State-based public options?
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/02/AR2009100200457.html
The Health Care Reform bill will pass out of the Finance Committee Tuesday or Wednesday-- the Committee markup period is done.
This is farther than any similar piece of legislation has ever gone; almost without doubt now, some form of Health Care reform will pass both houses and make it's way into law.
What's next:
The Finance Committee version of the bill will be merged by Harry Reid with the Health Committee version of the bill, and the Senate will begin open debate on the bill following Columbus day. Notable about this: the Health Committee version includes a public option, so almost without a doubt the version that goes to the Senate Floor will include a public option, for all you doomsayers about the public option's viability in the Senate.
With the appointment of an interim Senator from Massachusetts, the Democrats technically have all the votes they need to break a filibuster, so long as there aren't any party defectors. The interesting question is, will any of them break party lines and vote for a filibuster? So far the committee votes have been limited to 'for' or 'against' votes, but it's highly doubtful that many Democrats will side with Republicans on a public option filibuster, even if they choose to vote against the public option on a yea or nay vote.
Here's the thing: any Democrat willing to break ranks and join such a filibuster has to know that they will face a potentially well-funded primary challenge next year. Even those who think they could survive such a challenge have to be worried about the raw amount of funding that would be channeled to a primary opponent should they make that choice. It is now dumb politics to oppose the public option in federal form for a Democrat.
So, to handicap the home stretch of the bill:
The Senate version of the public option will probably look a good deal like Sen. Schumer's version, i.e. public option, but not at Medicare rates (and that's a good thing-- if you've ever had to look for a doctor, the majority of them won't work for medicare rates, so a public option that pays on parity with other insurance plans is likely to have wider provider participation). That would leave Baucus, Conrad and Lincoln to bring on board, plus potentially a few Senators not on the Finance Committee, though part of what has made the Finance Committee a hassle is that it has a way disproportionate number of the Democrats who haven't already voiced support for the public option, so my guess is that there may be no more than 2 outside the Finance Committee who would be opposed to the Schumer plan.
I expect Baucus to flip-- his vote in contradiction to his public statements of support for the public option smacks strongly of deals made at the negotiating table of the Finance Committee-- i.e. as Chairman he made certain promises he had to keep to get the bill out of committee, but once it goes to the floor he's clear of those promises and can vote as he sees fit. If Baucus flips, that leaves maybe 4 Democrats to put the screws to, and Conrad and Lincoln are already firmly in the cross-hairs of the left wing of the party for their Finance Committee votes. By Columbus Day, it would be surprising if the the two of them haven't been convinced at the very least not to join a Republican filibuster. Remember, they don't have to vote for the bill, the public option only really needs to break the filibuster to go to a full vote in order to pass.
If you're the kind of person who donates, even in micro-donations of say $10-20 in political contributions, there is going to be a lot of traction that activists of that nature can have on any Democrats willing to break with the Party and move to filibuster. Effectively, if there are one or two Senators that break, by that time there will be an organized PAC of some sort to run primary challengers against them, which should send a pretty strong message if in a couple days a potential primary challenger raises 200-300k.
Republicans are going to to attempt to sink this thing with amendments on the floor. They're going to fail. They just don't have the votes.
In the mean time, Harry Reid will shepherd the legislation around to the right Senators, and there will probably be 4-5 major amendments in order to bring along some Democratic fence-sitters. In the mean time, the House is going to pass it's version-- there's just not the votes to marshal in the House to stop this bill now.
One thing I want to talk about, though, is something mentioned by Sen. Carper of Delaware (who voted against the Rockefeller Public Option but for the Schumer public option): there's nothing in these bills to prevent a STATE from running a state-based public option. While probably not as potent as a Federally based public option, it's possible that State-based public options could effectively cover all the proposals that hard-core proponents of the public option support but won't have the support for on a national level.
So for instance, if Maryland decides that the Federal public option doesn't do enough to contain costs within the state, Maryland could put together it's own public option that would be free to compete in the Health Care Exchange. Notably, State-based public options would be much easier to pass through the legislatures of certain states where the idea is popular, and wouldn't add to the federal deficit. The States themselves would be in a good position to negotiate with their local providers, as they already administer local licensing and a myriad of other state-based regulations, which are preserved under the current reform package. A State could even go so far as to pass legislation to require a practicing provider within the State to participate in it's public option, for example, and then directly set rates within the State through the State-based public option.
And there are a LOT of states where such a thing could pass a local legislature without much hassle. And none of them would be beholden to any of the deals made at the Federal level. In other words, state-based public options are the next battlefront in the continuing effort to roll out health-care reform, even if a public option passes through the Congress at the federal level-- and especially so if one does not.
The Health Care Reform bill will pass out of the Finance Committee Tuesday or Wednesday-- the Committee markup period is done.
This is farther than any similar piece of legislation has ever gone; almost without doubt now, some form of Health Care reform will pass both houses and make it's way into law.
What's next:
The Finance Committee version of the bill will be merged by Harry Reid with the Health Committee version of the bill, and the Senate will begin open debate on the bill following Columbus day. Notable about this: the Health Committee version includes a public option, so almost without a doubt the version that goes to the Senate Floor will include a public option, for all you doomsayers about the public option's viability in the Senate.
With the appointment of an interim Senator from Massachusetts, the Democrats technically have all the votes they need to break a filibuster, so long as there aren't any party defectors. The interesting question is, will any of them break party lines and vote for a filibuster? So far the committee votes have been limited to 'for' or 'against' votes, but it's highly doubtful that many Democrats will side with Republicans on a public option filibuster, even if they choose to vote against the public option on a yea or nay vote.
Here's the thing: any Democrat willing to break ranks and join such a filibuster has to know that they will face a potentially well-funded primary challenge next year. Even those who think they could survive such a challenge have to be worried about the raw amount of funding that would be channeled to a primary opponent should they make that choice. It is now dumb politics to oppose the public option in federal form for a Democrat.
So, to handicap the home stretch of the bill:
The Senate version of the public option will probably look a good deal like Sen. Schumer's version, i.e. public option, but not at Medicare rates (and that's a good thing-- if you've ever had to look for a doctor, the majority of them won't work for medicare rates, so a public option that pays on parity with other insurance plans is likely to have wider provider participation). That would leave Baucus, Conrad and Lincoln to bring on board, plus potentially a few Senators not on the Finance Committee, though part of what has made the Finance Committee a hassle is that it has a way disproportionate number of the Democrats who haven't already voiced support for the public option, so my guess is that there may be no more than 2 outside the Finance Committee who would be opposed to the Schumer plan.
I expect Baucus to flip-- his vote in contradiction to his public statements of support for the public option smacks strongly of deals made at the negotiating table of the Finance Committee-- i.e. as Chairman he made certain promises he had to keep to get the bill out of committee, but once it goes to the floor he's clear of those promises and can vote as he sees fit. If Baucus flips, that leaves maybe 4 Democrats to put the screws to, and Conrad and Lincoln are already firmly in the cross-hairs of the left wing of the party for their Finance Committee votes. By Columbus Day, it would be surprising if the the two of them haven't been convinced at the very least not to join a Republican filibuster. Remember, they don't have to vote for the bill, the public option only really needs to break the filibuster to go to a full vote in order to pass.
If you're the kind of person who donates, even in micro-donations of say $10-20 in political contributions, there is going to be a lot of traction that activists of that nature can have on any Democrats willing to break with the Party and move to filibuster. Effectively, if there are one or two Senators that break, by that time there will be an organized PAC of some sort to run primary challengers against them, which should send a pretty strong message if in a couple days a potential primary challenger raises 200-300k.
Republicans are going to to attempt to sink this thing with amendments on the floor. They're going to fail. They just don't have the votes.
In the mean time, Harry Reid will shepherd the legislation around to the right Senators, and there will probably be 4-5 major amendments in order to bring along some Democratic fence-sitters. In the mean time, the House is going to pass it's version-- there's just not the votes to marshal in the House to stop this bill now.
One thing I want to talk about, though, is something mentioned by Sen. Carper of Delaware (who voted against the Rockefeller Public Option but for the Schumer public option): there's nothing in these bills to prevent a STATE from running a state-based public option. While probably not as potent as a Federally based public option, it's possible that State-based public options could effectively cover all the proposals that hard-core proponents of the public option support but won't have the support for on a national level.
So for instance, if Maryland decides that the Federal public option doesn't do enough to contain costs within the state, Maryland could put together it's own public option that would be free to compete in the Health Care Exchange. Notably, State-based public options would be much easier to pass through the legislatures of certain states where the idea is popular, and wouldn't add to the federal deficit. The States themselves would be in a good position to negotiate with their local providers, as they already administer local licensing and a myriad of other state-based regulations, which are preserved under the current reform package. A State could even go so far as to pass legislation to require a practicing provider within the State to participate in it's public option, for example, and then directly set rates within the State through the State-based public option.
And there are a LOT of states where such a thing could pass a local legislature without much hassle. And none of them would be beholden to any of the deals made at the Federal level. In other words, state-based public options are the next battlefront in the continuing effort to roll out health-care reform, even if a public option passes through the Congress at the federal level-- and especially so if one does not.