Pelosi (D-Calif.) rejected the idea of a "trigger" for a public option. That means that the government-run healthcare plan would be a fallback option, enacted only if other reforms didn’t make healthcare more accessible.
Sen. Olympia Snowe (R-Maine), who is being courted by the Obama administration as their best hope for getting a Republican to sign on to President Barack Obama's healthcare initiative, supports a trigger. But Pelosi does not.
"I don't even want to talk about a trigger," Pelosi said at her weekly press conference. She said the "attitude" of her fellow Democrats is that "a trigger is an excuse for not doing anything." Read it all at TheHill.com
More on the history of how triggers have been tried in the past - the public is always the ones being shot.
The idea of a legislative trigger to get Congress to do later something that it doesn't want to do now is not new. Such triggers have an excellent track record of demonstrating resolve where none exists. But as a policy mechanism, they have nearly always failed. Read it all at Slate Magazine
File under "Been there. Done That"
Somehow, lots of political observers have forgotten that [...] triggers are the template that the health care industry has long been using to destroy any kind of reform. And if there's any subset of Democratic congressional lawmakers who should know that, it is the progressives. The obvious lesson is that despite the rhetoric surrounding them, triggers have been proven to serve one purpose and one purpose only - to protect the interests of the health care status quo. That's not a fact - that's historical truth proven every time an American walks into a drugstore and is forced to pay the highest prices for medicines in the world.
What's amazing is that, knowing this history, anyone could think triggers are even good politics. Re-importation bills have been passed a few times now, each time with poison-pill trigger provisions. Each time, politicians publicly pretend this is some great victory and expect consumers to buy the charade. And then each time consumers walk into a drugstore and get gouged on medicine, thanks in part to the legislative poison pill, consumers find out they've been duped by those same politicians.
It's no stretch to think that this is exactly what will happen if overall health care reform is destroyed by triggers - only on a much bigger scale. If Congress passes a health care bill and trumpets a public option that is undermined by triggers, consumers are very quickly going to find out what really happened. When there is no public option because those triggers were (as they will inevitably be) written to make a public option impossible (just like they were written to make re-importation impossible), consumers will realize they've been treated like gullible fools, and not just on one part of health care reform (prescription drugs), but on all of it.
At that point, my bet is you'll see a kind of anger that makes today's Glenn Beck-inspired tea parties seem mild.
There is, certainly, one sliver of hope in all this, and it rests with leaders of the Progressive Caucus. Many of them were in Congress and invested a lot of time and energy in pushing the re-importation bill (and rightly so). Thus, many of them know firsthand that the trigger mechanism is designed only to destroy health care legislation, and not to accomplish some higher goal. So maybe, just maybe, they will take that firsthand knowledge and use it to strengthen their own resolve to stand against triggers and vote against any bill without a robust public option. Read it all here in the Denver Post.
Let me add a sort of larger point: aside from the essentially circular political arguments — centrist Democrats insisting that the public option must be dropped to get the votes of centrist Democrats — the argument against the public option boils down to the fact that it’s bad because it is, horrors, a government program. And sooner or later Democrats have to take a stand against Reaganism — against the presumption that if the government does it, it’s bad. Read it all
If the idea is to have a public option waiting in the wings in case private insurers blow it, why wait for it at all? If it gets lower costs and wider coverage, it should be included right from the start.
What worries me isn't just that the mainstream media are calling Snowe's trigger "centrist," but that the White House might see it as an easy out. "I continue to believe that a public option within that basket of insurance choices would help improve quality and bring down costs," the President said Monday. Fine. But he hasn't yet said the public option is essential. He hasn't threatened to veto a bill lacking it. There's even reason to believe the White House has quietly encouraged Olympia Snowe to pursue her "trigger."
The best way to give Blue Dogs cover is for the President to explain clearly and boldly why the public option is essential to health care reform, and why he's ready to veto any bill that doesn't include it. That's also the only way to give the nation a good chance of getting true health care reform. Hopefully, that's what he'll do Wednesday evening. Read it all at Robert Reich's Blo
Is it possible to create a useful trigger? Technically, yes. It would need to be a two year automatic trigger for a Medicare buy in public option if premiums grow faster than Medicare in any area for any one year.
What is so dangerous is that it is incredibly easy to make the trigger worthless or even harmful. Changing a few words in the legislation could strip the trigger of all its power. Understanding the difference between a good trigger and a terrible trigger is not easy. Don't expect the mainstream media ever acknowledge or even notice the difference.
The trigger would become the target of a quiet multi-million dollar all out lobbying assault and could be ruined at the last minute behind closed door with almost zero media coverage. Explaining how the smallest last minute change to the trigger had ruined the whole health care bill would be nearly impossible for progressives.
The trigger is so dangerous because it is so malleable. Progressive would need to guard it like a hawk and there would still be no guarantee that they would not be stabbed in the back at the last minute without media fanfare. If the Congressional progressives embrace a well designed trigger they are setting themselves up for a swift, subtle, and complete betrayal. The trigger could quickly go from a real tool to control cost to a fig leaf, or even a leaf poison ivy. Read it all at The Walker Report
WASHINGTON (CNN) -- The White House is quietly talking about drafting formal health care legislation after allowing Congress to work on its own for months, CNN has learned.
Multiple sources close to the process told CNN on Friday that while the plan is uncertain, the administration is preparing for the possibility of delivering its own legislation to Capitol Hill sometime after President Obama's speech to a joint session of Congress on Wednesday.
One source called the possibility of new legislation a contingency approach if efforts by Finance Committee Chairman Max Baucus, D-Montana, to craft a deal fall through.
The White House emphasized Friday that no formal bill has been written.
"The president has been reviewing all of the various legislative proposals, but no decision has been made about whether formal legislation will be presented," said Dan Pfeiffer, deputy communications director.
A source close to the White House said the administration is leaning toward dropping the public option, and continues to zero in on persuading Republican Sen. Olympia Snowe to come on board. Snowe has long pushed for a trigger option.
The source said the bill that would be presented to Snowe would leave out a public option but include a trigger provision that could lead to the introduction of a new government-run insurance plan under certain circumstances. The legislation would cover most, though not all, of the 46 million uninsured Americans. It would also include popular insurance reforms, such as ending the insurance industry practice of using pre-existing conditions to deny coverage.
This Democratic source also said that if the deal comes together, the key will be to successfully address the pushback from disaffected liberal legislators and congressional leaders.
President Obama took an initial step in that direction Friday afternoon, holding a conference call with some of the most liberal members of the House, who say they won't vote for a bill without a government-run insurance option.
Two congresswomen on the call said the president questioned them about how entrenched they are, even asking them to define what they mean when they call for a "robust" public option. Read it all at CNN.com
'Gang of 6' Urged to Act Now On Health - Negotiators Pressed To Offer Proposal Before Obama Does
The chairman of the Senate Finance Committee [Max Baucus] pressured his team of health-care negotiators on Friday to agree to a bipartisan overhaul plan before President Obama addresses Congress next week, warning that otherwise he will put forward his own proposal. Up to a dozen Senate Democrats are thought to oppose to some degree the federal insurance proposal -- the "public option" -- and it remains unclear how many would embrace a fallback measure that the White House is contemplating. Every Democrat who backs away means another Republican vote the White House would need to win.
The mood of the Senate is making liberal Democrats, particularly those in the House, uneasy. House Speaker Nancy Pelosi (D-Calif.) issued on Thursday an adamant defense of a "vigorous public option." Other House leaders noted that cutting the cost of the overall package, which several negotiators have said they want to do, will probably require cutting the federal subsidies to help people comply with a new mandate to buy health insurance -- an idea both parties have embraced.
"We're asking every citizen to take some responsibility for their own health care. But you can't reasonably ask somebody to do something that's totally beyond their financial means," said Rep. Chris Van Hollen (D-Md.), a member of the House leadership. "That's the trade-off." But in recent days, the White House has aggressively pursued a deal with Sen. Olympia J. Snowe (R-Maine), a member of the Gang of Six. She favors a slimmed-down bill that would take effect more slowly and would create a public insurance plan only if private insurance companies do not offer better coverage at lower rates. Under Snowe's "safety-net option," aides said, private insurance companies would be asked to develop plans affordable to 95 percent of the population in a given state or region.
In areas where private firms do not comply by 2013 -- when people are scheduled to begin entering a new federal insurance exchange -- a nonprofit insurance plan sponsored by the government would be added to the list of private options.
Senior Senate aides said Baucus had not yet decided whether to include Snowe's provision in his proposal or to offer a public-option alternative -- a network of nonprofit cooperatives -- which the group already endorsed.
Some Democrats are urging Obama to cease courting Republicans and to attempt to pass a Senate bill solely with Democratic votes, to preserve the public option in its full form. But that would require Democrats in the Senate to use a legislative maneuver known as reconciliation. A reconciliation measure cannot be filibustered, so the Senate could approve health reform with 51 votes, rather than the 60 usually necessary to pass legislation in the chamber. Read it all at washingtonpost.com
by Ryan Grim at Huffington Post
I'll be starting phone calls in the morning... This really pisses me off.
Conservative House Democrats agreed to a set of health care principles late last week that angered advocates of a overhaul of the health care system.
The Blue Dog Coalition issued a statement that said it would only support the public health care option as a fallback measure that would be triggered sometime down the road if private insurers don't meet a particular set of goals.
The backsliding took advocates of reform by surprise because 20 members of the coalition had previously signed a pledge expressing their support for a public option without a trigger. The statement was written and organized by the reform coalition Health Care for America Now (HCAN), which strongly opposes a trigger and sees it as an industry plot to strangle a public option in the crib.
Blue Dogs, by their charter, need two-thirds of their 51-member caucus to approve a position before it can be officially adopted. With 20 Blue Dogs backing a public option, they would be short several votes if everyone stuck to their pledge in the closed-door meeting.
A senior Blue Dog staffer, however, said that when the coalition first met to discuss the set of principles, they decided to stake out a negotiating position rather than draw a firm line.
"The sense in the room when these principles were drafted was that the coalition was shooting a bit past where they want to end up," said a top Blue Dog aide. "The final product is obviously going to be delivered through a negotiation and an ultimate compromise meaning the principles listed are much more of a starting place for the negotiation than they are an intractable position." Rep. Patrick Murphy (Penn.) still backs a public plan without a trigger, said his spokeswoman Kate Hansen. "Congressman Murphy stands with President Obama in supporting the inclusion of a public option without a trigger in healthcare reform legislation, and believes it would be a good way to introduce transparency, competition, and cost-control into the insurance market," she said.
Rep. Loretta Sanchez (Calif.) said she is waiting to see what emerges from committee before taking a stand, though she didn't back off her HCAN pledge. Beyond Sanchez and Murphy, the 18 other Blue Dogs to sign the HCAN statement include Democratic Reps. Jason Altmire (Penn.), Michael Arcuri (N.Y.), Joe Baca (Calif.), Marion Berry (Ark.), Sanford Bishop (Ga.), Leonard Boswell (Iowa), Chris Carney (Penn.), Ben Chandler (Ky.), Jim Cooper (Tenn.), Jane Harman, (Calif.), Stephanie Herseth Sandlin (S.D.), Tim Holden (Penn.), Frank Kratovil (Md.), Mike Ross (Ark.), Adam Schiff (Calif.), Zack Space (Ohio), Mike Thompson (Calif.) and Charlie Wilson (Ohio).
Several of those members played an active role in the creation of the principles that go against the original pledge they signed for health care reform. The 20 Blue Dogs have taken a combined $6,849,273 from various segments of the health care industry, according to data from the Center for Responsive Politics. Read the principles here. [PDF] Read it all and try not to throw up...
From Robert Reich's Blog
I'ved poked around Washington today, talking with friends on the Hill who confirm the worst: Big Pharma and Big Insurance are gaining ground in their campaign to kill the public option in the emerging health care bill.
You know why, of course. They don't want a public option that would compete with private insurers and use its bargaining power to negotiate better rates with drug companies. They argue that would be unfair. Unfair? Unfair to give more people better health care at lower cost? To Pharma and Insurance, 'unfair' is anything that undermines their profits.
So they're pulling out all the stops -- pushing Democrats and a handful of so-called "moderate" Republicans who say they're in favor of a public option to support legislation that would include it in name only. One of their proposals is to break up the public option into small pieces under multiple regional third-party administrators that would have little or no bargaining leverage. A second is to give the public option to the states where Big Pharma and Big Insurance can easily buy off legislators and officials, as they've been doing for years. A third is bind the public plan to the same rules private insurers have already wangled, thereby making it impossible for the public plan to put competitive pressure on the insurers. Enter Olympia Snowe. Her move is important, not because she's Republican (the Senate needs only 51 votes to pass this) but because she's well-respected and considered non-partisan, and therefore offers some cover to Democrats who may need it. Last night Snowe hosted a private meeting between members and staffers about a new proposal Pharma and Insurance are floating, and apparently she's already gained the tentative support of several Democrats (including Ron Wyden and Thomas Carper). Under Snowe's proposal, the public option would kick in years from now, but it would be triggered only if insurance companies fail to bring down healthcare costs and expand coverage in he meantime.
What's the catch? First, these conditions are likely to be achieved by other pieces of the emerging legislation; for example, computerized records will bring down costs a tad, and a mandate requiring everyone to have coverage will automatically expand coverage. If it ever comes to it, Pharma and Insurance can argue that their mere participation fulfills their part of the bargain, so no public option will need to be triggered. Second, as Pharma and Insurance well know, "years from now" in legislative terms means never. There will never be a better time than now to enact a public option. If it's not included, in a few years the public's attention will be elsewhere. All this will be decided within days or weeks. And once those who want to kill the public option without their fingerprints on the murder weapon begin to agree on a proposal -- Snowe's "trigger" or any other -- the public option will be very hard to revive. The White House must now insist on a genuine public option. And you, dear reader, must insist as well.
This is it, folks. The concrete is being mixed and about to be poured. And after it's poured and hardens, universal health care will be with us for years to come in whatever form it now takes. Let your representative and senators know you want a public option without conditions or triggers -- one that gives the public insurer bargaining leverage over drug companies, and pushes insurers to do what they've promised to do. Don't wait until the concrete hardens and we've lost this battle.
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