Moving forward on health care

It’s Labor Day week-end, but the political world does not appear to have gotten the memo as the past few days have brought plenty of high-profile developments. And it looks like the left found itself at the short end of the stick. How much should be read into Van Jones’s resignation can be debated, but the story’s basic schema doesn’t leave much to interpretation: The Fox News consortium went after a White House employee and the White House chose not to put up much of a fight.

The Administration’s transparent disinterest in helping Jones did not leave the environmentalist any other option than resigning. While some will say this episode is not characteristic of Barack Obama’s relationship with the right, the health care debate as it is unfolding at the moment leaves very little to the imagination. Faced with a choice between fighting dozens of liberal House members who have pledged to oppose a public option-less bill and pressuring centrist Democratic Senators, only two of which recently indicated their opposition to a public option, he has shown every intention of choosing the former.

Obama’s health care strategy will be clearer later this week, after the president addresses Congress. But the White House has allowed so many leaks about its willingness to jettison the public option that it already looks clear which camp they will choose when push comes to shove in the coming weeks. In the inevitable showdown between the Senate Finance Committee and the Congressional Progressive Caucus, I would be surprised if it’s the former group that gets angry phone calls from the president.

How much of a compromise Obama will propose for is still very much an open question, but what is starting to come in sharper relief is how far to the right Max Baucus would like to push health care reform. In what is the week-end’s second important development, the Chairman of the Senate Finance Committee signaled he is close to releasing his full plan - and things aren’t that pretty for liberals.

Unsurprisingly, the bill contains no public option. More surprisingly, it also does not propose a trigger, despite the fact that Olympia Snowe and Ben Nelson recently voiced their support for that idea - nor nor does it look like it will include the co-op plan that has been so hotly debated by moderate Democrats over the past few months. If negotiations depend on starting positions, it looks like Baucus has decisively outplayed progressives by not even acknowledging the need for any non-profit plan whereas House liberals long ago agreed to throw single-payer overboard.

Just as unsurprisingly, Baucus’s draft contains lower subsidy levels than the bills that have passed the Senate’s HELP Committee and the 3 relevant House committees. It also would amount to a far lower percentage of medical expenses paid by insurance for a given population: less than 70%, estimates the New York Times, compared to 70% to 95% for the House bills. In short, the bill could force individuals to buy insurance from private companies with relatively little help from the government and too timid limits on out-of-pocket expenses for it to be clear that this is worth their investment.

What is most striking is that it is unclear who Baucus is offering concessions to. Neither Chuck Grassley nor Mike Enzi have signaled any willingness to sign up to such a plan, despite the fact that it is far to the right of anything House Democrats are proposing. Since it is still unclear what Snowe’s end game is, Baucus has essentially given up on much of his party’s reform agenda - including provisions he himself supported last year - without any guarantee that any Republicans will back him in return. What better illustration that, in the health care fight, House progressives’ most formidable opponents are not Republicans but centrist Democrats?

One good news all proponents of health care reform should take out of the week-end: The process finally looks to be moving forward. Over the past few months, Baucus had single-handedly slowed down the debate by forcing Democrats to give the Gang of Six time. With the Montana Senator unwilling to even propose a bill in front of the full the Finance Committee, most congressional Democrats were condemned to waiting - and that undoubtedly heightened the stakes of August’s congressional recess.

But now that Baucus looks to be just days away from pushing the Finance Committee forward, we can look forward to negotiations picking-up along more concrete lines. First, within the Finance Committee, where Jay Rockefeller will no doubt have a lot to say about Baucus’s draft; then, between Finance and HELP, as the two committees’ bills will have to be reconciled; then, on the Senate floor, where a lot will depend on whether Massachusetts Democrats allow Deval Patrick to appoint Teddy Kennedy’s successor; and finally in the conference committee, where the confrontation between Baucus’s Senate allies and the CPC should reach fever pitch.

There’s still a long way to go, so for now I’ll go back to Labor Day.

3 Responses to “Moving forward on health care”


  1. 1 YSF

    One wonders from time to time whether Baucus’ bill is actually Obama’s — whether they’re working together behind the scenes to make the health care project work. Meanwhile, what will happen when this bill hits the Senate floor? Without Kennedy, is Baucus going to be the principal player in deciding where this bill goes?

  2. 2 fritz

    If the Baucus plan has no public option, no trigger or co-op option he may have trouble getting enough Democratic votes to get it out of committee. No matter what he proposes there will only be a single possible Republican vote (Snowe) and Democrats like Schumer, Rockefeller and Kerry may feel they cannot support a plan without even a fig leaf of the trigger or co-op idea.
    In the end I think Obama will get most of what he wants and he will sign a major plan with major reforms.
    The pundits and press have underestimated Obama since he began his trek to become POTUS. Two years ago they said he was to soft on Hillary and had to attack her; he had to defend himself more vigorously against the Wright/ Ayers attacks; he could never pass a 700 billion dollar stimulus package; his budget was just too big to pass; he could never get a cap & trade through congress etc. In the end he almost always got what he wanted and he will get a health insurance reform plan passed as well.
    One final comment. The USA is the only country on this planet that I can think of (rich or poor - powerful or not) that if its government offered universal health care, for free or a small fee, a large part of its population would say no we want to pay for our own health care. We don’t trust our government (Democrat or Republican) to be able to provide this crucial service to its population without destroying the fabric of the nation.
    This debate; government run health care or any other government run social program is inherently evil or at least foolhardy; would not happen in any other nation.

  3. 3 Maurice

    I have the sense that the West Virginians could block an option-less bill singlehandedly. And what I don’t understand is that Crapo isn’t attracting any attention. He is sort-of open to an option, with whatever’s wrong with his son. There’s some coverage clause he wants to add that would cover mental disabilities better, but I guess that this is just too liberal for any Idaho Senator. If you go back to Frank Church, he could do anything; he himself was at least a 75% Kennedy nationwide.

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