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Pelosi Considers Two Track Strategy For Health Care Reform
Speaker of the House Nancy Pelosi (D-CA)
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Politico is reporting that House Speaker Nancy Pelosi is pursuing a dual-track strategy for health care reform.
"We believe that it's possible to have comprehensive health care reform as we go forward, but at the same time, it can be on another track where some things can just be passed outside of that legislation, and we'll be doing both," Pelosi said.
But what exactly does that mean? A top House aide clarifies.
"We can work on a comprehensive bill...we've got to figure out what the process is, who goes first, and whether the Senate goes first or second it doesn't matter but the fact remains that it could take a couple weeks for them to debate on the floor," the aide said. "While we're doing that: What else can we do in the meantime?"
"This is just an example," the aide went on, "but the anti-trust exemption isn't in the Senate bill. So that couldn't be added through reconciliation. So the House could pass a couple of smaller things that can pass as freestanding items, and can't be added through reconciliation."
This strategy offer a number of potential benefits. First, it has the potential to make the bill better in the eyes of the House (provided the ancillary bills passes the Senate. Second, it turns up the pressure on all parties to make sure that a final, comprehensive bill passes. And it takes public attention off of the prevailing story of procedural logjams and Democratic infighting.
Interesting...
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ben_nelsons_hair
January 27, 2010 5:54 PM
Nancy deserves a lot more credit than she deserves.
The woman is fierce!
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jsdc007
January 27, 2010 6:44 PM in reply to ben_nelsons_hair
She does. But she has the cowardly Senate to deal with ultimately.
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Lestatdelc
January 27, 2010 6:59 PM in reply to ben_nelsons_hair
She deserves more than she deserves?
Can you diagram that sentence for us please. (grin)
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ben_nelsons_hair
January 27, 2010 7:34 PM in reply to Lestatdelc
Ooops!
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zonk
January 27, 2010 7:11 PM in reply to ben_nelsons_hair
Absolutely.
I'm one of the milquetoast supporters of the Senate bill being better than nothing, even by itself... but that doesn't mean I wouldn't prefer a better bill.
If we DO get a better bill, Pelosi deserves one hell of a lot of credit.
...and really, it's been a lot more than just HCR. Pelosi has been an extraordinarily effective Speaker since she got the job. She keeps the caucus in line, gets her votes, and generally does an excellent job. If she had even a Daschle-level effective counterpart in the Senate (and Daschle was no great shakes), it would be truly amazing what we'd probably already see passed.
50 years from now so long as she keeps on the same path, Pelosi is gonna deserve to be mentioned in the same breath as Cannon, Reed, O'Neil, Clay, etc so far as influential and effective Speakers go.
All the while, she's also been a lightning rod (just like other notable speakers) and has shrugged it all off admirably.
It's really pretty amazing when you think about it... to not only be a first, but a first that's earning her way into the pantheon.
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Sailormarlowe
January 27, 2010 7:32 PM in reply to ben_nelsons_hair
You meant...farce?
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MyMy
January 27, 2010 5:57 PM
Agreed. Bill O'Reilly can go take a flying leap for his horrendous remarks. It's tiresome for these good ol' boys to smirk about her.
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Lestatdelc
January 27, 2010 7:00 PM in reply to MyMy
What remarks are you referring to?
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JJNelson
January 27, 2010 7:26 PM in reply to Lestatdelc
He recently joked about kidnapping and waterboarding her.
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Indie Pro
January 27, 2010 6:18 PM
Very interesting. She's working on a solution, and that speaks well for her.
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hunter
January 27, 2010 6:19 PM
...the anti-trust exemption isn't in the Senate bill.
Er...what does this mean exactly? I thought the anti-trust exemption was the status quo, and that the question was whether we would get rid of it.
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Elizabeth2
January 27, 2010 6:35 PM in reply to hunter
I think they mean that *repeal* of the anti-trust exemption isn't in the Senate bill, nor is it something that could be gotten by way of reconciliation (not a 'money' item), so they could seek that as a free-standing bill on its own - the 2nd track.
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zonk
January 27, 2010 7:18 PM in reply to Elizabeth2
Even beyond that...
I just don't see what the big deal is over the anti-trust repeal. The issues people have with private insurers simply aren't really trust/monopolistic issues. I'm not aware of anyone ever claiming that private insurers are colluding and rate fixing, just that the systemic allowances in the private system (rescission, no discrimination limits, no caps, no minimum plan mandates) make private insurance fail to work.
The anti-trust issue is really nothing more than a punishment/billy club to rap insurers about the head for just generally not liking them.
I have no problem repealing it -- but I could see scenarios where it causes more problems than it solves (maybe you break up some of the BCBS's that control 95% of a certain state's market, but in fact -- some of those insurers have satisfaction rates much higher than the private insurance status quo... and most of the big troublemakers - the Aetnas, CIGNAs, et al - don't have trust-bust worthy market shares).
If we waste an ounce of effort holding out over the anti-trust exemption, sorry... but we're crazy. It's about 145th on the list of fixes needed for health care.
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goldiera
January 27, 2010 9:31 PM in reply to zonk
You've got to be kidding!
Please!
If you don't understand the power the anti-trust exemption gives insurance companies to continue to loot and pillage the American citizen, I don't know what to tell you.
I guess you don't mind the skyrocketing costs of health care. Never mind the daily battles people endure to get decent care for a service they are forced to pay for.
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midnight rambler
January 27, 2010 9:39 PM in reply to goldiera
Actually, the paradox is that part of the high cost of health care is the result of small market-share insurance companies not being able to negotiate rates that are as good as larger ones. As a result, the companies with a smaller base pay several times more than larger ones for the same procedure at the same facility.
This is why our health care system makes no sense. A real reform to reduce costs, or at least balance them, is to eliminate negotiated rates. As far as I know, Maryland is the only state that does this. Eliminating the anti-trust exemption without also evening the rates does nothing.
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Cool Blue Reason
January 27, 2010 6:35 PM in reply to hunter
It's just a lazy/imprecise way of saying, "Repeal of insurance companies' anti-trust exemption isn't in the Senate bill."
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jimbomoron
January 27, 2010 6:22 PM
Yeah. I love Speaker Pelosi, but has she not learned anything about health care reform in eight months? Get real, Madam Speaker! As Uwe Reinhardt has put it, lord knows what ugly duckling could emerge if the likes of Joe Lieberman, Ben Nelson, Mary Landrieu, et. al. get their mitts on the community rating, the individual mandate, the revenue measures all individually.
This Pelosi pussy-footing is the exact same sort of crap that got Democrats into the predicament they are in right now. Just delays from schemes to mitigate the political pain of having to cast politically difficult votes -- only to backfire politically.
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mans_best_friend
January 27, 2010 6:23 PM
Good plan. Start with the anti-trust exemption. Let's see the Republicans try to spin that as something bad. Watching them stand in the way of something that most everyone will see as a good thing de-legitimizes them in the eyes of the public and pretty soon people start asking questions about some of their other positions.
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philogratis
January 27, 2010 6:25 PM
Yeah, it's written wrong The recission of the anti-trust exemption is not in the Senate version. alhough it is in the house version. There aren't 60 Democratic votes for the anti-trust exemption. Possibly there are Republican votes? Pelosi thinks this bill is good politics even if it doesn't pass, because then they can talk Republicans (and a few Democrats) for voting against it.
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SamAL
January 27, 2010 6:31 PM
This president is toast and worthless without this powerful speaker. The only person in government with a spine, a anatomical feature otherwise missing from Dems at this time. Go NANCY!
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jimbomoron
January 27, 2010 6:35 PM
And newsflash to Speaker Pelosi, ending the anti-trust exemption will lower premiums by at most 10 percent.
The ratio of the average premium for 60-64-year-old man to the average premium of a 20-24-year-old man is 6:1. For women, this ratio for these same age groups is 3:1. In other words, lowering the age rating from 3:1 to 2:1 will lower premiums for adults ages 55-64 -- those who have the most trouble getting health insurance -- by more than 10 percent.
Which is more important? The community rating or the anti-trust exemption?
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Cool Blue Reason
January 27, 2010 6:37 PM in reply to jimbomoron
It's not an either/or kind of thing.
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jimbomoron
January 27, 2010 7:00 PM in reply to Cool Blue Reason
It's a priorities thing.
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zonk
January 27, 2010 7:28 PM in reply to jimbomoron
If that... and I highly doubt it would be that high (and certainly, not an across the board cut).
I'm completely with you (except, I'd go even further)... The anti-trust issue simply isn't that big a deal in the grand scheme of things. There are dozens of much more effective provisions for cost control in the bill.
Being a big baseball fan, it was pretty much the same thing years back when some baseball fans wanted to 'punish' MLB owners by removing baseball's antitrust exemption (I think SCOTUS has since gutted it anyway).
Anti-trust actions are only useful in a situation where collusion is at the heart of the problem. That's not the problem with private insurers... the problem is a complete lack of federal oversight, discrimination protections, and federal reporting/compliance.
I couldn't care less if they DO revoke the exemption, no skin off my nose - but it's hardly something worth really fighting over... It wouldn't be much more than a symbolic 'FU' to insurance companies.
The issues in the private insurance market are not endemic to areas where a certain BCBS controls the whole market - you'll find the exact same problems in markets where there actually ARE multiple insurers, and I'm not aware of any of those being matters of "if only we could bring a trust action".
All the revocation would do is open up insurers to a new and exciting kind of punishment that they previously never faced...assuming, of course, you could actually turn up some actionable cases.... hey, fine - punish away, but I'm more interested in fixing the system than punishing people.
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johnnydoughey
January 27, 2010 6:38 PM
I find it difficult to admire leaders in this nation who no longer believe they need to declare war before sending other folks to their death... and at the same time protect cronies who believe it's okay to torture other human beings..
I also find it difficult to allow these monstrous acts to go unnoticed and forgotten...
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Alex39
January 27, 2010 6:40 PM
Pelosi totally has our backs; I trust her more than anyone else up there. This is a clever strategy PR-wise as well as substantively.
Go NANCY!! Meanwhile, keep calling your Senators.
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Ethan
January 27, 2010 6:44 PM in reply to Alex39
Absolutely, no letting up.
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Sailormarlowe
January 27, 2010 6:46 PM
Half track & wrong track. Why won't the old harridan Pelosi face up to reality? It's over for the "health care" scam.
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bk
January 27, 2010 6:50 PM
Way to go Nancy. I wish the Dems would just go ahead and pass it already, then go about changing what they don't like. It's never going to be perfect!!
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Redshift
January 27, 2010 7:04 PM
Ummm, how? Are there 60 votes for any of these measures? If not, is there any indication that any Republicans will vote for them?
It may take attention off Democratic infighting, if the media actually reports that it's Republican filibustering that's blocking the measures, but so far they've preferred to just keep saying "of course it takes 60 votes to pass anything in the Senate." But even if that message gets through, the story is still procedural logjams, not accomplishments.
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AnswerFrog
January 27, 2010 7:32 PM
Nancy is great. I get the impression that unlike some of her colleagues (esp in the Senate) she is a liberal at heart and would do more if she could.
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Silence
January 27, 2010 7:34 PM
You mean how to subvert the constitution and implement another Ponzi scheme. Right, Nancy?
No. I don't think so.
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barbara63
January 27, 2010 8:15 PM
Nancy Pelosi has been pushing full-steam ahead since the MA election last week. If she does feel discouraged or frustrated, she doesn't let it show in public. I wish other Democrats would learn from her example.
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philogratis
January 27, 2010 9:23 PM
Yeah, it's written wrong The recission of the anti-trust exemption is not in the Senate version. alhough it is in the house version. There aren't 60 Democratic votes for the anti-trust exemption. Possibly there are Republican votes? Pelosi thinks this bill is good politics even if it doesn't pass, because then they can talk Republicans (and a few Democrats) for voting against it.
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USgreentech
January 28, 2010 3:56 AM
Talking points Memo was calling the bill over with. Idiots, fucking morons. Dumb shits. Get the site off the internet. GO BLUE!
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Alex39
January 28, 2010 8:08 AM in reply to USgreentech
Wise up, friend. Why do you think they took a dark view? Do you think we would have gotten off our asses if JMM hadn't raised the alarm?
F**k no. We'd be writing snarky comments all day instead of calling our goddam Congresspeople.
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Tosh
June 6, 2010 10:43 PM
You've got to be kidding!
Please!
If you don't understand the power the anti-trust exemption gives insurance companies to continue to loot and pillage the American citizen, I don't know what to tell you.
I guess you don't mind the skyrocketing costs of health care. Never mind the daily battles people endure to get decent care for a service they are forced to pay for.
m65 kamagra
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