Reid Ready With Opt Out Public Option

By Big Tent Democrat, Section Other Politics
Posted on Mon Oct 26, 2009 at 09:55:10 AM EST
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Looks like it is just about official - Reid putting in opt out public option:

According to news reports, Senate Majority Leader Harry Reid is sending the Senate's health care bill to the Congressional Budget Office today, and may unveil the bill publicly as early as tomorrow. [. . .] The bill reportedly includes a public option, but states may opt out of the program.

Some bad things in the tradeoff -- no employer mandate, just the ineffective free rider provision (also a Baucus/Snowe idea.) I think it is worth that trade - having the public option in this bill is, imo, the most important and critical part of this reform package (in terms of assistance, it is not - the Medicaid expansion provisions are). There are many many other terrible things in the Baucus bill (a few good ones not related to reform) like the excise tax. But the public option looks like it is in. That is reform that will work. Exchanges and all the other gizmos the Beltway Wonks love will not. The camel's nose under the tent that is the public option is THE essential element of the reform in this bill. Some of the rest is good of course, but not reform that will work.

Speaking for me only

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Reid Ready With Opt Out Public Option | 39 comments (39 topical)

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Once the public option makes it through (5.00 / 3) (#1)
by andgarden on Mon Oct 26, 2009 at 10:01:54 AM EST

everything else can be taken care of in conference.

I don't care about employer mandates. (5.00 / 2) (#2)
by inclusiveheart on Mon Oct 26, 2009 at 10:16:41 AM EST

In fact, I'd rather get off of this employer based system altogether. I think, it may be a good thing not to mandate employer insurance. It will ultimately increase the need for and use of a public option. Of course, we still have no idea about affordability where it comes to this public option, but still it is a better direction to go in - especially considering how many small businesses and self employed people who are basically paying extra to cover the big corporations' discounts on premiums for their employees.

: I read somewhere that .... (5.00 / 1) (#11)
by magster on Mon Oct 26, 2009 at 10:46:56 AM EST

... the way the employer mandate provision was weakened incentivized employers to hire either only the well-to-do, the already insured or illegal immigrants and that the people who need jobs the most are left out.

: Agreed (none / 0) (#5)
by Carolyn in Baltimore on Mon Oct 26, 2009 at 10:29:51 AM EST

With no employer mandates there will be more demand for the government program and more pressure on insurance premium collectors to compete.

Not sure who deserves the credit.... (5.00 / 1) (#3)
by magster on Mon Oct 26, 2009 at 10:22:27 AM EST

... but there clearly was a progressive strategy to pressure Reid primarily over Obama and all other players in the last two weeks. Whether it was the progressive caucus, MoveOn, FDL, Progressive Change Campaign, the unions, Schumer/Rockefeller or all combined, the strategy seems to have worked.

"Level play field" may be the camel's (5.00 / 2) (#25)
by oculus on Mon Oct 26, 2009 at 11:40:04 AM EST

nose under the tent, but doesn't seem to me to have the potential to ever be a "robust public option." It is conditioned on not imposing price controls on big Pharma etc.

: Cost controls on Big Pharma..... (none / 0) (#32)
by vicndabx on Mon Oct 26, 2009 at 12:40:31 PM EST

Watch the 800lb gorilla come over and sit on the camel's nose and force him out of the tent. No one knows how much all those docs, hospitals and labs are gonna charge. This program has to be small. As it is the risk is huge the costs are going to be unpalatable to taxpayers.

: Robust? (none / 0) (#39)
by norris morris on Mon Oct 26, 2009 at 10:40:37 PM EST

No. We will not see a robust bill, and from what I'm reading here I have the sinking feeling that there is a willingness to accept a bad bill because it has a title and a smidgen of something decent.
This is not healthcare reform. It's being snookered. Bait and switch just like MedicareRX Plan D dreamt up by the Republicans and shoved through by Tom Delay at midnight. Literally.
Can we really be this stupid? Rejecting a bad bill and demanding and demonstrating for a good one is the only answer. Back to square one.
Accepting a rotten almost totally compromised piece of crap would be inexcusable, and we will deserve what we're willing to demand.

This part: (5.00 / 1) (#26)
by TeresaInSnow2 on Mon Oct 26, 2009 at 11:40:55 AM EST

According to the Wall Street Journal, it also includes a $750 fine per employee for employers who don't provide insurance and whose workers receive government subsidies for health insurance.

Oh goodie. This will simply mean that (1) these employers will pay the fine because it's still cheaper than insurance; (2) they'll hire fewer employees and work them harder.

...unless the employers don't need to PAY for insurance, simply need to provide it for employees to buy.

And how will this affect part-time jobs?

I thought we needed to create jobs, not take them away.

Congrats Obama... (none / 0) (#4)
by Addison on Mon Oct 26, 2009 at 10:24:21 AM EST

...now (assuming the above bill gets past the Senate, goes through conference and winds up in some form on POTUS' desk) every historical reference to "your administration's" health care reform will be qualified -- either publicly (doubtful) or in the head of everyone who's been following all this -- with the fact that you didn't really support it, apparently fought against it, and in the end you signed a piece of legislation brought into being by other people's courage.

This cannot be undone by your taking credit for it, or through a self-congratulatory SOTU, of course.

You will either have to sheepishly mention health care reform or blithely take credit for something that, by all available accounts (though maybe Bob Woodward will show us the truth in a few months?!?) you fought against.

How dignified.

How did we get from (5.00 / 1) (#22)
by gyrfalcon on Mon Oct 26, 2009 at 11:26:21 AM EST

Obama being a bystander to "fought against it"? Far as I can tell, he hasn't fought for or against anything on this, good or bad.


At some point, I think one has to (5.00 / 1) (#30)
by Anne on Mon Oct 26, 2009 at 11:55:21 AM EST

acknowledge that even passive resistance is still resistance; this is one reason I have always taken Obama's "make me do it" to really mean "you can't make me."

However you define the terms, one thing seems clear to me: there has been a pretty shocking lack of courage and leadership from this White House, and I think it bodes ill for any number of big issues ahead.


: "you can't make me" is really just (none / 0) (#38)
by Inspector Gadget on Mon Oct 26, 2009 at 06:04:23 PM EST

a different way to spell "I'm the Decider."

Seems clear they were pushing against it (none / 0) (#29)
by Big Tent Democrat on Mon Oct 26, 2009 at 11:50:22 AM EST

late last week.


What gets me (none / 0) (#6)
by Steve M on Mon Oct 26, 2009 at 10:30:01 AM EST

is Ben Nelson's position that opt-in is okay, but opt-out is not. What the heck is that all about?!

I will never be able to understand the completely arbitrary places where the Senate moderates choose to draw the line. But I'm pretty sure Ben Nelson will not be filibustering opt-out, even if he claims not to like it.

I think people missed the real import of Nelson's (none / 0) (#8)
by Big Tent Democrat on Mon Oct 26, 2009 at 10:34:13 AM EST

words. It's not the opt in/opt out - it is the robust vs. level playing field.

Unfortunately, I think Schumer has already cut a deal on this. He was talking "level playing field opt out" yesterday.

The other bad thing is Obama's dithering has hurt in the House so I think we do not get robust public ption to take to the conference.

The deal looks like it will be level playing field opt out.


Re: Robust (none / 0) (#13)
by lilburro on Mon Oct 26, 2009 at 10:49:47 AM EST

public option in the House...we may still get that I think. How? As far as I'm aware Pelosi still has not busted out the official full CBO score for her favorite bill. She could make a strong argument for something stronger than what the Senate produces based on the numbers. However I don't think Obama will have her back on this and she'll be left out to dry.


The House (none / 0) (#24)
by jbindc on Mon Oct 26, 2009 at 11:33:32 AM EST

is having troubles with their numbers

Health care legislation taking shape in the House carries a price tag of at least $1 trillion over a decade, significantly higher than the target President Barack Obama has set, congressional officials said Friday as they struggled to finish work on the measure for a vote early next month.
Democrats have touted an unreleased Congressional Budget Office estimate of $871 billion in recent days, a total that numerous officials acknowledge understates its true cost by $150 billion or more. That figure excludes several items designed to improve benefits for Medicare and Medicaid recipients and providers, as well as public health programs and more, they added.
The officials who disclosed the details did so on condition of anonymity, saying they were not authorized to discuss them publicly.

: Opponents of a PO in the House (none / 0) (#28)
by Big Tent Democrat on Mon Oct 26, 2009 at 11:49:43 AM EST

are having trouble with the numbers you mean.
This is a obviously a slanted leak to hurt the PO.
Is the "shortcoming" the doctor reimbursement issue? Cuz then it is a lie from the leakers that it has anything to do with the Health Care bill.

President Helpless (none / 0) (#7)
by Carolyn in Baltimore on Mon Oct 26, 2009 at 10:32:15 AM EST

Maybe Obama secretly wants a decent public option but since he bargained it away he can now be all helpless with the insurance companies saying the Congress went beyond what he wanted.....
So he can take credit in public but still get the contributions from industry.
Maybe we can do this with wall street reform too.....

Maybe a slogan for it would help (none / 0) (#9)
by SOS on Mon Oct 26, 2009 at 10:39:58 AM EST

"It's about you" . . "Your the Chooser" . . "We work for you" . . "My Public Option" . ." YouHealth"

A fund raising bonanza! (none / 0) (#10)
by mmc9431 on Mon Oct 26, 2009 at 10:42:02 AM EST

The opt out clause is going to be a fantastic windfall for fund raising on both sides. Since each state will be able to make their choice, I bet politicians across the country will be seeing dollar signs in their sleep.

The insurance industry isn't going to go quietly into the night.

Will states run a referendum or will it just be up to state's legislature?

The Ninth Dimension of (none / 0) (#16)
by magster on Mon Oct 26, 2009 at 11:06:16 AM EST

11 dimensional chess: Provide economic stimulus to the states to create jobs in the state lobby, media and legal industries in the state-by-state fight to opt-out.


: Every two years (none / 0) (#17)
by Fabian on Mon Oct 26, 2009 at 11:17:42 AM EST

it seems that millions of dollars pour into the pro/anti gambling lobby.
I think we should play up that economic activity. Look! Elections are good for the economy!

It's going to be interesting to (none / 0) (#12)
by dk on Mon Oct 26, 2009 at 10:49:37 AM EST

watch the A-list suddenly remove the word "robust" from their vocabulary. But, this is really more about marketing versus good public policy, anyway, IMO.

When will the public option kick in? (none / 0) (#14)
by BDB on Mon Oct 26, 2009 at 10:49:58 AM EST

I'm skeptical about the whole camel under the tent theory, but I'd love to be proven wrong and have a public option genuinely lead to better healthcare reform. One of the things that makes me skeptical is that it looks like a lot of the bad, likely unpopular things kick in immediately, but the public option doesn't kick in until 2013. So if there is a public uprising over the bad parts of the bill it might not be accompanied by a demand to expand a public option that doesn't exist yet and nobody has any experience with.

Also, a question, what do you mean by no employer mandate? Because the one thing that has seemed sacrosanct to the White House has been a mandate (which is how its buying off the insurance industry).

: Individual mandate (none / 0) (#23)
by gyrfalcon on Mon Oct 26, 2009 at 11:28:48 AM EST

not employer mandate.

State option (none / 0) (#15)
by Stellaaa on Mon Oct 26, 2009 at 11:03:19 AM EST

What does that mean politically? It just means that DC is spreading the wealth. Sending some insurer lobby money to their state cousins, sure, why leave them out.

Now the insurance companies will have to mount campaigns in each state and we (the opposition) will have to fight with meager resources.

Now that is what I call stimulating the economy.

: Insurance companies state campaigns (5.00 / 2) (#31)
by MO Blue on Mon Oct 26, 2009 at 12:02:59 PM EST

paid for with taxpayer money and increased premiums.
Gee, aren't we lucky. We get to pay for the insurance industry to screw us every which way.

Reid Press Conference Today (none / 0) (#18)
by Alvord on Mon Oct 26, 2009 at 11:20:29 AM EST

Reid will announce his decision at the press conference.

Don't dismiss the value of health exchanges. (none / 0) (#19)
by steviez314 on Mon Oct 26, 2009 at 11:23:25 AM EST

They allow small businesses (and individuals) to get insurance at large group rates (or basically community rated rates) rather than the small-group or individual rates. This is not nothing.

The thing about the opt-out (none / 0) (#20)
by CST on Mon Oct 26, 2009 at 11:25:20 AM EST

public option is - it better work, and well at that. If it works well, the opt-out states will eventually opt-in. If not..

This should be a good test of the effectiveness of the policy.

The devil is in the details (none / 0) (#21)
by TheRealFrank on Mon Oct 26, 2009 at 11:25:52 AM EST

Opt-out after, say, 2 years would be good. Undoing the public option would be political suicide then.

However, immediate opt-out would be a political disaster. It would basically extend the shouting and anti-reform ads until next fall. And, of course, it would make people in a number of states the victims of grandstanding Republicans.

And BTW (none / 0) (#27)
by TeresaInSnow2 on Mon Oct 26, 2009 at 11:41:47 AM EST

is Reid facilitating a PUBLIC OPTION or a "public option".

It will be interesting to see the bill.

Can states out of the taxes too? (none / 0) (#33)
by roy on Mon Oct 26, 2009 at 01:38:08 PM EST

One of the concerns -- I haven't researched carefully enough to say how realistic -- about a public option is that it will fail to be self-funding. Even private insurance companies, whose primary goal is profitability, sometimes lose money. So the public option may require subsidization from federal tax money. Opting out of participating in the plan, but still being required to help fund it, is a mere facade of federalism.

Disclosure: I live in Oregon, the only way we'll opt out is to implement an even stronger public option.

The states (5.00 / 1) (#34)
by CST on Mon Oct 26, 2009 at 01:53:52 PM EST

that are most likely to opt-out (red states) generally receive more federal funding than per capita than blue states. So yes, they will still have to pay federal taxes. And even without the public option, will probably still receive even more money back from the gov't per capita than blue states. I pay subsidies for farmers in the midwest too, and transportation projects all over the country. This isn't that different.


Strange way of looking at it (none / 0) (#36)
by roy on Mon Oct 26, 2009 at 02:35:37 PM EST

The imbalance in tax benefits among states may make the opt-out proposal fair (though to me, it illustrates that we should stop using federal money for farm subsidies and intrastate travel projects), but it doesn't make it honest to call the proposal "federalist" or even a real "opt-out".

Is it OK to lie to welfare recipients just because they get more in government benefits than they fund in taxes? Obviously no, and would be similarly wrong to mislead the voters of Alaska on the HCR issue.


: I really don't follow (none / 0) (#37)
by CST on Mon Oct 26, 2009 at 02:52:19 PM EST

First of all, if you don't use federal funds for interstate travel projects, what do you use? This will still cause an imbalance in funding. So will welfare. That's the nature of the federal beast.
When the republican senators of certain states were trying to "opt-out" of the Stimulus funding on "federalist" principles, what was that? We didn't make up this language, we're just borrowing it.
Finally, I don't think anyone here is trying to "mislead" voters. I would like nothing more than to have the voters of Alaska stand up and say "we will not accept an opt-out". Including it in the bill is not in some hope that these voters will be duped and we can take all their federal funding, it's in the hope that they will stand up and demand the program.

I just watched Reid's announcement (none / 0) (#35)
by kenosharick on Mon Oct 26, 2009 at 02:33:11 PM EST

and he did not seem too enthusiastic- but then again, he never does.