Health Care

Senate Switchboards On Fire As Health Care Calls Flood Zone

Christina Bellantoni | November 20, 2009, 6:48PM

Women at a switchboard

We've heard all day about senate offices getting flooded with phone calls about the upcoming vote on the health care bill tomorrow.

As we reported earlier, Organizing for America is doing a call blast urging supporters to ask their senators to back the first procedural vote to start debate. Republicans also have been working the phones to ask senators to block the bill.

An aide to a Senate Democrat tells TPMDC their boss' phone rang so frequently today, the lines were busy for hours.

The calls "continued to fill our voicemail box over and over again," the aide said.

The overflow prompted another flood of calls to state offices. The majority of calls to this senator, who already supports the legislation, were in favor of the bill.

Ben Nelson

Tomorrow's Health Care Vote: A Cheat Sheet

Brian Beutler | November 20, 2009, 5:40PM

Senator Chris Dodd (D-CT), Senator Harry Reid (D-NV), Senator Max Baucus (D-MT)

With Ben Nelson now in the "yes" column, there are now two known Democratic hold outs on tomorrow's health care vote: Sen. Mary Landrieu (D-LA) and Sen. Blanche Lincoln (D-AR).

Landrieu told reporters today that she'll likely make an announcement tomorrow morning. Lincoln, on the other hand, has been unreachable, and it's unclear if, or when, she'll announce her intent publicly before the vote, which will come at 8 p.m. tomorrow night.

It's probably a safe guess that, if at the end of the day, there's something standing between Senate Majority Leader Harry Reid and 60 votes on the motion to debate to his bill, he won't hold the vote. As unlikely as that is, here are the potential hangups.

Read more »

Chuck Schumer

Is Chuck Schumer Taking Temperature On Carper's Public Option Compromise?

Brian Beutler | November 20, 2009, 5:15PM

Sen. Chuck Schumer (D-NY)

I'd missed this before, but check out what Sen. Mary Landrieu (D-LA) told reporters last night about conservative Democrats' push for something like a public option trigger mechanism.

"Senator Carper has been trying to help forge a compromise and I'm very proud of his efforts, and he's still at work, I understand, on that, so is Senator Schumer. They've been trying to negotiate this compromise among the various factions for a while and I think actually we're getting closer. We're not there yet. But we're a lot closer than we were two months ago, where it was just a logjam."

Schumer's name, in this context, is interesting. It's possible that she simply means Schumer is talking to all parties, trying to get everybody on the same public option page as he has been for months. But it certainly sounds like she's saying he's taking the caucus' temperature on this Carper compromise, which I outlined here.

Read more »

Health Care

With Reid's Support Wyden And Baucus To Cosponsor 'Free Choice' Amendment

Brian Beutler | November 20, 2009, 2:33PM

Sen. Ron Wyden (D-OR), Sen. Harry Reid (D-NV), Sen. Max Baucus (D-MT)

If this amendment passes, it could significantly change--and most experts would say improve--the Senate health care reform bill.

As part of an agreement hashed out at the end of the Finance Committee mark up process, Sen. Max Baucus (D-MT) and Sen. Ron Wyden (D-OR) will join forces to amend the Senate health care bill with Wyden's "Free Choice Act." If it can attract 60 votes, it would give low- and middle-class Americans with employer-provided insurance the option of purchasing subsidized insurance in the exchanges.

Baucus and Wyden have the support of Senate Majority Leader Harry Reid (D-NV).

"Senator Wyden has worked tirelessly to reform our health system, and I am pleased to have his support for the Patient Protection and Affordable Care Act," Senator Reid said. "I will support the inclusion of his proposal for workers whose employer coverage is unaffordable but are not able to access the exchange."

Sixty is a tough climb. It would have likely been impossible under the original terms of the Wyden amendment, which would have opened the exchanges up to everybody. This is a scaled down version of that, and it will be a hard amendment for Democrats to vote against.

Blanche Lincoln

OOPS! Durbin Walks Back Statement Suggesting Lincoln's Health Care Vote Is In The Bag

Brian Beutler | November 20, 2009, 12:28PM

Earlier today, Senate Majority Whip Dick Durbin (D-IL) told reporters that Sen. Blanche Lincoln (D-AR)--a vulnerable incumbent, and a key health care swing vote--had confided in Majority Leader Harry Reid that she'd made up her mind about tomorrow's test vote on health care reform.

That must've touched off some nerves, because he's now issued a statement walking back that contention.

"In a conversation with reporters earlier today, some of my remarks regarding Senator Lincoln were unclear and have been incorrectly interpreted," Durbin's statement reads. "Let me be clear: Senator Lincoln has had a number of conversations with Sen. Reid about the health care reform legislation. She has asked important questions and there has been a positive and healthy give and take. But Sen. Lincoln has not yet signaled her intention as to how she will vote on tomorrow's cloture motion."

Back on the fence, I guess? You can read the entire statement below the fold.

Read more »

Ben Nelson

Nelson: Let's Debate This Health Care Bill

Brian Beutler | November 20, 2009, 12:13PM

Sen. Ben Nelson (D-NE)

Sen. Ben Nelson (D-NE) just announced that he will vote yes tomorrow on a motion to proceed to debate on Senate health care legislation, though he says he will filibuster the bill if parts of it are not tailored to his liking during the amendment process.

"This weekend, I will vote for the motion to proceed to bring that debate onto the Senate floor," Nelson says. "The Senate should start trying to fix a health care system that costs too much and delivers too little for Nebraskans."

"In my first reading," Nelson said, "I support parts of the bill and oppose others I will work to fix. If that's not possible, I will oppose the second cloture motion--needing 60 votes--to end debate, and oppose the final bill.

Read more »

Blanche Lincoln

Reid Knows How Lincoln Will Vote On Early Health Care Test Vote

Brian Beutler | November 20, 2009, 11:30AM

Sen. Blanche Lincoln (D-AR)

What will Sen. Blanche Lincoln (D-AR) do tomorrow? Perhaps Harry Reid knows.

"She's told Senator Reid," Sen. Minority Whip Dick Durbin (D-IL) told reporters after a Friday press conference. "You will have to ask Senator Reid."

Reid has zero margin for error tomorrow, and it's difficult to imagine he would move forward if he knew Lincoln planned to vote "no." A very telling sign in.

Of all the health care reform fence-sitters in the Democratic party, Lincoln is the only one that faces re-election next year, and her prospects don't look particularly good. As a result, pinning down her intentions has been particularly difficult. But in a coup, Congress Daily caught up with Lincoln yesterday, and she hinted that she may be on board herself.

"Without a doubt [Reid] has always stressed ... that you gotta believe in a little bit of the process," Lincoln said. "That's what we're here for. I mean, certainly knowing that not all 100 of us are going to agree on anything, you gotta be able to depend a little bit on the process. It gives you an opportunity to make the case and move things forward."

Lincoln stressed, of course, that she has to finish reading the bill before making up her mind, but said she'd announce her intentions publicly before the vote.

Health Care

Though Still Undecided, Landrieu Looks Ahead To Health Care Debate

Brian Beutler | November 20, 2009, 9:53AM

Sen. Mary Landrieu (D-LA)

Sen. Mary Landrieu (D-LA) spoke to reporters last night about her intentions going forward on health care reform. I wasn't present, but a colleague passes along the audio. The short version is, Landrieu is still uncommitted on tomorrow's test vote on the motion to proceed, but she's looking forward to changing the bill (particularly the public option) on the floor, indicating she doesn't imagine the bill will falter at this stage.

"I have leverage now, I'm using it to the best of my ability, I'm going to use it on the Senate floor," Landrieu said. "I have people voting for me who are liberal Democrats, independents, conservative Democrats, and some moderate Republicans. I understand what my base is. My base is very broad."

And in that spirit, Landrieu says that even if her vote is there tomorrow, it won't necessarily be there down the line.

"The other thing that remains a concern to me is the shape of this public option," she says. "We have made a lot of progress taking it from a robust, government run [plan] to now something that is more mainstream, more narrow, more private sector oriented, I'd like to take it a step or two even further. So that will be debated on the floor. And if it's not done that way, maybe my vote's not there at the end."

Ben Nelson

Landrieu, Nelson Win Goodies As Reid Seeks Their Vote On Reform

Brian Beutler | November 20, 2009, 9:27AM

Sen. Mary Landrieu (D-LA), Sen. Ben Nelson (D-NE)

Sen. Mary Landrieu's state of Louisiana is still ailing years after Hurricane Katrina devastated its largest city. So Senate Majority Leader Harry Reid could be killing two birds with one stone by including in his health care bill $100 million in federal Medicaid aid for any states (aka, Louisiana) that have suffered a natural disaster in the last seven years. That's much needed help for the poor in Louisiana, and also a sweetener for Landrieu, whose support for health care reform has never been terribly certain.

That appears to be a more justifiable offer from Reid than a separate concession to Sen. Ben Nelson (D-NE), another health-care fence sitter. In a move that appears designed to win Nelson's initial procedural votes, Reid decided not to include a measure ending anti-trust exemptions for the insurance industry.

Reid originally fought hard to lift the exemption, even testifying before the Senate Judiciary Committee on the need to end insurance companies' monopolistic practices. But his decision may be paying political dividends, as Nelson inches toward supporting a key health care test vote on Saturday.

The only remaining question: What's in it for Arkansas?

AR-SEN

HCAN: Health Care Swing States Want An Up-Or-Down Vote On Reform

Brian Beutler | November 20, 2009, 9:13AM

Sen. Mary Landrieu (D-LA), Sen. Ben Nelson (D-NE)

Congressional procedure can be confusing even for politicos, but the reform campaign Health Care for America Now has boiled it down. The group has distributed polling data to its largest member organizations indicating that voters in key swing states believe health care shouldn't be stymied by procedural supermajority requirements in the Senate.

The polls were taken in Nebraska, Louisiana, and Arkansas, home of reform skeptics Ben Nelson, Mary Landrieu, and Blanche Lincoln, don't believe their senators should kill reform by voting with Republicans to block either a debate or a vote on the bill.

"In the Senate, before a bill can be voted on, there must be a vote to allow it to be debated," reads the first survey question. "Regardless of whether you support or oppose the health insurance reform plan itself, do you believe that it should be debated on the floor of the Senate?"

In all states, voters overwhelmingly said the Senate health care reform bill should be debated on the floor. Nebraska: 88-9, Louisiana: 82-9, Arkansas: 84-11.

Read more »

Health Care

Coburn Drops Demand For Health Care Bill To Be Read Aloud, In Exchange For Day-Long Debate Saturday

Brian Beutler | November 19, 2009, 6:02PM

Sen. Tom Coburn (R-OK)

The headline pretty much says everything you need to know. Senate Republicans, led by Sen. Tom Coburn (R-OK) had been threatening to require that the entire 2000-plus page health care bill be read aloud on the Senate floor once it overcomes its first major procedural hurdle. Now, I've confirmed that the Republicans have agreed to back off this plan in exchange for Democrats allowing a full-day's debate on Saturday, before the scheduled evening vote.

Also, and importantly, as part of a unanimous consent agreement, the Saturday vote will serve as the motion to proceed itself. If there are 60 votes on Saturday, the bill will be on the floor, and debate can begin.

Happy Saturday!

Abortion

Flip Flop? Republicans Attack Reid's Abortion Language Even Though Gang Of Six Endorsed It

Brian Beutler | November 19, 2009, 5:08PM

Sen. Olympia J. Snowe (R-ME)

Earlier today, I had an interesting exchange with Sen. Olympia Snowe (R-ME) about the abortion language in the Senate health care bill. She seemed to think Harry Reid made the right call--that the provision is similar in many ways to the provision passed by the Senate Finance Committee, which she supported. Interestingly, though, she also said the notorious Group of Six health care negotiators--including staunch conservatives Chuck Grassley and Mike Enzi--also thought that language was acceptable.

"We discussed that for an extensive period of time within the Group of Six and what approach to take that would work, and be consistent, with codifying current law, and we thought that the approach that was embraced in the Senate Finance Committee did that."

Now, of course, Republicans are all up in arms. I asked Snowe whether Grassley and Enzi believed at the time that Reid's approach--segregating federal and private funds to prevent tax payer dollars from financing abortion--was sufficient.

Read more »

Health Care

Snowe, Carper In Discussions About Trigger-Like Amendment

Brian Beutler | November 19, 2009, 4:48PM

Sen. Olympia Snowe (R-ME)

This afternoon, I asked Sen. Olympia Snowe (R-ME) whether she'd been looped in on an idea, floated recently by Sen. Tom Carper (D-DE), to tweak her proposal to affix a public option to a trigger mechanism. Indeed she and Carper have discussed his plan, but she remains pessimistic that it'll ever be adopted.

"Tom and I have been working on it, we've had discussions and so on, but, you know, we haven't got down in concrete terms, and he'd like to have my affordability language and so on," Snowe said. "But nevertheless it's still going to require 60 votes so I don't know when that would happen, and frankly I would have preferred that to happen at the outset of this process, rather than going through this convoluted procedural gymnastics."

Read more »

Filibuster

UPDATE: Reid Files Cloture, First Floor Vote On Senate Health Care Bill Saturday, 8 PM

Brian Beutler | November 19, 2009, 4:23PM

Sen. McConnell (R-KY) Sen. Reid (D-NV)

UPDATE: Senate Majority Leader Harry Reid just filed for cloture on the motion to proceed to debate on his health care bill. That pretty much seals it. Unless conservative Democrats take a very public stand by voting "no," the bill unveiled yesterday will be the bill the Senate hashes out on the floor.

The Senate will be in session this Saturday evening, ahead of a scheduled 8 pm cloture vote on the motion to proceed to debate historic health care legislation, TPMDC has learned. Assuming Majority Leader Harry Reid has the 60 votes he needs to leap that hurdle, Democrats will likely have to eat up 30 hours before they can hold the actual vote--at a 51-vote threshold--on the motion to proceed itself. Still with me?

Doing some math, that means the bill won't be cleared for debate and amendments and so forth until, at the earliest, 2 am Monday morning. Even if that happens, the bill will likely have to be read aloud (another two day process) so we're still looking at debate in earnest after Thanksgiving recess.

And since nothing says Saturday night like Senate cloture votes on procedural motions, we'll bring you all the action live.

Abortion

Nebraska Republican: A Vote To Proceed Is A Vote For Abortion

Brian Beutler | November 19, 2009, 2:42PM

Sen. Ben Nelson (D-NE) better have a chat with his friends on the other side of the aisle.

At a press event this afternoon, Republicans lambasted the Senate health care bill for not adopting the language in the House's Stupak amendment, and reiterated their point that a vote to proceed to debate may as well be a vote for abortion.

"This first vote is the key vote," Nelson's Nebraska colleague, Sen. Mike Johanns, told reporters today.

That statehood camaraderie isn't likely to be lost on Nelson, who will soon have to decide whether to vote to allow the bill to proceed to debate. Nelson has gone to great lengths to distinguish this early procedural votes for more consequential votes down the line. But he says he still hasn't decided what his next move is, and isn't too pleased with the abortion provision in the Senate health care package.

Abortion

Senate Abortion Provision Wins Support Of Key Pro-Choice Democrats

Brian Beutler | November 19, 2009, 1:54PM

Rep. Diana DeGette (D-CO)

We now have much more clarity on how the abortion provision in the Senate health care bill will work, and it's won the support of both senior administration officials, pro-choice Senators, and the co-chair of the House pro-choice caucus.

"I am pleased that the U.S. Senate has maintained current law when addressing the abortion issue," says Rep. Diana DeGette (D-CO) in a statement to reporters. "By adopting a common-sense abortion provision, the U.S. Senate ensures that no federal funds will be spent on abortion coverage while not further restricting a woman's right to choose. The health care bill is about providing access to quality health care to over 36 million Americans. I encourage the U.S. Senate to work towards producing a bill that works for everyone."

DeGette included a breakdown of the Senate's abortion provision, which I've included below the fold. One of the key sections reads, "Issuers of health insurance plans that offer coverage for abortion beyond those permitted by the Hyde amendment must segregate from any premium and cost-sharing credits an amount of each enrollee's private premium dollars that is determined by the Secretary to be sufficient to cover the provision of those services."

Which is a fancy way of saying insurers will have to set up an accounting system to keep private money separate from federal money, and only draw upon the private money when paying providers for abortion. Compare that to the Stupak amendment to the House bill, which both requires separation of funds, but also prevents women who receive federal premium assistance from purchasing policies that cover abortion, and it's no wonder Harry Reid's compromise is being met with praise by pro-choice members.

Read more »

Filibuster

Reid On Passing Health Care: 'I'm Not Using Reconciliation'

Brian Beutler | November 19, 2009, 1:30PM

Senate Majority Leader Harry Reid (D-NV)

Yesterday, I asked Sen. Ben Nelson (D-NE) what he and other moderates had heard from Senate Majority Leader Harry Reid at an impromptu afternoon meeting about health care reform. Nelson said Reid "talked about process, procedure, discussion about reconciliation and a whole host of issues of that sort."

Reconciliation is a complicated legislative process that would allow Reid to pass some version of reform without having to contend with a filibuster. "Nobody's really jumping up and down to push for reconciliation," Nelson added, "he's not threatening that, but anybody can conclude that if you don't move something on to the floor, that is one of the possibilities."

Today, at an event celebrating the unveiling of his health care bill, I asked Reid what specifically he'd said to Nelson--along with Sens. Blanche Lincoln (D-AR) and Mary Landrieu (D-LA)--about reconciliation. His answer left no wiggle room: "I'm not using reconciliation," he said.

Ben Nelson

Will Concessions, And A Trim CBO Score, Appease Conservative Democrats On Health Care?

Brian Beutler | November 19, 2009, 11:37AM

Sen. Mary Landrieu (D-LA), Sen. Ben Nelson (D-NE)

Conservative Democrats couldn't have asked for better top-line numbers from the CBO on Senate health care legislation. Low total cost, big long-term deficit reductions, millions insured, and a public option that insures perhaps one percent of the population. But is that enough to actually cool their heartburn?

Well, yes and no.

"Listen, anytime you add more to deficit reduction, you have to say that it's a move in the right direction," Sen. Ben Nelson (D-NE) told reporters yesterday. "So there's no doubt...that clearly would be one [area of improvement]--but again you have to have a lot of faith and trust in the scoring system."

Nelson cautioned that the CBO numbers released yesterday are preliminary, and subject to some uncertainty, but basically applauded the bill for being fiscally responsible.

But is that what's really driving the moderates' skepticism?

Read more »

Health Care

Can States Opt Out Of The Public Option Immediately?

Brian Beutler | November 19, 2009, 9:22AM

Sen. Harry Reid (D-NV)

When Senate Majority Leader Harry Reid first announced that he'd chosen to include a public option with an opt-out provision in his health care bill, he suggested that states would be required to offer the government insurance plan for a year before opting out. Well, it appears as if he's dropped that requirement.

In general, the bill reads, "A State may elect to prohibit Exchanges in such State from offering a community health insurance option if such State enacts a law to provide for such prohibition." Separately, if a state opts out, they can also opt back in, if they repeal the law they used to opt out. But one of the key selling points of the opt out provision to liberals is that states wouldn't be able to opt out until after the public option became somewhat entrenched. We're looking for more guidance on this, but it seems as if that entrenchment period is gone.

Health Care

No Public Option Or Mandates Until 2014 Under Senate Bill, But There Are Some Early Goodies

Brian Beutler | November 19, 2009, 9:07AM

Rep. Nancy Pelosi (D-CA) with Sen. Harry Reid (D-NV)

For liberals, one of the most frustrating aspects of health care reform is that the most tangible goodies (the exchanges, and, within the exchanges, the public option) won't be available to the public for years. In the House bill, the main structural changes to the health care system--including the exchanges/public option, mandates, taxes, and the Medicaid expansion--go into effect in 2013. Under the Senate bill, they take until 2014.

But there are some aspects of the bill that would take effect right away if the bill became law as is. For instance, the Senate bill would immediately ban insurance companies from imposing annual and lifetime caps on benefits, and would make it illegal for them to cancel people's policies (a practice called rescission) except in cases of fraud.

There's more, too, and we'll bring you a fuller set of details later today.

CBO

CBO Says Higher Premiums Under Senate Public Option, 'Opt-Out' Clause Would Impact One-Third Of Consumers

Brian Beutler | November 19, 2009, 12:37AM

Sen. Harry Reid (D-NV)

The CBO has posted its first analysis of the Senate's health care bill, which you can access
here.

As advertised, the bill reduces the deficit considerably in both the near- and long-term, while expanding coverage to 94 percent of Americans. By 2019, 25 million people would be buying insurance through a health insurance exchange.

However, it's not all roses. For instance, based on an assessment of the political popularity of the public option, the CBO has concluded that enough states will "opt out" to prevent a full third of consumers from purchasing government insurance.

Read more »

Health Care

Reid Outlines Bill For Caucus, Warns Conservative Dems That Reconciliation Is Still An Option

Brian Beutler | November 18, 2009, 6:45PM

Sen. Harry Reid (D-NV) and Sen. Charles Schumer (D-NY)

At a special evening meeting of the Democratic caucus tonight, Senate Majority Leader Harry Reid outlined, in broad strokes, the details of his health care bill, which the CBO has found, in a preliminary analysis, will expand coverage to 94 percent of Americans while reducing the deficit. And earlier in the day, during a separate meeting about floor procedure, Reid let three of his party's key skeptics know that if they join Republicans at any stage of the process to block the bill, he still retains the option of passing major parts of it through the filibuster proof budget reconciliation process.

In response to a question from TPMDC Nelson told reporters that, at a meeting this afternoon with Sens. Mary Landrieu (D-LA) and Blanche Lincoln (D-AR), Reid "talked about process, procedure, discussion about reconciliation and a whole host of issues of that sort."

"Nobody's really jumping up and down to push for reconciliation," Nelson said, "he's not threatening that, but anybody can conclude that if you don't move something on to the floor, that is one of the possibilities."

Nelson said he has still not committed to vote for even the first procedural vote, but in a sign that he's leaning toward bringing a bill to the floor, he emphasized his view that the floor debate is a chance to improve the legislation. "I wanted to make it clear that that is, unlike some are suggesting, is not the vote...it's a motion to enter into the debate and possible amendments and improvements of the legislation" Nelson said. "The vote is the second cloture vote, and that is the cloture on a motion to cease debate, and I wanted that clear, because I've already begun to see people out there say, 'oh no, no, if you vote [to take it up] you've voted for health care."

Senate Minority Leader Mitch McConnell (R-KY) has explicitly stated that the Republican party will treat Democrats who vote for any procedural motion as if they've voted for the entire health care bill.

Read more »

CBO

CBO: Senate Bill Costs $849 Billion, Major Deficit Reducer

Brian Beutler | November 18, 2009, 4:52PM

Sen. Majority Leader Harry Reid (D-NV)

Democratic leadership has distributed figures to reporters from a CBO analysis of Senate health care legislation. The numbers affirm what we reported this morning--that Majority Leader Harry Reid is very pleased.

The health care bill--which includes an opt-out public option--will require $849 billion over 10 years in new spending, to be paid for with cuts to Medicare, while reducing the deficit by $127 billion.

In that time it will extend coverage to 31 million Americans--94 percent of citizens will be covered by 2019.

Over the second 10 years, CBO projects even greater cost savings--up to $650 billion, with the caveat that after 10 years, their analyses become highly uncertain.

This meets all of President Obama's goals, and, as has been the pattern during this legislative process, the Senate bill comes at a lower cost, and with greater cost-savings than the House bill, while the House bill covers more Americans.

CBO

Reid To Unveil Health Care Bill To Caucus At Evening Meeting

Brian Beutler | November 18, 2009, 9:36AM

Senator Chris Dodd (D-CT), Senator Harry Reid (D-NV), Senator Max Baucus (D-MT)

Senate Majority Leader Harry Reid will unveil and discuss his health care bill to Democrats at a special 5 pm caucus meeting tonight, leadership sources say. Reid hopes to brief the caucus before the bill is publicly unveiled, and that could happen late tonight. A CBO analysis of that legislation is expected to be unveiled publicly somewhat earlier in the day, and despite some last minute road bumps, Reid is very pleased with the report.

Reid may give the public 72 hours to review the bill before holding a cloture vote on a motion to proceed this weekend, though he may call for that vote slightly earlier.

Republicans, led by Sen. Tom Coburn (R-OK) are expected to call for the entire bill to be read aloud before debate can begin in earnest after the Senate returns from a week-long Thanksgiving recess at the end of the month.

Health Care

Carper: Conservative Democrats Not Likely To Support Senate Public Option

Brian Beutler | November 17, 2009, 5:22PM

Sen. Thomas Carper (D-DE)

Sen. Tom Carper (D-DE) cast serious doubt tonight on whether conservative Democrats will ultimately vote for cloture on the Senate health care bill if it retains a public option with an opt-out clause, and gave new details on yet another compromise that he says might work for them.

Carper, who voted for a public option amendment during the Senate Finance Committee proceedings, first floated his idea last week as a potential alternative, in the event that Reid's public option proposal failed to muster enough Democratic support to overcome a filibuster. Now he says he doubts the support is there.

"We're concerned that a number of centrists aren't prepared to vote for a national public plan, even with an opt-out," Carper said in response to a question from TPMDC. "We're trying to find something that addresses their concern about government run, government-funded, but still addresses the need for the affordability needs and the need for more competition in states that don't have it."

"What we're asking centrists is, What concerns do you need to have addressed so that you can vote for cloture, either to bring the bill to the floor, or to take the bill off the floor and to go to conference? And the two concerns we keep hearing over and over again: government-run, government funded."

(The opt-out plan Reid has proposed would not be government funded, though it's not clear whether it would be run directly by the government, or outsourced to a non-governmental body accountable to Congress.)

Read more »

Health Care

Influential Economists Say Tax On Cadillac Health Care Plans Must Remain In Health Care Bill

Brian Beutler | November 17, 2009, 4:41PM

Sen. Harry Reid (D-NV)

A number of high-profile economists are asking Senate Majority Leader Harry Reid not to change a number of key aspects of his health care legislation, including a controversial tax on insurance companies that sell luxurious insurance policies.

"Four elements of the legislation are critical: 1) deficit neutrality, 2) excise tax on high cost insurance plans, 3) independent Medicare commission, and 4) delivery system reforms," they write in a letter delivered to Reid today.

Here's what they say about the excise tax, specifically: "Like any tax, the excise tax will raise federal revenues, but it has additional advantages that are essential."

The excise tax will help curtail the growth of private health insurance premiums by creating incentives to limit the costs of plans to a tax-free amount. In addition, as employers and health plans redesign their benefits to reduce health care premiums, cash wages will increase. Analysis of the Senate Finance Committee's proposal suggests that the excise tax on high-cost insurance plans would increase workers' take-home pay by more than $300 billion over the next decade. This provision offers the most promising approach to reducing private-sector health care costs while also giving a much needed raise to the tens of millions of Americans who receive insurance through their employers.

Read more »

Ben Nelson

Reid: No Health Care Bill Today, First Vote May Come This Weekend

Brian Beutler | November 17, 2009, 2:58PM

Senate Majority Leader Harry Reid did not present his caucus with a CBO analysis of his health care bill at a weekly lunch meeting this afternoon. And though that report may still come in later this afternoon, according to his spokesman, Jim Manley, Reid is unlikely to unveil his bill until tomorrow at the earliest.

"He didn't go into any of the numbers...nothing yet. He said he would have that information for us soon, soon meaning not giving us a particular time to come here and announce it. He'll announce it." said Sen. Ben Nelson (D-NE) as he emerged from the meeting.

Once the numbers are in and the bill has distributed to Democrats, Reid will likely old one or two more meetings with the caucus, to answer any questions, and allay any concerns, before holding the first procedural vote--on the motion to proceed to debate--later this week, or possibly this weekend. "We're going to hold it as soon as we can," Reid told reporters today.

Read more »

Health Care

Progressives To Moderates: Do You Really Want To Kill Health Care Reform?

Brian Beutler | November 17, 2009, 12:46PM

Senator Jay Rockefeller (D-WV)

The urgency of last night's meeting between Senate progressives and Majority Leader Harry Reid surrounded the fact that, though the overwhelming majority of Democrats want a public option, and several think they've already compromised enough on that score, the votes still aren't there. So, with key votes just around the corner, how can those moderate hold-outs be swayed, and what happens if they can't be? One possibility is simply leaving the ball in the moderates' court.

"There's potentially a dynamic that works in all of this that as you get closer and closer to the vote, you say--you really do say--we're going to make or we're not going to make history, and it takes on another dimension, psychologically," Sen. Jay Rockefeller (D-WV) told reporters. "I mean I've been through that myself. I've gone downstairs thinking maybe I'm not going to vote for that, and then suddenly I see its dimension, think of it in large terms, and then vote for it."

Rockefeller downplayed the possibility that, at the end of the process, there won't be 60 votes to end a filibuster.

"We're not taking that tack, what if we can't--we're talking about how we can," Rockefeller told TPMDC. He said using the budget reconciliation process as a procedural tool to circumvent a filibuster would be ugly, and, for that reason, the focus has to be on making sure Democrats (and perhaps Olympia Snowe) stick together to against a filibuster.

Read more »

Health Care

Progressives Push Reid On The Public Option

Brian Beutler | November 17, 2009, 9:02AM

Sen. Sherrod Brown (D-OH)

Last night, a number of Senate progressives, led by Sherrod Brown (D-OH), met with Majority Leader Harry Reid to make sure his eyes are still trained on the importance of a public option, and to game out a strategy for getting 60 votes to pass a health care bill with a public option on the floor.

According to sources, the meeting was meant to serve as a reminder to that progressives still feel very strongly about the importance of including a public option in the Senate's health care bill and that they've compromised enough.

Today, Reid expects to receive an analysis of his bill from CBO, which he'll circulate among members of his caucus. It should show that the cost of the bill is below $900 billion, and that it reduces the deficit in both the near and long term.

CBO

CBO Senate Health Care Score Now Expected Early Next Week

Brian Beutler | November 13, 2009, 11:06AM

Senate Majority Leader Harry Reid (D-NV)

Sigh. Washington waited through a slow holiday week with bated breath for a CBO analysis of Senate health care legislation, which had been expected today. But now sources say the report won't likely be ready until early next week.

The development calls into doubt the likelihood that the bill itself will be introduced on the Senate floor next week. Democratic leaders have vowed to post the bill online for 72 hours before moving the bill toward the floor, and in those 72 hours, they will have to corral all Democratic caucus members into agreeing to proceed to debate.

This week, Senate Majority Whip Dick Durbin (D-IL) suggested Democrats would be lucky to get the bill on to the floor before Thanksgiving recess. Looks like they'll be pushing up against that deadline.

Chuck Grassley

Judiciary Committee Ranking Member Ventures Into Tentherism

Brian Beutler | November 13, 2009, 9:02AM

Sen. Jeff Sessions (R-TX)

Sen. Jeff Sessions (R-AL)--the highest ranking Republican on the Judiciary Committee--is unclear about the Constitutionality of current health care legislation, and he's turning for clarity to the Federalist Society.

"I think that's a good question," Sessions said on a panel at the Federalist Society's National Lawyers' Convention. "Matter of fact I met with my staff...we were talking about, and you know what I said Leonard? I said we ought to ask Federalist society folks what they think too. I said let's begin to think about that question and what's the constitutional thing...can the government require to do what we think is in your best interest if you don't think it's in your best interest?"

Sen. Chuck Grassley (R-IA), who also sits on the Judiciary Committee, once said there was a bipartisan consensus in favor of individual mandates. But he too seems to have joined the tenther fringe.

You can see the video here. The exchange occurs about 27 minutes in.

CBO

Tomorrow Could Be A Really Big Day For Health Care--Here's Why

Brian Beutler | November 12, 2009, 6:13PM

Senator Chris Dodd (D-CT), Senator Harry Reid (D-NV), Senator Max Baucus (D-MT)

Senate Majority Leader Harry Reid has been trading options and numbers with the CBO for weeks now, and they're reportedly nearly done. A final analysis on a complete package could be available as early as tomorrow. If that happens, it will be yet another big day for Senate Democrats as they struggle to reach consensus over landmark health care reform legislation.

Once it's unveiled, and the bill meets daylight, it will be crunch time for conservative Democrats--most notably Ben Nelson, Mary Landrieu, and Blanche Lincoln--who have been withholding their commitment to supply the bill much-needed procedural votes until they've had a chance to see it and hear from CBO.

Read more »

Bart Stupak

Clyburn: Stupak Amendment Won 10 Votes

Brian Beutler | November 11, 2009, 10:15AM

Rep. James E. Clyburn (D-SC)

On Monday, I noted that 40 Democrats had voted for the Stupak amendment--which would prohibit low- and middle-class women from buying health insurance policies that cover abortion--and then voted for final passage of the health care bill. That's a large number, but a key question remained unanswered: How many of those 40 would have voted against the final bill if the Stupak amendment had failed, or not been given a vote?

Well, House Whip James Clyburn (D-SC) has some answers.

Read more »

Bill Clinton

Clinton To Senate Democrats: Whatever You Do, Don't Lose

Brian Beutler | November 10, 2009, 2:40PM

Fmr. President Bill Clinton

After an hour-long lunch with the Senate Democratic caucus, former President Bill Clinton found himself surrounded by dozens of reporters, and summarized his message as one of the urgency of action. "The worst thing to do is nothing," Clinton said of the party's health care reform push. "We can do so much better."

As they emerged from the lunch one by one, a number of senators echoed this rendering.

"His message was very simply it is so important that this be done, that there are so many people, I think 30 percent of the population he said at one point or another, don't have any health care coverage," Sen. Dianne Feinstein (D-CA) told TPMDC, "and so the ability to fix the problem is really upon us."

"He made clear that this is a once in a lifetime opportunity," she added, noting that Clinton did not directly address the politically divisive policy aspects of reform--abortion, the public option--in his presentation.

To members who are facing tough re-election races next year (such as fellow Arkansas native Blanche Lincoln) Clinton's message was equally simple: "You're going to do it, and then people are going to begin to see that none of the bad things that people are talking about will come to pass, essentially," Feinstein said.

Read more »