The horizon is not so far as we can see, but as far as we can imagine

The House Bill Ain’t That Much Better

While I’m enjoying seeing some Progressives come out against the Senate bill, noting that it’s worse than nothing, the fact of the matter is that the House Bill wasn’t that much better.  The public option in the House bill was so weak that insurance provided by it was expected to have higher premiums than private plans, and while the subsidies were more generous they weren’t so high that they wouldn’t have driven many folks into bankruptcy.

I am heartened that there was a red line that some would not cross, especially my ex-colleagues at FDL, but I am mystified because the fundamental arguments that are being used apply almost as much to the House plan as the Senate plan with a few exceptions.

At this point I don’t suppose it matters.  The Senate plan is what’s going to pass, any changes to it will be minor, since Nelson and Lieberman will walk if anything major is changed and there isn’t a block of progressive Representatives with enough guts to threaten to do the same and mean it.

But I wonder if there’d been a firestorm earlier, from the left, pushing for a better House bill, if the envelope might not have been moved left enough to get a better bill.  This last minute firestorm, while welcome, seems unlikely to change anything.  Perhaps complaining earlier wouldn’t have either.  I guess we’ll never know.


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  1. I think a major difference between the two is the Excise Tax in the Senate, when combined with its awful employer mandate, will spread the sickness through the whole system faster. Ultimately the political fallout from the House plan would be somewhat limited, because, after all, it mostly screws the poor, and in America you rarely lose at the polls for doing that. The Senate version, on the other hand, will cost tens of millions of people the coverage they have through employers now, forcing them into the Exchange or onto lousier employer health plans. You could look at this in either a cynical way (progressive support for the bill drops when they might be its next victims) or a more charitable one (the Senate bill is objectively worse than no reform for millions of people), depending on your inclination.

  2. Ian Welsh

    Yes, I agree, the excise tax is the main difference (not the public option) but the public option is the headline reason.

  3. anonymous

    Gee, after all these months of punching the hippies, apparently it is still unthinkable to suggest Holy Joe and Ben Nelson be forced to back up their filibuster threats with an actual filibuster. As though a filibuster is the nuclear option and nothing can stop it, and you can’t even just let it run its course. That would be unprofessional and uncollegial to their fellow Senators. Seriously, how long could they last? Just more proof that nobody is committed to improving on the horrendous bills before them.

  4. I think the Public Option was always too important for the online progressives. They attached a lot of their faith in good government to it, to an unreasonable degree. They became emotionally invested, almost like with a child or a beloved pet. So when it got axed, they reacted accordingly. Likewise, before it got axed, they were willing to accept almost any odious bill so long as something called a Public Option was attached. The left’s response to the House bill, rather than being one of sustained revulsion, was muted praise, because it got their baby off the ground.

    Everyone thinks their child is special.

  5. To tell you the truth, I don’t think complaining earlier would have done any good, at least once we started down the road of trying to pass a public option. Whether even demanding single-payer would have worked as a starting point, thus getting us to a viable public option. The progressives in Congress are so outnumbered by conservatives and DLCers, (the latter being just as happy to shill for insurance and medical corporations as conservatives), I just don’t see how we could have gotten a good deal without Obama’s insistence.

    I hope I’m wrong, and that there was just a strategy we didn’t pick up on, because there’s a whole lot more that’s going to go wrong in the next ten months if we can’t figure out something.

  6. Umm, “viable public option is open to question

  7. John J. Sears, think again. You can psychoanalyze all you want, but the plain fact is that the reason many of us wanted the public option was that we just didn’t trust the government to make the insurance companies do the right thing. I see no reason to change that opinion at this point, either.

  8. Ian Welsh

    No, the progressives aren’t outnumbered in the House. The progressive caucus is larger than the blue dog caucus, for example. The difference is that the blue dogs are willing to stand up and the progressives aren’t.

  9. S Brennan

    I offer these politically feasible band-aids…once again

    1] Extend Medicare downwards to 50 to those willing to pay a 6% payroll tax with an exemption tied to the poverty level [in today’s terms about 12,000.00]. So somebody making 48,000 would pay about 180/month for REAL COVERAGE. It is at 50 that single policy holders get taken to the cleaners and employers actively discriminate due to health insurance costs [yes it’s against the law, but the “Jackson 5” of the “Supremes” just re-wrote the law last July]. If you lose your job/income you are still covered by this plan.

    2] Take John Kerry’s 2004 idea of all citizens being covered by a catastrophic plan of 20,000. No moral hazard here…who wants to get that sick? Insurance no longer have any reason for dropping folks when they need insurance most.

    3] Expand the VA system, nobody who put his ass on the line deserves to die of a preventable illnesses due to lack of insurance. If your DD-214 says honorable, you’re covered for life. No more status reviews, no more having to prove to a partial legal ajudicator that your injury is service related…end those abuses. Who pays/ 1% capitol gains..let ’em whine about paying taxes to people who protect them…and their money. This helps young, patriotic, lower class folks, start families.

    4] Establish denial of claims court, no more of one party to a contract being the final arbitrator of it’s enforcement. Want to deny a claim? Fine have a Senior Company Executive and his lawyer make a case and take it to an elected judge. I think that will put an end to “frivolous” denials. Oh, triple fines for “frivolous” denials.

    5] Drug pricing needs federal regulation. I have somebody else buy a drug I use. Why? Because even though they pay all costs, they get charged 30.00, while I get charged 326.00 for the same drug. Suppose your neighbor paid less than 10% of what you paid for electricity? Every year, citizens wind up in emergency rooms and subsequently die because they could not afford to buy drugs that are available in every other developed country for 1/ extreme cases 1/10th the price…who pays for that final emergency care? Next patient please. A fair pricing schedule that limits extremes should not be beyond the bounds of government. We regulate electricity and other utilities…are medicines less of a utility?

  10. The progressives are the second-largest caucus. The (Republican) Conservative caucus is the largest. Add up the Conservative caucus, the Blue Dogs, and the DLC, and that’s way more than there are progressives.

    I don’t disagree that the progressives have done a lousy job of standing up. They have. At least once in the last year they should have stood up and just said no to something, to see if the conservatives could work around them. But they never did, and we’re already seeing signs that they won’t now.

    In the end, that fact makes our argument theoretical. We can’t tell what would have happened if they had stood up.

  11. Don’t get me wrong Cujo; I don’t trust the private insurers either.

    But the public option in the House bill is so weak it will be beaten in the exchange. It’s not tied to Medicare rates, or even Medicare+5, and the risk adjustment mechanism is so weak it will be the site of massive patient dumping.

    So, putting a lot of hope into the House version of the PO was not a realistic scenario.

  12. Celsius 233

    The House Bill Ain’t That Much Better;
    okay, whats to be done about it?

  13. Since I’m never cynical enough, I’ll just say that a firestorm earlier would have jeopardized access, but a firestorm now sets up the next funding cycle.

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