12.09.2009

We might just have a health care bill, with a public option by another name

From the amazing Bob Cesca, here and here:

Chris Bowers writes that the battle for the public option was fairly successful, despite the compromise:
--4 million more people covered by Medicaid, which is a public option, than the July version of the House bill
--1-2 million covered by a Medicare buy-in, which is also a public option, and which was entirely absent in the July version of the House bill

--An increase, from 85% in the July House bill to 90% now, in the percentage of money companies receive on health insurance premiums that must be spent on health care.

These are all concessions directly made to progressives in return for dropping a Medicare +5% public option that would have covered 10 million people. Not bad.
And this doesn't even count future expansions. I don't know what to make of the compromises yet, but I don't think they can be interpreted as a loss. In fact, I think the Medicare buy-in will have a better chance of expanding into something like Medicare For All than the opt-out public option would've.

As near as I can tell, here's the substance from the Gang of 10 negotiations.

--Public option becomes a trigger.

--The (Swiss) OPM plan replaces it. Non-profit policies negotiated by the government. If the privates don't offer adequate non-profit deals, the public option is triggered. My hunch is the CBO will score this as having much better premiums than the opt-out public option.

--Medicare buy-in for high-risk people 55-64 beginning a year from now. Everyone else 55-64 can buy in when the exchanges begin in 2014. Don't tell your favorite conservadem, but this is our path to single-payer. This bill will establish a precedent for lowering the buy-in age for Medicare. Expect further lowerings over the years, but only if we demand it. Single-payer was always going to be a work in progress, but now we have a template.

--Increased regulations on the private insurers, according to Brian Beutler. This is great news. Now what will this include?

Overall, I hesitate to call this good news. Anything we like will probably be dropped before Noon.

Benen:
As for the political implications, how on-the-fence senators will respond to the compromise is anyone's guess. Will Lieberman balk because there's a trigger? Will Snowe reject it because of Medicare expansion? Will House Dems oppose it over changes to the public option? Will Ben Nelson move away from the bill just because?
Even senators within the Team of 10 aren't sure. Sen. Jay Rockefeller (D-W.Va.) was delighted with the deal, but Sen. Russ Feingold (D-Wis.) hinted that he's now on the fence because of changes to the public option.

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