Medicare

The Bipartisan Political Alliance That Will Turn The Fight Over Medicare On Its Head

Brian Beutler and Benjy Sarlin | December 14, 2011, 9:08PM

Sen. Ron Wyden (D-OR), and Rep. Paul Ryan (R-WI)

An unholy, unexpected political marriage between a Democratic senator and a House Republican firebrand will have implications beyond Capitol Hill -- and could conceivably alter both the political tenor of the 2012 elections and the long-term policy fight over the future of Medicare.

Sen. Ron Wyden (D-OR) is teaming up with Paul Ryan, the House's top budget guy and the author of the GOP's controversial budget which proposes phasing out traditional Medicare and replacing it with a private plan. The two announced via The Washington Post that they'll be teaming up on a different version of that Medicare plan -- one that closely mimics plans offered by leading GOP presidential candidates Newt Gingrich and Mitt Romney, and a proposal authored by former Sen. Pete Domenici and former Clinton budget director Alice Rivlin, which loomed large in the Super Committee's failed negotiations.

The move makes Wyden the first elected Democrat to endorse creating a premium-support system to compete with traditional fee-for-service Medicare, and for Ryan represents a de facto admission that his own plan was too radical to ever gain bipartisan support. That's bound to affect how congressional and presidential candidates approach the issue, which will feature prominently in next year's elections. But it raises a number of other questions, both about the merits of the policy and of the political calculus behind it.

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Tom Coburn

Back From The Dead? Obama Hugs Gang Of Six, Aides Caution Not To Conflate With Debt Limit Fight

Brian Beutler | July 19, 2011, 2:41PM

Sen. Tom Coburn (R-OK)

President Obama likes it. A wide array of Senators, including influential conservative Tom Coburn (R-OK), have given it their blessings. Out of nowhere, the Gang of Six's bipartisan plan for addressing the country's fiscal imbalance has returned from legislative hinterlands -- and has become the only viable, publicly available framework by which Congress can make good on its supposed desire for a grand bargain on deficit reduction.

But according to an aide briefed on the Gang of Six's negotiations, the fledgling framework is still too new and incomplete to be included in a package to raise the debt limit before August 2nd -- and it's more likely to become the basis for a bigger-deal in the weeks and months ahead.

"It will play into getting us through August 2nd in absolutely no way," the aide said. Senators on Tuesday, according to the aide were given "a briefing on a framework of what could become a plan," but the imperative now is to get the debt limit raised one way or another.

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Health Care

Poll: Public Still Doesn't Like Health Care Bill -- And Still Like Public Option, Medicare Buy-In

Eric Kleefeld | December 22, 2009, 8:48AM

President Barack Obama

A new Quinnipiac poll finds that a large majority of Americans continue to oppose the health care bill -- and that two policies that have been dropped, the public option or the Medicare buy-in, which were both very popular.

The poll finds 53% of respondents saying they mostly disapprove of the health care plan in Congress, to only 36% who approve. From the party internals, support is at 64%-22% among Democrats, 10%-83% among Republicans, and 30%-58% among independents.

The now-departed public option, however, is supported by a 56%-38% majority, including a 54%-41% margin among independents. Also, the Medicare buy-in for Americans ages 55-64 was supported by 64%-30%, including 57%-36% among independents and even a 50%-44% margin among Republicans.

The poll also finds that only 31% agree both that the President and Congress must take on health care reform now and support the current proposals. Another 28% want reform now but don't support the current proposals (a number spread pretty evenly across all partisan sub-samples), while 36% don't think reform should be taken on now.

From the pollster's analysis: "While the Senate leadership reportedly has the votes to pass a health care overhaul plan this week, outside the Beltway there appears to be weak support, both to what voters understand as the plan, and the need to pass that plan now."

Health Care

Brown: Public Option Or No, I'm Voting For This Health Care Bill

Brian Beutler | December 15, 2009, 8:04PM

Sen. Sherrod Brown (D-OH)

Sen. Sherrod Brown (D-OH) says he's in for health care reform, even though his key initiative--the public option--and all of its alternatives, have been swept into the dust bin.

"I'm going to vote for it," Brown told reporters. "I can't imagine I wouldn't. I mean there's too much at stake. And it's not at me, it's not about any senator, it's not about Lieberman, it's not about Harry Reid."

I asked Brown if he'd challenged Lieberman on his opposition to the public option and the buy-in.

"In the meeting with the President, I just made a direct appeal to him...I answered the arguments I've heard him make from your reporting: that it's revenue neutral, that it doesn't hurt Medicare," Brown said.

So what of the fact that Lieberman supported the buy-in as recently as three months ago?

"That's for him and his...that's for him to figure out.

Joe Lieberman

Lieberman: 'I Am Encouraged' By Progress On Health Care Bill

Eric Kleefeld | December 15, 2009, 2:35PM

Sen. Joe Lieberman (I-CT)

Sen. Joe Lieberman (I-CT) released this statement this afternoon, explaining his seeming reversal on a Medicare buy-in, and praising the progress that has been made in the health care talks:

"I am encouraged that progress has been made toward passing health care reform legislation in the Senate in the very near future. As I have said all along, health care legislation must expand coverage, contain costs, reform the way health care is delivered, and impose consumer protection regulations on the health insurance industry. While I objected to some provisions that I believed would unnecessarily add to the national debt, raise taxes, or endanger the fiscal solvency of the Medicare program, there is much that is needed and worthy in the core bill that I support.

"There has been some misunderstanding about my past position on the Medicare buy-in proposal, which I would like to clarify. I have long been concerned about making health care more accessible and affordable. One idea that has been discussed for years is expanding Medicare to people younger than 65. For example, the Medicare buy-in proposal was part of the Gore/Lieberman platform in 2000, but in 2000 our nation's budget was balanced, debt levels were less than half current levels, Medicare was not on the verge of insolvency, and there was no viable proposal like the one we are debating today to provide affordable coverage to more than 30 million Americans who currently lack health insurance, including people 55 to 65.

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Olympia Snowe

With Public Option, Medicare Buy-In Gone, Is Snowe A Gettable Health Care Vote?

Brian Beutler | December 15, 2009, 1:17PM

Sen. Olympia Snowe (R-ME)

That's the question Senate Majority Leader Harry Reid is trying to answer right now. The two met briefly earlier this afternoon just off the Senate floor.

According to a Senate leadership aide, with the public option and the Medicare buy-in now essentially out of the picture, Reid is "gauging where she is," hoping, perhaps, to turn the Lieberman debacle into an extra vote...or maybe two.

Of course, even with one of her major substantive concerns addressed, Snowe still says she's likely to oppose the bill unless Reid and the Democrats slow walk the bill to a final vote.

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Health Care

Lieberman: Senators Should Wait To See Bills In Writing Before They Threaten Filibusters

Brian Beutler | December 15, 2009, 12:17PM

Sen. Joe Lieberman (I-CT)

Sen. Joe Lieberman (I-CT) has a lesson for fellow legislators: wait until legislative proposals have been unveiled in writing before making final judgments (unless those proposals involve the public option or a Medicare buy-in).

"One of the things we've learned in the hectic last couple of weeks is that we all ought to be looking at paper," Lieberman told reporters this morning. "We ought to be looking at specific legislative language before we say I agree or I object."

Of course, Lieberman has objected to a public option compromise, that would allow people age 55-64 to buy into Medicare. "But to be as explicit as I can be now, if, as appears to be happening, the so-called public option government run insurance program is out, and the Medicare buy-in...is out, and there's no other attempts to bring things like that in, then I'm gonna be in a position where I can say--I'm getting to the position where I can say what I wanted to say all along: that I'm ready to vote for health care reform."

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Health Care

Rahm To Reid: Give Lieberman What He Wants

Brian Beutler | December 14, 2009, 8:02PM

White House Chief of Staff Rahm Emanuel

Obama administration officials were not pleased when word leaked out earlier today that the White House was leaning on Senate Majority Leader Harry Reid to cut a deal with Joe Lieberman on a public option alternative--and they gave their counterparts on the other end of Pennsylvania Ave. an earful about it. But in the end, sources are unanimous: The White House wants Reid to hand Joe Lieberman the farm.

An aide briefed on discussions with the White House says that there would be no story if Chief of Staff Rahm Emanuel hadn't interceded. The aide confirmed an account, reported by Huffington Post, that Emanuel visited Reid personally, telling him to cut a deal with Lieberman.

Then the aide provided more detail.

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Health Care

Are Pro-Public Option Senators Mourning The Loss Of The Medicare Buy In?

Brian Beutler | December 14, 2009, 7:46PM

Sen. Jay Rockefeller (D-WV)

Joe Lieberman is the man of the hour. But though he's threatening to filibuster the Democrats' health care bill, he did not speak at an impromptu caucus meeting on the legislation this evening. Perhaps that's because he appears to have won this round: The Medicare buy-in--the key feature of a public option compromise reached tentatively last week--is now being discussed in the past tense by some of its most ardent proponents.

One member who did speak, according to a source briefed on the meeting, was Sen. Arlen Specter (D-PA), who offered an impassioned plea. "Don't let these obstructionists win," Specter reportedly said. "I came to this caucus to be your 60th vote." His words were met with a loud applause, which was audible through the doors of the LBJ room, and down the hall toward the Senate chamber.

But that applause may belie the reality--that the chief items on the Democrats' wish list appear to be dead or dying. The public option is gone from the Senate bill. The Medicare buy-in, which was supposed to take its place, is on life support at best.

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Health Care

Lieberman: No Need For Medicare Buy-In Because Baucus Bill Was So Good

Brian Beutler | December 14, 2009, 5:59PM

While en route to a meeting of the Democratic caucus this evening, where members will discuss his threat to filibuster health care reform, Sen. Joe Lieberman (I-CT) addressed charges of hypocrisy over an alternative to the public option. Sort of.

"I didn't change my mind," Lieberman insisted. "I've been in this position for the last few weeks."

"We've got this very strong network and system of subsidies for people, including people who are 55-65 so the idea of the Medicare buy in no longer was necessary because they're taken care of very well under the Finance Committee proposal," Lieberman said.

For years, Lieberman had supported the idea of a Medicare buy-in as a promising vehicle for reform, including, as TPMDC first noted this morning, as recently as three months ago. Asked specifically about his position this past September, Lieberman now says that the Senate Finance Committee bill, finalized in October, dealt with the problem of the uninsured so well that the buy-in became redundant.

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Barack Obama

White House Pressures Reid To Cut A Deal With Lieberman

Brian Beutler | December 14, 2009, 2:26PM

President Barack Obama

As Politico first reported, the White House is pressuring a reluctant Senate Majority Leader Harry Reid to cut a deal with Sen. Joe Lieberman (I-CT) to keep the prospects for health care reform legislation alive, a keyed in aide confirms.

Reid's inclination is to wait until the CBO reports back on the public option compromise at the root of Lieberman's filibuster threat. But the White House has made it clear that they don't want to mess around.

The White House denies the charge. Spokesman Dan Pfeiffer tells TPMDC, "The report is inaccurate. The White House is not pushing Senator Reid in any direction. We are working hand in hand with the Senate Leadership to work through the various issues and pass health reform as soon as possible."

White House Press Secretary Robert Gibbs was less responsive. "The President is anxious to see progress and will continue to work with Democrats and Republicans and independents and everyone in between."

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Health Care

Progressives Demand Meeting With Obama In Wake Of Troubling Health Care Signs

Brian Beutler | December 14, 2009, 2:04PM

Rep. Raul Grijalva (D-AZ)

In the wake of some troubling signs that the progressive wishlist might get cut out of health care legislation, Reps. Raul Grijalva (D-AZ) and Lynn Woolsey (D-CA), co-chairs of the Congressional Progressive Caucus, have sent a curt letter to President Obama, requesting a meeting to discuss the push for reform.

"On behalf of the Congressional Progressive Caucus, we write to request a meeting with you to discuss health care reform legislation," they write. 'We have attached the Congressional Progressive Caucus' Principles that we expect to be included in the health care reform bill conference report."

Those principles include: "The creation of a nation-wide public option, such as the one in the House bill that increases competition, affordability and access for all Americans."

But, of course, all indications in the Senate are that the public option will not be part of the package, and now it appears as if even the consolation prize--a Medicare buy-in--might have to be stripped from the legislation as well. You can read the entire letter here. This could get ugly.

Health Care

Obama Confidant Podesta Says Lieberman Threat Will Renew Push For 51-Vote Health Care Bill

Brian Beutler | December 14, 2009, 12:52PM

President Barack Obama and Former Chief of Staff John D. Podesta

John Podesta, President of the influential Center for American Progress, and head of President Barack Obama's transition effort, says that Sen. Joe Lieberman's filibuster threat likely has Senate Democrats pulling their files on passing health care reform through the 51-vote reconciliation process off the shelves.

"I suspect musty folders on reconciliation got dusted off this morning," Podesta told USA Today's Susan Page. "If you don't have Lieberman and you don't have Nelson, the question is whether you can get Snowe and Collins."

Podesta is, of course, referring to Sens. Ben Nelson (D-NE), Olympia Snowe (R-ME), and Susan Collins (R-ME).

The Democrats will be discussing this question--how to get 60 votes for a health care bill without Lieberman's support--at a 5:30 p.m. caucus meeting tonight. Emotion's are expected to be very raw.

Health Care

If Lieberman Doesn't Back Off His Threat, Democrats Face Unappealing Options

Brian Beutler | December 14, 2009, 12:20PM

Sen. Joe Lieberman (I-CT)

Senate Majority Leader Harry Reid was apparently caught unawares by Sen. Joe Lieberman's latest assault on health care reform, and that's left Democratic leadership scrambling to figure out how to cobble together a bill that can get 60 votes on the Senate floor, without creating a tremendous head ache down the line when the House and Senate meet to tie their bills together.

Assuming that Lieberman can't be persuaded to back down from his threat to filibuster the bill unless all public option compromises are stripped from it, here are the options before the Democrats:

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Filibuster

With Health Care Reform Tied Up In The Senate, Harkin Revisits Call To End Filibuster

Brian Beutler | December 14, 2009, 11:06AM

Sen. Tom Harkin (D-IA)

Opening up Medicare isn't the only issue Sen. Joe Lieberman (I-CT) seems to have flip-flopped on lately. In 1995, he joined Tom Harkin (D-IA)--one of the most ardent supporters of reform in the Senate--in a call to end the modern filibuster. Today, Lieberman is threatening just such a filibuster on a major health care reform bill, which could easily kill the initiative altogether.

It's amid this episode that Harkin is revisiting his call to end the filibuster.

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Health Care

Health Care Reform In Peril; Lieberman Threatens Filibuster Over Medicare Buy In

Brian Beutler | December 13, 2009, 11:47PM

Sen. Harry Reid (D-NV) and Sen. Joe Lieberman (I-CT)

In a move that senior leadership aides say has left them stunned, Sen. Joe Lieberman (I-CT) has told Senate Majority Leader Harry Reid (D-NV) that he will filibuster a tentative public option compromise unless it's stripped of its key component: a measure that would allow people aged 55-64 to buy insurance through Medicare.

The development casts substantial doubt on whether or not a health care reform bill can pass in the Senate, and even more doubt on whether a bill that does pass the Senate will be reconcilable with substantially more progressive House legislation in such a way that a final reform package can once again pass in both chambers of Congress.

Lieberman told Reid this afternoon, after a contentious appearance on Face the Nation, that he's a "no" vote on the new compromise unless the Medicare buy-in is stripped, and he's not even waiting for the CBO to weigh in--a move one leadership aide described as "extremely unfair."

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Health Care

Grijalva Says The Senate Public Option Compromise Is A Non-Starter

Brian Beutler | December 10, 2009, 5:05PM

Rep. Raul Grijalva (D-AZ)

An influential progressive in the House of Representatives says that the public option compromise taking shape in the Senate might not survive the lower chamber--particularly if the Senate tries to jam its health care bill through the House.

In an interview this afternoon, Rep. Raul Grijalva (D-AZ) said he met with the Congressional Progressive Caucus' health care task force yesterday and they all agreed. "There is consensus within the progressive caucus," Grijalva said. "Personally I'm in agreement with them. I don't think very much of it."

"We're questioning whether you can define [what's coming out of the Senate] as a robust PO, and we don't think you can," he told me.

"There's rumors that we will skip conference--that we won't do conference--and bring their bill directly to the floor, and we are very, very opposed to that," Grijalva said.

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Health Care

Lieberman 'Increasingly Troubled' About Medicare Buy-In

Rachel Slajda | December 10, 2009, 4:01PM

Sen. Joe Lieberman (I-CT)

Sen. Joe Lieberman (I-CT) tells Politico that he's not totally on board with a proposal to expand Medicare.

"I am increasingly troubled about the proposal," Lieberman said. "I am worried about what impact it will have on the Medicare program's fiscal viability and also what effect it will have on the premiums paid by people benefiting from Medicare now and whether the whole thing is viable. If you separate it from Medicare, it will be an extremely expensive program."

Lieberman had remained neutral on the buy-in proposal since it was brought up Tuesday night, saying he would wait to make a decision until he saw legislative language and a score from the Congressional Budget Office.

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Health Care

Pelosi: Let's Wait And See What Public Option Compromise Comes Out Of The Senate

Brian Beutler | December 10, 2009, 11:52AM

Speaker of the House Nancy Pelosi (D-CA) with Senate Majority Leader Harry Reid (D-NV)

At her weekly press conference this morning, House Speaker Nancy Pelosi suggested today that the House could embrace a compromise emerging among Senate health care negotiators that would replace the public option with regulated national non-profit insurance companies and an opportunity for people aged 55-64 to buy into Medicare.

In the past, Pelosi has described the public option as a must-have provision, but today she said the House included the public option in its health care legislation because members believed it's "the best way to keep insurance companies honest...and also to increase competition."

Now, it's wait and see. "As soon as we see something in writing from the Senate, we'll be able to make a judgment about that," she said.

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Health Care

Democrats Take Aim At GOP Flip Flops On Medicare

Brian Beutler | December 10, 2009, 9:26AM

For decades, the Republican party has been the scourge of Medicare, hostile to it as a wasteful government program, and happy to see it, in the words of former House Speaker Newt Gingrich, "wither and die on the vine." Over the past several months, as Democrats propose paying for health care reform with savings wrung from waste in Medicare, Republicans have tried to position themselves as Medicare saviors. Sen. Tom Coburn (R-OK) took to the Senate floor recently to warn that health care reform will make seniors "die sooner."

Now, though, Democrats are pondering a Medicare expansion of sorts. They want to let people between the ages of 55 and 64 buy insurance through Medicare. And suddenly, Republicans are stuck in a booby-trapped rhetorical space, defending Medicare from all attackers--real and perceived--and also lashing out at the idea of letting more people benefit from it.

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CBO

Nelson: No Serious Objections To Public Option Package Sent To CBO

Brian Beutler | December 9, 2009, 5:28PM

Sen. Ben Nelson (D-NE).

As readers are well aware, the line of the day is that the emerging public option compromise in the Senate can't and won't be finalized until the Congressional Budget Office weighs in on the cost.

That raises the question of whether the negotiators thought the ideas sent to CBO--Medicare buy-in etc.--were worthy on the merits. I asked Sen. Ben Nelson (D-NE), whose objections to the public option helped lead to the new plan being discussed, whether he would have a problem with any of the options even if the CBO give them a passing grade.

"I'm not aware of anything that was raising serious objections about it, I think it was about, 'Well, that sounds okay, let's see how it scores,'" Nelson said.

That's likely to quiet some heartburn among leading Democrats, who really need this new initiative to succeed, so they can get 60 votes to pass the bill. Now let's wait for CBO.

Congressional Progressive Caucus

Key House Progressive: This Public Option Compromise Stinks

Brian Beutler | December 9, 2009, 3:57PM

Rep. Lynn Woolsey (D-CA), co-chair of the Congressional Progressive Caucus, isn't pleased with the public option rumblings she's heard out of the Senate, and suggests that, unless the final product has the same impact as a public option, her Caucus could reject it.

"I am looking at, Where's the competition in this compromise?" Woolsey told me today. "Are we offering competition to the private insurance providers? I don't see where that is. That's what the public option was all about was having competition so that premiums don't spike."

"We have 30 million new customers for the insurance industry, and what, we don't let them choose an option that would be less expensive?" she said incredulously.

Woolsey said the Medicare buy-in plan is a good one, though too limited.

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Health Care

HCAN's Kirsch: Public Option Compromise Not Good Enough

Brian Beutler | December 9, 2009, 3:43PM

Richard Kirsch, leader of the reform campaign Health Care for America Now says there are some nice things about the emerging public option compromise in the Senate...but it's still not a public option.

"Our take is pretty simple," Kirsch told me in an interview. "We're glad to see there's a good public option for people 55 and over, and we're going to work hard to extend that."

Kirsch is refering to the Medicare buy-in, which would allow people 55-64 to pay for the same insurance seniors receive from the government. In essence, that amounts to a public option.

He went on, "We don't view non-profit insurers as a substitute for a public option. We're not going to compromise on our principles"

"Our position has always been that we want a national, robust public option," Kirsch said. "The closest thing we've seen to that is the House and that's our position today.

Health Care

Landrieu, Lincoln: No Final Public Option Deal Until CBO Weighs In

Brian Beutler | December 9, 2009, 3:29PM

Sen. Mary Landrieu (D-LA)

Health care negotiators have not yet sealed the deal to remove the opt out public option from the Senate bill. Speaking to reporters this afternoon, Sens. Blanche Lincoln (D-AR) and Mary Landrieu (D-LA)--two health care swing votes who helped negotiate a bourgeoning compromise on the public option--said much still depends on what the CBO concludes about the menu of alternatives sent their way.

Lincoln was reluctant to describe last night's news as a deal.

"There was no compromise," Lincoln corrected, refusing to weigh in on the broad outline on the table. "There were a lot of ideas, where there was consensus that we needed more information to move forward."

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Health Care

Who Likes The Public Option Deal, Who Doesn't, And Will It Win 60 Votes For Health Care

Brian Beutler | December 9, 2009, 1:45PM

Democratic Senators Harry Reid, Chris Dodd and Tom Harkin

The Senate was remarkably quiet this morning, less than a day after Democratic leaders and health care negotiators announced a tentative deal to swap out the public option in health care legislation for a menu of other measures. But slowly, members have begun making their positions known.

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Health Care

Lieberman: I Continue To Oppose Any Kind Of Trigger

Brian Beutler | December 9, 2009, 12:01PM

Sen. Harry Reid (D-NV) and Sen. Joe Lieberman (I-CT)

In a statement to reporters this morning, Sen. Joe Lieberman (I-CT) reiterated his longstanding position on the public option: Namely that he opposes any form of it, including if it's attached to a trigger mechanism.

"My opposition to a government-run insurance option, including any option with a trigger, has been clear for months and remains my position today," Lieberman says.

That's crucial because, as I reported last night, a (admittedly very stiff) trigger is part of the bargain liberal and centrist health care agreed upon last night. We'll try to pin down whether the announcement, or details, of the deal make Lieberman any less likely to filibuster the health care bill.

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Health Care

Weiner On Medicare Buy-In: 'This Is One Idea I Like A Lot'

Rachel Slajda | December 9, 2009, 11:33AM

Rep. Anthony Weiner (D-NY)

Rep. Anthony Weiner (D-NY), one of Congress' fiercest supporters of the public option, has come out to support the Medicare buy-in proposal in the Senate Democrats' deal.

"This is one idea I like a lot," Weiner said in an email to the Daily News, calling the idea "remarkable."

Winning the support of Weiner, who has championed not only a public option but a universal single-payer system, could be a sign that the Dems' proposal may yet win over progressives, even without a public option.

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