Wyden's Free Choice Amendment, Generic Drugs and the Exchange

During an appearance on Rachel Maddow's program, Senator Ron Wyden said that he would fight all the way to floor to open the public option to everyone, not just the 10% who cannot get private insurance as is the case now. He says this is the time for progressives to demand that the rhetoric of choice matches reality in policy. As Wyden says,

The bottom line is that the public option can’t really hold private insurers accountable if it is only competing for 10 percent of the insurance market, because private insurance companies aren’t going to change their business practices if 90 percent of their customers can’t take their business elsewhere.

Real reform means empowering Americans to choose insurance that works well for them and their family, while rejecting plans that don’t. Including a public option is a step in the right direction, now let’s remove the firewalls in this bill that prevent Americans from choosing it,'' Wyden said in a statement.

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Currently the Public Options being discussed would be open to 10% who have no other access to health insurance. This population would be disproportionately filled with very medically high risk people, and the cost of insuring them, even under a government sponsored public plan, could quickly skyrocket. Dumping by the big insurers during the first couple of years while reforms were still "kicking in" could further exacerbate this, effectively bankrupting the public plan (which must be law be self-sustaining) before it ever has the chance of succeeding.

Employee based coverage, Mandates and Opt-Outs:

Some additional thoughts I want to make sure you understand. Right now, only small businesses, those who can't get insurance and those who buy insurance on the individual market will be eligible to purchase insurance on the exchange. If you work for a large employer who offers bad insurance coverage, you can't purchase something better for yourself through the exchange or public option.

Most citizens no longer count on remaining with the same employer for 5 years, much less 20 and in the last few years, we've seen that it is not uncommon to have to change jobs multiple times within a few years. Should you also have to be switching insurance companies and doctors every time you change jobs? An individual able to buy their own insurance on an exchange or through the Public Option would not be burdened with that constant change - which frequently depending on the insurance plan, may require changing healthcare providers.

If states are allowed to opt-out of the Public Option, then shouldn't the citizens of those states who do want and need a public option have access to it on their own? Especially if there are mandates that everyone must have insurance.

The entire health care exchange along with the Public Option should be open to all citizens. Wyden's Free Choice amendment is not mere icing; it is essential. We should definitely rally to support this.

The New Republic had a forum in Washington, D.C. this morning and Representative Anthony Weiner shared his thoughts on this issue. Ezra Klein reports:

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Wyden and the Baucus Debacle

When the Finance Committee eventually gets around to voting on the bill they cobbled together last week, it's still not entirely certain that it will pass...

To put it more directly, the exchange as set up in the Baucus bill will be open to just 25 million people, most of whom have been uninsured, un-doctored, untreated for a long time. It's enough to make one think they're setting not just the public option but the exchange to fail.

The hostility among the committee's senior members, particularly those on Baucus's Gang of Six, to the Wyden Free Choice amendment just reinforces that impression. Jon Walker at FDL has the whole sordid story of how Baucus blindsided Wyden on that late night of markup, when Baucus ruled his amendment out of order because it hadn't been scored by the CBO. Except that the amendment that Wyden offered had been scored, more than a week before the markup.

To put it more directly, the exchange as set up in the Baucus bill will be open to just 25 million people, most of whom have been uninsured, un-doctored, untreated for a long time. It's enough to make one think they're setting not just the public option but the exchange to fail.

The hostility among the committee's senior members, particularly those on Baucus's Gang of Six, to the Wyden Free Choice amendment just reinforces that impression. Jon Walker at FDL has the whole sordid story of how Baucus blindsided Wyden on that late night of markup, when Baucus ruled his amendment out of order because it hadn't been scored by the CBO. Except that the amendment that Wyden offered had been scored, more than a week before the markup.

There are two issues at play here--Baucus's actions as committee chair which have shown him essentially incompetent to achieve a decent bill of this scope and dishonest in dealing with his colleagues. But the more important issue for the moment goes back to Rockefeller's problem with the bill--the half trillion dollar gift it is to the insurance industry, made an even bigger gift by the crippled exchange it creates.

There's going to be tremendous pressure on Wyden and Rockefeller, from Baucus, from the White House, from Reid, to vote for this crappy bill to get it out of committee so the process can move on (pressure that should have been on Baucus months and months ago, since it's his fault we're now well into October with no bill). As long as there's a Snowe-inspired delay why the CBO does it's work on the crappy bill, Wyden and Rockefeller should hold out on saying how they'll vote. They should be using this time to extract as many concessions as possible from Reid and the White House before agreeing to anything.

Read it all at Daily Kos