Monday, October 26, 2009

Reid: Health Care Bill Includes Public Option with an 'Opt Out' Provision

Reid says he’s moving forward with a Senate bill that has a public option with an opt-out in it "with the support of the White House, and Senators Dodd and Baucus." He says that the Senate bill will also have co-ops included - which confuses me a bit. My hope is that he is not considering the co-ops a public option. And of course, just who will be allowed to participate in the Public Option is still fuzzy. So while we don't know just what the Public Option will look like, the best news is that we don't have the "trigger" deeply disappointing Olympia Snowe.

From the Los Angeles Times:
Fueling the push for a new government insurance plan, Senate Majority Leader Harry Reid (D-Nev.) said today that his chamber's healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out.

"The public option is not a silver bullet, [but] I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said. "Under this concept, states will be able to decide what works for them."

Reid sent the proposal to the nonpartisan Congressional Budget Office to be analyzed today, a key step before he can bring a bill to the floor for debate.

His decision does not settle the debate roiling Democratic ranks over how to create a government plan that would give consumers who don't get coverage through their employers an alternative to plans offered by commercial insurers.

The "opt-out" compromise is still two votes shy of the 60 Reid needs to overcome a Republican filibuster, according to a senior Democratic aide on Capitol Hill who requested anonymity when discussing the plan.
Reid and House Speaker Nancy Pelosi (D- San Francisco) are advancing separate healthcare bills in the Senate and House, which would have to be reconciled later this year before they are sent to the White House for President Obama's signature.

But Pelosi indicated Friday that the opt-out alternative could be included in a reconciled bill.

For now, House Democrats are poised to pass a bill that would create a nationwide government plan, although there is still disagreement about how much such a plan should pay doctors, hospitals and other medical providers.

Liberals, including Pelosi, favor a proposal that would link those payments to the existing Medicare program, which often pays providers less than commercial insurers. Proponents believe such an arrangement would save money and help drive down costs.

But many conservative Democrats, particularly from rural areas where Medicare typically pays less, want the government plan to negotiate its rates with providers, as commercial insurers do.

Pelosi hopes to settle those differences in time to unveil a bill later this week, according to her office.

Baucus: I Support Harry Reid And A Public Option
For more than a year, we've been working to meet the goals of reducing the growth of health care costs, improving quality and efficiency and expanding coverage. There are a tremendous number of complicated issues that go into reform and the public option is certainly one of them. I included a public option in the health reform blueprint I released nearly one year ago, and continue to support any provision, including a public option, that will ensure choice and competition and get the 60 votes needed to pass the Senate. Success should be our threshold and I am going to fight hard for the 60 votes we need to meet that goal this year.

Dodd: I Fought For A Public Option
Sen. Chris Dodd (D-CT)--who lead the HELP committee's health care process, and supported the public plan behind the scenes--is a very big reason this compromise came to life. He wants you to know that: "I fought for a strong public option - in the HELP Committee and in this merger process - because it is the best way to keep costs low and insurance companies honest," said Dodd.
And a bit of applause for our phone calls, emails and faxes....

Durbin: Progressives Forced Our Hand On The Public Option
Democratic leaders were forced to include a national public health insurance option as part of health care reform by progressive Democratic senators who refused to support anything less, Senate Majority Whip Dick Durbin (D-Ill.) said on Monday.

Durbin's assessment was made to a handful of reporters following the announcement by Senate Majority Leader Harry Reid (D-Nev.) that after weeks of talks with his colleagues he had determined that including a public option that states could opt out of was the best way to go.

My favorite paragraph:

For many years, it's been centrist and conservative-leaning senators who have been scoring legislative victories by digging in their heels, so this represented a quite dramatic turnabout. It is difficult to remember the last time that progressives won a legislative victory by laying down firm demands and sticking to them. In the House, the Congressional Progressive Caucus has found its feet, too, and is locked in a final battle with conservative Democrats over the shape of a public option.
 Progressives in the House and the Senate could dig in their heels because Democratic activists took to the phones.  Sent in the emails and burned up the faxes.  We had their backs, providing the support so they could stand firm.  And we did it week in and week out over some long months.
Sen. Roland Burris (D-Ill.) had insisted he would oppose any bill without a public option and rejected the trigger as a compromise. Sen. Bernie Sanders, a Vermont independent and self-described democratic socialist who caucuses with Democrats, had come close to making such a threat but said he was "playing it day to day." Sen. Russ Feingold (D-Wisc.) said over the weekend that the lack of a public option was a "good reason" to vote against it.

Durbin said that he is confident the progressive wing in the Senate is satisfied with the opt-out compromise.
Senator Sherrod Brown, another progressive in the Senate who had been pushing a "robust" public option says he is not worried about the opt-out:
While the bill would allow a state to opt-out of offering the public option to its residents, I am confident that the states will choose to put middle class families ahead of the insurance industry.

A public option in the Senate health reform bill is an important victory for taxpayers, middle class families, and American businesses. For too long, insurance companies haven't played it straight with the American public. They've limited or denied medical care based on gender, location, and pre-existing health conditions, they've placed arbitrary caps on how much care you can receive, and they've fattened up their premiums with bloated administrative costs and record CEO salaries. Some of these insurers even reduce benefits for women if they've been victims of domestic violence. And they've been able to get away with it because of a lack of competition. A public option will inject much-needed competition into the insurance industry, keep HMOs honest, and ensure that families across the country have a choice between affordable, quality health plans.

A little more good news - Democrats are going to push for some of the health benefits to start by 2010
Democrats are pushing Senate leaders and the White House to speed up key benefits in the health reform bill to 2010, eager to give the party something to show taxpayers for their $900 billion investment in an election year.

The most significant changes to the health care system wouldn’t kick in until 2013 — two election cycles away. With Republicans expected to make next year a referendum on health care reform, Democrats are quietly lobbying to push up the effective dates on popular programs, so they'll have something to run on in the congressional midterm elections.

Democrats are anxious to mix the good with the bad since some of the pain would be phased in early, including more than $100 billion in industry fees that critics say could be passed on to consumers.
Under the Democratic wish list, senior citizens would receive discounts on brand-name drugs next year. Small businesses that provide insurance would see tax credits. And a $5 billion high-risk pool would cover people with preexisting conditions.

Democratic strategists expect the 2010 election to present a stark contrast between the parties, particularly if the health care bill receives minimal Republicans support. The front-load strategy could help blunt GOP attacks on the bill as a toxic mix of higher taxes, rising premiums and cuts to Medicare.

I still believe that Single Payer would still be the best plan and while we are not going to get it this go around it is still worth the effort to push for the single-payer options we do still have on the table for setting benchmarks and so that the public option we get is the best we can make it in the current climate. Keeping the Kucinich Amendment in the final bill is especially important to helping the states make the changes they may need down the road.

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