self-absorbed Republican filibuster lovers.
We need to get Pavlovian on their asses.
And for the love of God will the Dems please play hardball on the filibuster abuse? What wimps!
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sanssouci0
December 8, 2009 3:58 PM
SIMPLE ABORTION COMPROMISE:
1.Request that the CBO calculate the total amount of money over a ten year period that would flow from the billions of dollars in federal exchange insurance plan subsidies into actual individual abortion reimbursement.
2.Calculate the total number of abortions estimate to occur over that 10 year period of time, and divide the 'indirect' federal abortion subsidy by that number, and VOILA, you have an "abortion deductible" that would be an out of pocket expense for any concerned beneficiaries.
My estimate is that this 'abortion deductible' would be very low, somewhere around $20-$25.
This 'abortion deductible' would keep conservatives happy, while still allowing insurers to offer affordable abortion coverage. It isn't great but nowhere near as dramatic as the Stupak amendment. It nonetheless ensures with much more precision than the overinclusive Stupak amendment, that no new federal money, directly or indirectly will flow to abortions.
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sanssouci0
December 8, 2009 4:03 PM
Just to elaborate on the previous post: assume that the federal insurance subsidy on the exchange would be roughly 1K/yr per plan. Of that 1K, on average only an infinitesemal portion, maybe 0.001% will end up flowing back out of the insurance pool into an abortion reimbursement. Hence, the very low 'abortion deductible' to compensate for such indirect subsidy.
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Cool Blue Reason
December 8, 2009 4:25 PM in reply to sanssouci0
If you really believe that would make conservatives "happy," you're giving them far too much credit. They have zero interest in actual public policy solutions to the "problems" they have created. Their purpose is to present as many intractable obstacles as possible. The issue of abortion gets them more mileage only because it riles up their useful idiots, and shuts down rational thought and debate on both sides.
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wbgonne
December 8, 2009 4:10 PM
At what point does compromise become something else, say, capitulation? Or failure?
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cube3u
December 8, 2009 4:17 PM in reply to wbgonne
It's capitulation when there is NOTHING in the bill that benefits working, middle class families. Establishing the principle of federal regulation of insurance is a plus. Making it illegal for Insurance Companies to deny coverage based on pre-existing conditions, reaching a set lifetime dollar amount, and cancelling on a whim is a plus. Subsidizing folks is a plus.
It's failure when nothing passes. It will be a failure for us and a complete failure for the Democratic Party who can expect heads to roll next year. Any elected Democrat who opposed reaching consensus on this will will be "un-elected". Elected Democrats will discover that their votes will matter. Party members and activists will ensure that!
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Indie Pro
December 8, 2009 4:29 PM in reply to cube3u
The bill is being watered down.
Even with those rules in place, "there's no power to really hold the insurance companies accountable," said consumer advocate Betty Ahrens, executive director of the Iowa Citizen Action Network. "It's toothless." ...
...A 1996 federal law called HIPAA, the Health Insurance Portability and Accountability Act, prohibited rescissions unless consumers defrauded the insurer or deliberately misrepresented their medical condition. But the federal agency responsible "has done nothing to enforce those rights or to ensure that states do so," Rep. Henry A. Waxman (D-Calif.) said in a hearing last year.
An official testifying for the agency, Abby L. Block, confirmed that it had taken no enforcement action. She said her hands were tied unless it appeared that a state was not "substantially enforcing" the federal requirements.
Despite the HIPAA standard, most states have allowed rescissions even if policyholders' misrepresentations were accidental, the staff of the House Energy and Commerce Committee reported this year.
From article:
Even if health bill passes soon, wait for reforms could be long...enforcement in doubt
http://www.washingtonpost.com/wp-dyn/content/article/2009/11/29/AR2009112902425.html
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Stroszek
December 8, 2009 5:43 PM in reply to Indie Pro
The problem with HIPAA is that it still allows rescission in regards to medical conditions. The new legislation would allow you to say you are an immortal god and the insurance companies would have no recourse (not that it would matter, since they couldn't adjust your rates on that basis one way or the other) and no argument if you took them to court.
The other key difference is that HIPAA depends on state regulators which are, obviously, pretty weak in a lot of states. This legislation puts regulatory enforcement directly in the hands of HHS.
Now, you could say that state regulation is doomed to be useless, but that argument is pretty much an argument against progressive ideology altogether. And so it shouldn't be a surprise that WaPo, which takes bribes from insurers for "access" to their writers, would spread the idea that there's no point passing regulatory reform.
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condew
December 8, 2009 5:52 PM in reply to Indie Pro
Wow, then recissions are another abuse that Obama could fix by merely instructing executive-branch officers that he appointed or at least nominally work for him.
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cube3u
December 8, 2009 6:33 PM in reply to Indie Pro
If the consumer answers "yes" to HIPAA, then there are policies to choose from. HIPAA invokes privacy--so the consumer does not have to share physical and mental history with the insurer. So the insurer assumes worst case and prices the policies as if the worse case exists so policies offered under HIPAA are expensive. Let's face it, folks involing HIPAA certainly arouse the suspicion that they have a pre-existing condition.
Bit disingenuous to assume that the problem with HIPAA policies is something other than cost. And, yes, it is difficult to get 50 states on board quickly--the squirming and fighting is enormous. But, hey, the Clintons should have taken care of this little issue with new legislation. Right? What could have possibly interfered with that?
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wbgonne
December 8, 2009 4:31 PM in reply to cube3u
If the bill enacted consists only of 1) mandatory insurance and 2) insurance regulation it will be a failure because no systemic change would be introduced. Regulations are nice but transient.
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Cool Blue Reason
December 8, 2009 4:12 PM
Wouldn't all of this come together in a so-called "managers' amendment," which would include such measures as the public option compromise and have the explicit endorsement of Senate Democratic leadership?
Presumably this managers' amendment could have some kind of abortion compromise language in it. Even if Nelson's abortion amendment fails on its own, I don't think we should assume that similar abortion language would be fatal to a "grand compromise" amendment designed to break cloture, and which they've gotten Nelson to sign onto.
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sanssouci0
December 8, 2009 4:19 PM in reply to Cool Blue Reason
I agree. I think that the only way to ensure cloture is a vote on a large overarching amendment that includes all the necessary changes to ensure cloture, one of which will be some form of compromise on the Stupak-Nelson abortion complaints. (This of course assumes that Nelson's new-found indignation at the possibility of abortion subsidies is being made in good faith, not just as a facade for opposition to any substantive reform).
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CT Voter
December 8, 2009 5:16 PM in reply to sanssouci0
This of course assumes that Nelson's new-found indignation at the possibility of abortion subsidies is being made in good faith, not just as a facade for opposition to any substantive reform
I think it simultaneously is in good faith, but simultaneously represents the most useful reason for opposition right now. I'm fairly sure that even if the bill managed to outlaw all abortions (by mandating that electricity to clinics/hospitals that perform abortions cannot be delivered or something equally stupid), Nelson would find another reason to oppose this.
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mcc
December 8, 2009 4:25 PM in reply to Cool Blue Reason
It's extremely possible that the bill itself could fail to get 60 votes once "compromised" in this way.
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Cool Blue Reason
December 8, 2009 4:38 PM in reply to mcc
Well, that's where we are. Either Reid & Co. can get 60 votes on a grand compromise amendment (and thus 60 on cloture), or we're stuck.
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sanssouci0
December 8, 2009 4:14 PM
If NARAL wanted to, it could finance the proposed abortion deductible for low income insurees at a minimal annual cost.
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Derek Stodghill
December 8, 2009 4:29 PM
Someone needs to tell Pro-Choice Snowe that her vote for a filibuster is a vote to end abortion rights. If Reid convinces her that unless she votes for cloture abortion rights will go down in flames, maybe she would relent to vote for cloture before voting against the bill.
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masanf
December 8, 2009 4:49 PM in reply to Derek Stodghill
How exactly does a government restriction on abortion subsidies end the "right" to an abortion? One does not have a right to government-subsidized medical procedures in this country.
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Derek Stodghill
December 8, 2009 4:58 PM in reply to masanf
A bit of hyperbole on my part, I admit. From what I read, it will make abortion so expensive only the rich will be able to afford them. Practically the same as outlawing them.
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masanf
December 8, 2009 4:47 PM
"I'm unafraid of everything, and afraid of everything. I'm exactly where I should be.... we have no votes to lose."
And in other, related news, a new study was released today indicating that Senators like to be as opaque as possible when questioned on various topics.
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traitorjoe
December 8, 2009 4:50 PM
Olympia Snowe has managed to lose the respect and friendship of Senators on both sides, a rare accomplishment, and both Good Americans (liberals) and Bad Americans(conservatives) hate her. Even Stalin had a few friends at the end.
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Florida Democrat
December 8, 2009 5:14 PM
The leverage is stimulous dollars. Every no vote on cloture is being threatened with a cut-off of all stimulous funds for their state. Yes votes get "beneficial" stimulous dollars.
Stimulous funds equal re-election donations and re-election votes.
This is old style LBJ politics and it is being played very well and quietly by a skilled set of enforcers from the administration. (Hey, Rahm, can you hear me?)
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mcc
December 8, 2009 5:50 PM in reply to Florida Democrat
Didn't Nelson already do everything he could to slash down the stimulus?
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syvanen
December 8, 2009 5:24 PM
At what point has the bill reached the point of just being not better than nothing but worse than nothing. One thing that has worried me for months is that the bill will cover existing Medicare. Having Medicare in play must have the right licking their chops in anticipation of suckering the Dems into a compromise health care "reform" bill with items that will undermine the best public health care system we actually have in hand. I have no idea what is going on in these negotiations, but there might come a point where the progressive position will to oppose the bill in its entirety.
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Stroszek
December 8, 2009 5:46 PM in reply to syvanen
What items are those? The cuts to Medicare overpayments through private insurers most certainly don't have Republicans licking their chops.
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syvanen
December 8, 2009 6:28 PM in reply to Stroszek
Well if that is all there is to it, then my worries are without foundation. Quite frankly, I really have trouble following what is in this bill. But ever since Glass-Steagall was repealed with a majority of Democratic votes, I think it is prudent for progressives to be concerned about past progressive legislation as well as trying to make improvements for the future.
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condew
December 8, 2009 6:05 PM
Everything that gets negotiated out has got to come back as ammendments on war funding bills. If Conservadems and Republicans want to fight Bush's wars, then the only way to get funding is to approve a pubic option, regulate insurance for real, allow medically necessary abortions, etc. We need to turn whatever passes into what should have passed piece by piece as part of everything conservatives want to do.
Why is it that when conservative Republicans took power, they told their moderate members to sit down and shut up; and when progressive Democrats took power, they let their "moderate" members write the legislation?
I'd like to know what's so "moderate" about threatening to filibuster your own party. Call the right-wing Democrats or teaparty Democrats.
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