"On Wednesday, the first day of the 112th Congress, Rep. Lynn Woolsey (D-CA) introduced a measure to establish a robust public health insurance option as a supplement the Patient Protection and Affordable Care Act.
The California congresswoman argued the measure would lower insurance costs and address deficit concerns, pointing to a Congressional Budget Office report saying it would cut the deficit by $68 billion."
While the provision -- controversial in Congress but popular among the public -- is extremely unlikely to gain any traction in the Republican-controlled House, it serves to illustrate flaws in GOP's budget-related arguments regarding repeal of the health care law.
Republicans have argued that the health reform law would explode the deficit, but the CBO has said it would do the opposite. The nonpartisan scorekeeper has also said repealing the measure would add $143 billion to the deficit.
A copy of the 17-page bill was provided to Raw Story [.pdf].
Andy Cobb has had enough. A former pitchman for BlueCross Blue Shield of Florida, Cobb is breaking with the firm and speaking out in favor of health care reform and a public health insurance option.
"This is the time when Americans have to choose which side we're on," Cobb told HuffPost, quoting Rep. Dennis Kucinich (D-Ohio). "Is it the insurance companies or the American people?"
Cobb calls on what he dubs his fellow "spokes-jerks" -- singling out the FreeCreditReport.com guy -- to stop hawking products that hurt the American people.
Cobb teamed with Brave New Films to create the short video.
"I do know that 19 percent of every dollar of our premiums goes to administrative costs, for executive compensation and people like me. We can't afford people like me any more in this country," he said.
The goal of the Charter Oak Health Plan is to provide affordable health care coverage to Connecticut adults, aged 19 to 64, of all incomes. It’s the first time every uninsured adult in Connecticut can get quality, affordable health insurance, and it costs as little as $75 per month in premiums, depending on your income.
Sen. Joe Lieberman (I-CT) said Tuesday that he’d back a GOP filibuster of Senate Majority Leader Harry Reid’s health care reform bill.
Lieberman, who caucuses with Democrats and is positioning himself as a fiscal hawk on the issue, said he opposes any health care bill that includes a government-run insurance program — even if it includes a provision allowing states to opt out of the program, as Reid has said the Senate bill will.
Asked about Lieberman’s threat to filibuster a final vote on the Reid plan, White House press secretary Robert Gibbs said: "I haven't seen the report from Sen. Lieberman or why he's saying what he's saying. I think Democrats and Republicans alike will be held accountable by their constituents who want to see health care reform enacted this year.”
Lieberman said that he’d vote against a public option plan “even with an opt-out because it still creates a whole new government entitlement program for which taxpayers will be on the line."
His comments confirmed that Reid is short of the 60 votes needed to advance the bill out of the Senate, even after Reid included the opt-out provision. Several other moderate Democrats expressed skepticism at the proposal as well, but most of the wavering Democratic senators did not go as far as Lieberman Tuesday, saying they were waiting to see the details.
Lieberman did say he's "strongly inclined" to vote to proceed to the debate, but that he’ll ultimately vote to block a floor vote on the bill if it isn’t changed first.
UPDATE - Be sure and take the time to read Marcy Wheeler's piece:
So here’s what Joe Lieberman claims the public option will do:
* Be costly to taxpayers
* Drive up premiums
* Involve cost-shifting to private plans
* Create an entitlement
* Increase the national debt
* Put more of a tax burden on taxpayers
Lieberman’s justification on this is just nonsense – the public option would SAVE money for the government, to the tune of $100 billion dollars over 10 years according to the Congressional Budget Office. It also would cost nothing to the taxpayer, being financed by individual premiums.
Now, there’s the possibility that if the public option was set at Medicare +5, there might be cost shifting, if you ignored challenges to that claim, if you ignored the way insurance companies will game the system to push high cost people into the public option, and if you ignored the many other ways the insurance companies will be cost shifting themselves once this system is set up.
But everything else Lieberman said is horse puckey. He is either completely ignorant about health care works (unlikely, for a Senator from Connecticut). Or, he’s lying his ass off as to his rationale.
Don’t you think the press ought to call him on that?
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.
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:
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.
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.
According to news reports, Senate Majority Leader Harry Reid is sending the Senate's health care bill to the Congressional Budget Office today, and may unveil the bill publicly as early as tomorrow.
The bill reportedly includes a public option, but states may opt out of the program.
According to the Wall Street Journal, it also includes a $750 fine per employee for employers who don't provide insurance and whose workers receive government subsidies for health insurance.
It will also prohibit insurers from dropping or denying coverage to sick patients.
One of the reasons that I am a strong proponent of a single-payer, Medicare-for-all proposal is that it is much less complicated than what we are going to end up with in Congress. A single-payer approach saves hundreds of billions of dollars a year because you don’t end up with thousands of different health insurance programs appealing to all different kinds of people and costing a fortune to administer. I am going to continue the fight for single-payer. I am cautiously optimistic that we may end up with legislation that will allow states to go forward with single-payer if they want to.
"We respectfully ask that the Office of the President take a stronger stand on a robust public option in order to enact true health care reform this year," says the letter, signed by representatives of MoveOn.org, Campaign for America's Future, and NAACP
There's good news and so-so news coming from the House. With votes still in a state of flux, Pelosi has decided to wait until early next week, probably Monday, to make the decision on whether to include the robust public option based on Medicare Plus 5%, or the negotiated rates public option
All of the "lean yes" members from earlier today have been confirmed as yes votes on the robust public option. Meaning now we're down to about eight that we really need to get. Luckily, folks whipping on the Hill know the most likely folks for us. As CaptUnderpants diaries, these are the members most likely to join in:
* Gabrielle Giffords (AZ-8): 202-225-2542, 520-459-3115, 520-881-3588
* Dennis Cardoza (CA-18): 202-225-6131; 209-383-4455, 209-527-1914
* Joe Donnelly (IN-2): 202-225-3915, 574-288-2780
* Curt Schraeder (OR-05): 202-225-5711, 503-588-9100
* Lincoln Davis (TN-04): 202-225-6831, 931-490-8699, 931-473-7251
* Glenn Nye (VA-2): 202-225-4215 757-326-6201
* Jim Costa (CA-20): 202-225-3341, 661-869-1620, 559-495-1620
* Rick Boucher (VA-9): 202-225-3861, 276-628-1145
If you live in the district of any of these Congresspeople, please call and urge him or her to pledge their vote to a robust public option, based on Medicare rates plus 5%. Make sure to call their district offices as well as DC offices. The impact of constituent calls in district offices is much greater because they generally don't get the same volume of calls as the DC office. The House needs to pass the strongest bill possible going into negotiations with the Senate. All of the things that House members have fought to have included in this bill, not just the public option, will be best preserved with the strongest possible bill being passed by the House.
As usual, leadership needs to hear from us, too. Here they are.
* Steny Hoyer (MD-05): 202-225-4131, 301-474-0119, 301-843-1577
* Chris Van Hollen (MD-08): 202-225-5341, 301-424-3501
* Jim Clyburn (SC-06): 202-225-3315, 803-799-1100
* John Larson CT-01): 202-225-2265, 860-278-8888
* Henry Waxman CA-30): 202-225-3976, 323-651-1040
* Chuck Rangel (NY-15): 202-225-4365, 212-663-3900
Below the fold, I have the list of members who have moved into the solid yes column. If you are so inclined, give them a thank you call.
A new study by Representative Anthony Weiner (D – Queens & Brooklyn), member of the Health Subcommittee and Co-Chair of the Caucus on the Middle Class, revealed that 151 members of the House and Senate currently receive government-funded; government-administered single-payer health care - Medicare.
On the list of recipients are 55 Republicans who have steadfastly opposed other Americans getting the public option, like the one they have chosen.
Weiner said, "Even in a town known for hypocrisy, this list of 55 Members of Congress deserve some sort of prize. They apparently think the public option is ok for them, but not anyone else."
The list of congressional recipients of Medicare who also oppose the public option is below:
I am told that if the leadership does not confirm 218 "solid" yes votes by the end of the 9:30 a.m. Democratic caucus meeting tomorrow morning, they will probably include the negotiated rate public option in the bill that is sent to the floor, not the Medicare +5% public option. At the very latest, we have until 2 p.m. to get the votes.
Note that "the list" is at the bottom of this post or in PDF format here.
If you member of Congress is on the list, call and leave a message tonight. We have to get through before 9:30 a.m., if possible.
If your member of Congress is not on the list , but you are represented by a Democrat, call your member of Congress and urge them to support the Medicare +5% option at the caucus meeting tomorrow morning.
If you are represented by a Republican, call either a member of the Democratic leadership or a Representative on the list who is from your state.
Call and leave a message. The campaign could really go either way depending on what happens in the next 14-18 hours.
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The leadership and Democratic Caucus will be meeting Friday morning to determine which version of the Public Option they will include in the House bill.
Nancy Pelosi has said that she believe they have 218 representatives on board for a good public option. That means that they are only 12-15 votes away from the strongest version of the bill - the Medicare Plus 5 version that ties public option rates to Medicare reimbursement rates.
We desperately need the strongest possible House bill going in to conference with the Senate if the final bill is going to help us at all.
As soon as you get up in the morning, please make calls to the following "leaning" Dems. [Set your alarm a bit early so you will have time to call before leaving for work!]
It takes longer to get through - but if you need to, use this 800 number so there will be no cost to you:
1-800-828-0498
These are Representatives we believe are considering supporting the Medicare Plus 5 version. The first number is their DC office, the others are their district office numbers - thanks to Chris and mcjoan at Daily Kos for pulling this information and the the numbers together.
* Ron Klein (FL-22): 202-225-3026, 561-544-6910
* Dennis Moore (KS-03): 202-225-2865, 913-621-0832, 913-383-2013
* Stephen Lynch (MA-09): 202-225-8273, 617-428-2000
* Bob Etheridge (NC-02): 202-225-4531, 919-829-9122, 919-829-9122
* Dina Titus (NV-3): 202-225-3252, 702-387-4941
* John Boccieri (OH-16): 202-225-3876, 330-489-4414
* Steve Driehaus (OH-1): 202-225-2216, 513-684-2723
* Charles Wilson (OH-06): 202-225-5705, 740-633-5705, 330-533-7250
* Christopher Carney (PA-10): 202-225-3731, 570-585-9988, 570-327-1902
* John Sprat (SC-05): 202-225-5501, 803-327-1114
* Ruben Hinojosa (TX-15): 202-225-2531, 956-682-5545, 361-358-8400
* Solomon Ortiz (TX-27): 202-225-7742, 956-541-1242, 361-883-5868
Additionally, it never hurts to put some pressure on leadership. Most of these committee chairs haven't yet committed precisely because they're the committee chairs negotiating with leadership, but they need to hear from us as well to know the strength of public support for the strongest public option possible.
* Steny Hoyer (MD-05): 202-225-4131, 301-474-0119, 301-843-1577
* Chris Van Hollen (MD-08): 202-225-5341, 301-424-3501
* Jim Clyburn (SC-06): 202-225-3315, 803-799-1100
* John Larson CT-01): 202-225-2265, 860-278-8888
* Henry Waxman CA-30): 202-225-3976, 323-651-1040
* Chuck Rangel (NY-15): 202-225-4365, 212-663-3900
Below the is the full list of Dems who haven't fully committed one way or the other on the public option and on the most robust public option possible.
According to the survey, 61 percent favor a public health insurance option that would compete with private plans. That's a six-point increase in support since August.
The CNN/Opinion Research Corporation poll joins an ABC/Washington Post survey released Tuesday in indicating an increase in support for a government option.
A preliminary analysis from CBO may have sealed the deal. Speaker Nancy Pelosi is preparing to move ahead with a "robust" public option--one that reimburses hospitals and providers at Medicare rates, plus five percent--in the House's health care bill. She is briefing her caucus about the plan's savings tonight, and, pending the approval of a sufficient majority of members, will adopt the measure as part of the complete reform package
The bill remains nominally more expensive than the Senate Finance Committee proposal, but would cover 96 percent of all Americans, providing greater bang for each federal dollar spent. And, aides note, the bill that comes to the floor of the Senate will be a hybrid of the Finance and more expensive HELP Committee bills, so the price is expected to rise.
A new Washington Post-ABC News poll shows that support for a government-run health-care plan to compete with private insurers has rebounded from its summertime lows and wins clear majority support from the public. Click Graphic to enlarge. Read the article.
If the bill comes to the floor with no public option in it, and the "deal" is that opponents are to be allowed a vote on an amendment that would add it in, here's what will happen:
The "deal" will be a unanimous consent agreement that the public option amendment (and possibly other amendments) will require 60 votes to pass
The public option amendment will garner majority support on the Senate floor -- say, around 55 votes -- but because Senators agreed unanimously that 60 would be needed, the amendment would fail
The Senate would pass a bill with no public option, and would go to conference with the House to settle that difference (and all others)
The House and Senate would vote on whatever settlement they reach in conference, and the fate of the public option would be in the hands of the conferees
Now, why would there be such a unanimous consent agreement?
Opponents of the public option will threaten to filibuster an amendment to add it
leadership on both sides will know that the filibuster will be useless if there are 60 votes to end it
leadership also knows that ending a filibuster means:
the trouble of conducting that filibuster
filing a cloture motion which takes one day plus one hour (at minimum) to become eligible for a vote on it.
the trouble of running out the clock on the 30 hours of post-cloture debate permitted by the rules
So instead of going through all of that, they agree ahead of time to transfer the 60 vote threshold onto the vote on the amendment itself
Transferring the 60 vote threshold directly onto the amendment itself puts the amendment at no disadvantage relative to the hurdle of overcoming an actual filibuster, so in that sense it's not a concession at all. But it does relieve opponents of the public option amendment of the burden of having to go on record as opposing cloture on that amendment. Instead, all they have to do to require 60 votes to pass it is silently assent to a unanimous consent agreement.
Now that the primary responsibility for health reform has shifted to Senate Majority Leader Harry Reid, progressives are pushing him to get tough with conservative Democrats looking to delay progress of a unified Senate reform bill.
Progressive Caucus member Rep. Alan Grayson (D-Fla.) and representatives from the Progressive Change Campaign Committee delivered their respective petitions to Reid's office Wednesday afternoon. With some 87,000 signatures collected in the past week, the PCCC urged Reid to strip leadership powers from members of the Democratic Caucus who do not vote for cloture to prevent a Republican filibuster -- a clear shot at Sen. Joseph Lieberman (I-Conn.), who chairs the Homeland Security committee and said Monday he "wouldn't rule out" allowing a filibuster to proceed.
Reiterating the urgent need for reform outside the Hart Senate office building Wednesday afternoon, Grayson didn't single out any congressmen or senators, but said he was baffled by continued delays given the Democratic supermajority and the cost of delay.
"Every single day in America, 122 more Americans die for lack of health insurance. That means that as we stand here in front of you right now, one or two or three more Americans have died because we have not acted yet," Grayson said. "I apologized to the dead and their loved ones for our inaction. Now it's time to move beyond that and get the job done."
Reid's deputy, Sen. Dick Durbin (D-Ill.), said the PCCC and Grayson ought to "count to 60 and understand we need to be together, and there are times when we need to work out our differences."
Grayson wasn't sympathetic to that argument Wednesday, noting that other Americans are paying the price while the Senate tries to work out its differences. Pulling a large American Journal of Public Health study from his jacket pocket, he said, paraphrasing the study authors, "You take two Americans who are otherwise identical in every single way -- same age, same gender, same race, same smoking habits, same weight -- you put them side by side, if one has insurance and one does not, the one without insurance is 40 percent more likely to die."
Reid pushed back Wednesday afternoon against the consensus that health reform is on him -- after Sen. Chuck Schumer (D-N.Y.), laid the fate of the public option in the Majority Leader's hands Tuesday night. "He would rather say anything so it wasn't up to him," Reid snapped Wednesday, en route to a meeting with White House Chief of Staff Rahm Emanuel and Sens. Chris Dodd (D-Conn.) and Max Baucus (D-Mont.).
Dodd said he expects the Senate finance and health bills to be reconciled by the end of next week. "The Leader will set the agenda," he said.
Here is Schumer with the best plan:
SCHUMER: "Well, first, Leader Reid has the option of putting it in the final bill. If he puts it in the final bill, in the combined bill, then you would need 60 votes to remove it. And there clearly are not 60 votes against the public option."
Fifty-nine members of the Harvard Medical School Class of 1959 are convinced that reform of the American health care system is essential, must be substantial and carefully designed, and must include a public health insurance option.
Each of the signers has 50 years of experience and leadership in clinical practice, medical education, administration, and/or research. Our collective careers cover a wide variety of primary care and specialty fields in a range of organizational settings, in both private practice and academia, across the United States.
Excluding a public option would throw away a vital opportunity to test different ways to provide quality care for all. A public plan would help develop and evaluate new standards of practice, malpractice reform, and reimbursement of physicians, and would emphasize preventive care. To be affordable, it would have to avoid financial incentives for unnecessary services and contain measures that curb financial abuse and waste by some hospitals and, unfortunately, by some of our medical colleagues.
A public option would also identify and encourage use of demonstrated best practices shown to be effective at less cost, offer greater access, and provide higher quality of care. Administrative overhead, as now in Medicare, would be significantly lower without for-profit intermediaries. These innovations could help lift the competitive burden that health care places on American employers in the global marketplace, while also offering portability and continuity of coverage during job changes and illness.
Common sense demands a planned, full comparison of the relative benefits of public vs. private options. At the outset, there must be clear and uniform ground rules for measuring, reporting, and evaluating cost, access, and quality of care for all plans.
We urge Congress and the President to take this courageous step at a vital time in our nation’s history.
So it is in the U.S. Senate, where the Finance Committee finally got around to finishing its health care reform assignment.
The vote on the measure -- which does not include a public option to hold insurance companies to account -- was 14-9, with all Democrats on the committee and Maine Republican Olympia Snowe voting Tuesday to toss the measure into the legislative sausage-grinder that will eventually produce final legislation for the Senate to consider.
The important thing to remember is that for all of Tuesday's attention to the finance committee vote, the full Senate will never vote on this particular measure.
Senate Health, Education, Labor and Pensions Committee chair Tom Harkin, D-Iowa, has said throughout the process that "the bill that (the Finance Committee) proposes is just that – a proposal."
Harkin is too polite to state the obvious: The Finance Committee proposal is no more likely to become law than the slacker student's last-to-be-handed-in homework assignment is to be awarded academic honors.
That's a good thing because the Finance Committee bill falls far short of real health care reform. It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally-responsible alternative to their profiteering.
The problems with the Finance Committee's proposal extend far beyond the fact that it fails to establish a government-run alternative to compete with the private insurers that will be ridiculously enriched by it.
But the lack of a "public option" should make the Baucus bill a nonstarter. As insurance-industry insider turned whistleblower Wendell Potter explained in an advertisement produced by MoveOn.org, the Baucus bill would, if enacted effectively, "kill health reform."
"Take it from me," argues Potter, "the Senate Finance bill is a dream come true of the health insurance industry. If there is no public option insurance companies aren't going to change. The choice of a public health insurance option is the only way to keep insurance companies honest."
Perhaps that is why the other four congressional committees that produced health-care reform bills – three in the House and the Senate Health, Education, Labor and Pensions (HELP) Committee -- have included far more robust language with regard to alternatives to for-profit insurance companies.
It is Harkin, not Baucus, who is the serious health-care reformer in the Senate.
It is Harkin, not Baucus, who has consistently promoted the public option and who continues to argue that it can and will be a part of any final legislation. "Look," says Harkin, "five committees have reported a bill out on healthcare. Four of them have a public option. One doesn't. So you would think the weight would be on the side of having a public option in the bill – and that's where it is."
And it is Harkin, the chairman who gets his work done on time and right, that we should be paying attention to now that Baucus has finally finished his silly sideshow.
