The Public Option for Obamacare Was Not Impossible
***This is a Guest Post by Dan From T.O.***
Back in 2009-2010, Chris Bowers, co-founder of openleft.com, (at the time an “A-List” liberal/progressive blog by all accounts*) and Adam Green of the PCCC led a set of outsider “whip count” exercises in support of improving & passing the Affordable Care Act.
- The initial whip count effort in 2009 was focused on garnering 60 votes for cloture in the Senate in support of a public option (the House bill had one). This actually succeeded,** and had all 60 Democratic senators on the record in support of a public option, until 4 Senators backed out.
- In early 2010, a whip count was run to gain Senate support to pass health care under reconciliation rules (meaning only 51 votes were needed for passage). This also succeeded, and ultimately the ACA included a “side-car” reconciliation fix once Democrats lost the 60th vote in the Senate via the MA Senate special election.
- Concurrently with #2, another whip count was run to pass a public option via reconciliation. This also succeeded and Bowers & Co had 50 or 51 Senators publicly in favour of passing a public option through reconciliation.
All this is to say: The Public Option was very plausible. Even Joe Lieberman & Ben Nelson were open to it and, really, they weren’t needed as it could have been done under reconciliation. Is it 100 percent certain that it could have passed? Of course, no counterfactual can be perfectly certain. Given how close Bowers et al. got without much support from the Democratic leadership, and in fact the secret opposition of Obama who had traded away the Public Option, it is not ascribing magical powers to the Bully Pulpit to think that if Obama had wanted a Public Option in the bill, he could have got one.
The history here in this set of posts by Bowers is worth a review of the chicanery in play. In both occasions, progressive activists were given seemingly impossible tasks to get a public option passed, did so, and somehow had the goal posts moved. The posts read like a House of Cards plot to manipulate activists; not giving them what they wanted while still appearing sympathetic. For instance, this excerpt from Bowers’ 2009 post-mortem:
Back on May 21st, there were only 28 Senators in support of a triggerless public option. Through your tireless participation in a whip count effort, by October 8th we raised that number to 51 when Jon Tester came out in support. By October 30th, when Evan Bayh said he wouldn’t filibuster, we were up to 56 Democrats for cloture on health care reform with a public option.
From that point, the only four Senators we still needed all lied to us in one form or another. Both Mary Landrieu and Blanche Lincoln signed a document stating that they supported a public option, only to reverse their positions. Blanche Lincoln’s website still comically claimed she supported a public option even as she was declaring her opposition to one on the Senate floor.
Still, Landrieu, Lincoln and Ben Nelson were all part of the group of ten Senators who forged a deal on the public option that included a Medicare buy-in. Further, immediately after that deal was reached, Harry Reid contacted Joe Lieberman to see if he liked the deal. Lieberman told Harry Reid that he was liking what he was seeing, and just wanted to wait for the CBO report. Further, Lieberman had supported an even stronger Medicare buy-in (for Americans aged 50-64) as recently as September 2009.
Six days later, Lieberman and Nelson went on national television to engage in some more mendacity. Lieberman said he would filibuster the deal, despite the facts that he’d told Reid he liked it and had recently advocated for it. Ben Nelson badmouthed the deal even though he helped forge it.
Tell me that does not read like Obama’s team working behind the scenes to flip Lieberman & Co. back to ensure the deal with Pharma was kept.
The demise of the Public Option in the 2010 effort comes off about as bad, with a bad-faith exercise in finger pointing between the House & Senate over who should add the Public Option to the bill, and even a bonus arm-twisting of Bernie Sanders to try to prevent him from doing so by amendment.
All of this is “I told you so” of course, but I-told-you-so is important at times so mistakes aren’t repeated. The ACA is most likely going to be gutted or repealed entirely and the lack of a Public Option has certainly not helped it ever get the strong base of public support it needed to survive a term of opposition government. If one reviews the history of polling on the ACA, it is clear that between the “it’s ok” camp and the “it needs to be expanded/made more liberal” camps there is consistently well over 50 percent support for it, but in straight up approval polling, the law was always more unpopular than popular.
The theory from the law’s proponents back in 2009-10 was that once it took effect and started helping people, it would get more popular. This was plausible except that it isn’t really what happened–probably because private insurance companies are awful to deal with. Thus, more people felt the ACA was hurting rather than them as time went on:
The public option would have meant that those people finding they hated the exchanges could have opted out of that mess and bought into some version of government provided plan that could have been simple, not subject to major price changes, and regular cancellations (frequently a problem for ACA plans). It also would have meant more people attributing their shiny new access to health care to Obama and the Democrats which only could have helped in those mid-term blowouts.
Like his unforced errors on the too-small stimulus, HAMP helping banks instead of people and not prosecuting Wall Street fraud, this error is on Obama: He chose to not have a public option in the ACA and if he’d wanted one, it is quite likely he could have had it.
* – See here for Hillary Clinton herself being sent an openleft.com post from 2010 per the Podesta email dumps.
** – Sorry, link rot has really set in on a lot of this. Someone (Bowers himself possibly) is maintaining the archive of openleft.com posts I am linking to but most of the links from those posts no longer work.