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Healthcare: Your mom is a public option (abortions void where prohibited)
werehippy
Registered User regular
Registered User regular
There've been some developments on the healthcare front and there are going to be a lot more coming fast and furious in the near future, so it seemed time to kick of the next iteration of the perpetual healthcare thread.
For those of you just joining us: The House has three committees who have jurisdiction over healthcare, all three of which worked together and passed nearly identical bills months ago. The Senate has two committees involved; HELP, a more liberal committee that passed a bill before the summer recess, and Finance, a more conservative committee that just finally passed a bill recently.
Since the last thread closed: The Senate has been working to combine the bills in closed door meetings between Reid, Sen Harkin (from HELP, representing the 30 odd progressive Democrats), Baucus (from Finance, representing the 10-15 conservative Dems), and a few members of the White House Team in a hands off roll. Things are moving extremely well there, with Snowe (the one Republican vote that has been courted) being shunted off a bit, the public option becoming a matter of what kind not will it exist at all, and brand new and fantastic, insruance companies being stripped of their antitrust exemption.
On the House side Pelosi has been coming out absolutely full bore in favor of a robust public option. She's up to 210 of the 218 votes she needs for a robust public option, and she submitted a request to the CBO to get the various options fully scored out, hoping for a big saving from the public option to push the last few votes she needs off the fence.
From here we need to wait and see how Pelosi's play works out and just what exactly the Senate brings to the floor out of this first round of closed door negotiations. That should likely play out within the next two weeks, at which point the House will vote relatively and the Senate will drag a fair bit as the republicans have explicitly planned to do everything possible to drag out the proceedings. There are almost certainly enough votes to break a filibuster and pass a bill, so after another couple weeks of foot dragging both chambers will have bills, at which point everything goes into a closed door reconciliation with representatives of the House, Senate, and White House. Ideally we'll see final deal and a bill up for a vote before mid-December.
For those of you just joining us: The House has three committees who have jurisdiction over healthcare, all three of which worked together and passed nearly identical bills months ago. The Senate has two committees involved; HELP, a more liberal committee that passed a bill before the summer recess, and Finance, a more conservative committee that just finally passed a bill recently.
Since the last thread closed: The Senate has been working to combine the bills in closed door meetings between Reid, Sen Harkin (from HELP, representing the 30 odd progressive Democrats), Baucus (from Finance, representing the 10-15 conservative Dems), and a few members of the White House Team in a hands off roll. Things are moving extremely well there, with Snowe (the one Republican vote that has been courted) being shunted off a bit, the public option becoming a matter of what kind not will it exist at all, and brand new and fantastic, insruance companies being stripped of their antitrust exemption.
On the House side Pelosi has been coming out absolutely full bore in favor of a robust public option. She's up to 210 of the 218 votes she needs for a robust public option, and she submitted a request to the CBO to get the various options fully scored out, hoping for a big saving from the public option to push the last few votes she needs off the fence.
From here we need to wait and see how Pelosi's play works out and just what exactly the Senate brings to the floor out of this first round of closed door negotiations. That should likely play out within the next two weeks, at which point the House will vote relatively and the Senate will drag a fair bit as the republicans have explicitly planned to do everything possible to drag out the proceedings. There are almost certainly enough votes to break a filibuster and pass a bill, so after another couple weeks of foot dragging both chambers will have bills, at which point everything goes into a closed door reconciliation with representatives of the House, Senate, and White House. Ideally we'll see final deal and a bill up for a vote before mid-December.
werehippy on
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Well, it's basically built into the idea. Collective action and all when you're the only one (or one of few) opting out while the rest of the country goes for it and gets better care.
Is the stripping anti-trust thing really sticking? I'd have thought the insurance companies would be fighting tooth and nail to get it removed.
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There's a bunch of committees each versions of the bills have to go through, then reconciled, then reconciled between Senate and House so...process time.
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Haha, me too actually. That was one of the links I read today that made me want to start up the thread, and once I was home I couldn't find it to save my life. I'm pretty sure it wasn't in TMPDC, just because I checked pretty thoroughly. Do you read Ezra Klein or Tapped? There's got to be an overlap somewhere.
A few conservative Democrats realized how many political IOUs they could get by pretending to be on the fence.
The problem is the insurance industry tried unloading their big guns, and promptly got curb stomped. So they're really going to eat the short end of the stick on this one, both because they've got nothing left to negotiate with and because the democrats really wanted to kick their ass anyway to bring a scalp back to the voters.
No idea if it'll really go the distance, but the fact it's a legitimate possibility at this point is noteworthy enough. When they're fighting for your lives they aren't going to be doing much undermining elsewhere in the bill.
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[5e] Dural Melairkyn - AC 18 | HP 40 | Melee +5/1d8+3 | Spell +4/DC 12
The Democrats have no where near the discipline and uniformity of the Republicans, which has its benefits and, as we are seeing now, its costs. Also, there are two members of the Democratic caucus who are independents: Sanders and Lieberman. Sanders is a socialist though (a real one), so we don't have to worry about him nearly as much Lieberman in joining a filibuster from the right.
So there are a few members in the Democratic caucus that threaten to derail things if they join the Republicans in filibustering, but there's probably a safe buffer if they just vote against the bill after voting for cloture. However Harry Reid is an invertebrate, so it is an open question whether he will be able to keep the conservadems in line without completely selling out on the bill. Some people are growing very cynical about it.
Sounds...fun.
Best I could find describing it. If it's submitted to the CBO I'd imagine we'd get more details of it.
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[5e] Dural Melairkyn - AC 18 | HP 40 | Melee +5/1d8+3 | Spell +4/DC 12
Whenever they talk about "robust public option" they are talking in code about how claims pricing is handled. Unless they are Senator Wyden, that is.
Basically, they want to set payment rates to piggyback on the Medicare pricing for a "robust public option", and pay out the same amount plus a small percent higher (5% in the house bill, 10% in the HELP committee bill I believe). This means that the claims will be lower, theoretically pushing down premiums. The potential problem is doctors bristling against being paid less and refusing to accept the patients covered under the public option. Also, insurance companies could be run out of business due to the price competition, though there probably aren't too many people here who will feel too bad about that.
That's the one. And it's buried in the links, but Pelosi was within 8 votes of passing it. With a good CBO score and with the wind at the Dems back, it could happen. And if not, the fallback is still something we were reaching to get to a month ago.
Oh I see. Dropping the claims costs is an idea I've had in mind but I've always figured it wouldn't fly because of the doctors wanting to make money. Like it's one thing to drop administrative costs on asshole companies, but when you get to the people doing the hands on work it gets a little harder (in my opinion, at least).
If it could be done, I will be amazed.
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[5e] Dural Melairkyn - AC 18 | HP 40 | Melee +5/1d8+3 | Spell +4/DC 12
If the hit on bargaining power isn't that bad, keeping the public option out of the loser states might actually help it stay solvent.
Guess it would depend on the population differences between the opted-in and opted-out. Don't the Blue states (California in particular) account for quite a bit of the population of the US?
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[5e] Dural Melairkyn - AC 18 | HP 40 | Melee +5/1d8+3 | Spell +4/DC 12
To the best of my knowledge, Dean is considered pretty fearsome.
Yeah, the states that wouldn't opt out of it would represent a pretty hefty majority of the population. There are only a handful of the really populous states, like say Texas and Florida, that I would consider it even remotely likely of opting out.
I don't think the states opting out would be enough to seriously effect the negotiating clout of the public option. Those states might run into some trouble due to uncompetitive markets though.
He really wasn't ready to be a presidential candidate, but since then he's kicked ass. I'm so looking forward to watching him kick Rove's ass up and down a stage next week.
See here we have the public option and theres a private option for those that want fancier, faster treatment which they pay for themselves. Theres no reason the companies will go out of business, just that they won't be able to gouge and grow fat on the lives of ordinary people anymore.
Maybe, you know, they should have thought about doing that...months ago?
They can lower their costs too, and still get fucking rich. Just not as quickly or as much as they'd like. They don't have to go out of business at all though.
Seriously, this. I can't even remember what blog it was (Klein or Yglesias, I think), but some random internet guy brought it up when the public option was supposedly on it's last legs and started bitching about how it should have been Medicare Part E for Everyone and I had a face palm moment, it was that perfect.
The problem with baby steps is that if a babystep passes, a lot of people in the government will set the entire thing on the back burner.
Edit - Unless you mean proposal. In which case I don't know.
The House hasn't really been the main threat to derailing this thing though, even though there were some periods where some of the Blue Dogs have been puffing up their chests trying to water things down. It's the Senate that has been the truly dysfunctional part of the equation, especially with all of the BS in the Finance Committee.
The Senate in its current form is pretty awful on an institutional level.
i love the idea of the insurance companies losing their antitrust exemption, npr had a particularly nice explanation of it as i didnt really understand it until today. Bonus because you could hear the snark in the reporter basically shouting "hell yes." (donate to npr :P)
It is more my annoyance that single payer was thrown out before this even started. I put this on the house, senate and a bit on Obama. The Senate though is more with a few conservative Democrats who just seem to be doing because they are bought (Bacaus) or because they have no spine (Reid). To tell the truth Pelosi and the house have actually made me rather happy recently. If they do go with a Medicare E idea I will be very happy with them.
A jellyfish would be a pretty good whip, if you used the stingers.
Portuguese Man O' War ring any bells? :P
I love the removal of the anti-trust exemption too, but I don't quite understand how it fits into the reform exactly. Not in terms of costs and lowering them and such. I mostly love it because it's a kick to the nuts to the assholes who abuse the system as it stands, and if anyone knows me I'm all for dicking over the abusive rich.
Dean also (mostly) has the simple position of Medicare for everyone wooooo.
He's awesome either way, of course.