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The Federalist Option Gaining Steam?

By Big Tent Democrat, Section Other Politics
Posted on Wed Oct 07, 2009 at 05:51:44 PM EST
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Sam Stein:

Senate Democrats have begun discussions on a compromise approach to health care reform that would establish a robust, national public option for insurance coverage but give individual states the right to opt out of the program.

The proposal is envisioned as a means of getting the necessary support from progressive members of the Democratic Caucus -- who have insisted that a government-run insurance option remain in the bill -- and conservative Democrats who are worried about what a public plan would mean for insurers in their states.

This is the camel's nose under the tent compromise I support. Good to see it gaining traction.

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    The Federalist Option Gaining Steam? | 43 comments (43 topical)

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    As long as (5.00 / 3) (#5)
    by s5 on Wed Oct 07, 2009 at 07:40:45 PM EST
    The decision is (a) opt-out and (b) decided by legislators or popular referendum, rather by a governor.

    Structure it right and no one will opt out (5.00 / 1) (#11)
    by andgarden on Wed Oct 07, 2009 at 08:08:36 PM EST
    just tie it to funds the states don't dare refuse (Medicaid is the most obvious, but I would use the "death penalty" an attach it to highway funding).

    Parent
    Also (5.00 / 1) (#6)
    by s5 on Wed Oct 07, 2009 at 07:46:25 PM EST
    What happens to the individual mandate? I'm a supporter of mandates, but only in the presence of a good public plan. If we allow states to opt out of the public option, then we must allow them to opt out of the mandate, and with it, they would have to opt out of pre-existing condition coverage.

    In other words, we'd have to pass health reform for most states, no reform + subsidies for opt-out states. If that's how it has to be, then fine, it's not me who would suffer, though it would still be a continuation of the moral tragedy of our health care system in many parts of the country.

    I have to laugh (5.00 / 1) (#7)
    by Salo on Wed Oct 07, 2009 at 07:52:54 PM EST
    Just read iceb erg slim's Diary over at dkos. "this is not what I voted for" bwahahaha. What a sucker. She didn't notice certain things about her pick until now?

    Enough of the bitters. This idea has merit. Once people get to taste a clean glass of water they will not want to drink GOP sump oil.   I still don't trust Obama will deliver any sort of real reform though. Frist Daschle etc are theives like the rest. The very serious centrists are coming out of the woodwork to bail out the insurance companies. Mark my words

    No public option only mandates.

    I'm still (5.00 / 1) (#9)
    by Ga6thDem on Wed Oct 07, 2009 at 08:01:03 PM EST
    skeptical that there's going to be anything other than mandates to purchase junk insurance and changing the denial of preexisting condition status. I guess time will tell. One day it's news like this and then the next day it's a complete 180.

    please, please let this gain steam (5.00 / 1) (#13)
    by jes on Wed Oct 07, 2009 at 08:20:26 PM EST
    it would be Republican suicide to opt out. I also suspect we'll begin to hear much more "compromise" forthcoming from the Republicans in order to avoid this if it has a chance. By then, one would hope the train had left the station.

    They are not going to (none / 0) (#15)
    by Salo on Wed Oct 07, 2009 at 08:30:34 PM EST
    Compromise, but this does allow the blue dogs to weasel out without cost to themselves.

    Parent
    Help! from Texas (5.00 / 2) (#21)
    by TexasYellowDog on Wed Oct 07, 2009 at 08:48:21 PM EST
    Please don't throw us under the bus.

    Eat rubber, tejano! (5.00 / 1) (#22)
    by Salo on Wed Oct 07, 2009 at 08:53:46 PM EST
    Mwuhahahaha.

    Parent
    I guess we better learn to enjoy the view (none / 0) (#35)
    by easilydistracted on Thu Oct 08, 2009 at 07:27:54 AM EST
    from the drive-shaft.

    Parent
    From the "crying over spilt milk" (none / 0) (#1)
    by lilburro on Wed Oct 07, 2009 at 06:13:50 PM EST
    faction...

    The proposal is envisioned as a means of getting the necessary support from progressive members of the Democratic Caucus -- who have insisted that a government-run insurance option remain in the bill -- and conservative Democrats who are worried about what a public plan would mean for insurers in their states.

    You are certainly right - this option blows the cover of people like Conrad who need to pretend to be interested in something other than insurance companies, but who are actually exclusively about insurance companies.  I am impressed to see your idea picking up speed.

    But it doesn't seem like it was necessary to blow Conrad's cover in this way, by actually forcing him into this situation.  There was no.other.way to blow his cover than this?

    Finally I'm interested to see what Booman and other firm believers in 11th dimensional chess think of what is a flat-out compromise.  Is this "what Obama really meant"?  Based on what Booman's written I believe he thinks Obama wants a robust or modest public option.  This is a somewhat different beast.

    I guess people will be chattering away about it tonight.  My fear is that it will be a distraction that makes House Progressives who won't agree to it seem radical for not doing so (and there will be some of those), and that in turn will end up crumbling the public option entirely.  I think it's a bomb thrown into the Progressive bloc.  Maybe I'm wrong.  

    Sheesh... (none / 0) (#2)
    by lambert on Wed Oct 07, 2009 at 06:36:42 PM EST
    So the national health care plan -- whatever it turns out to be -- becomes a ceiling, not a floor, because states can't adopt single payer?

    Thanks, "progressives"....

    I'm a Centrist (none / 0) (#3)
    by Big Tent Democrat on Wed Oct 07, 2009 at 06:47:50 PM EST


    Parent
    I present everything (none / 0) (#8)
    by Salo on Wed Oct 07, 2009 at 07:55:51 PM EST
    I say as centrism to people I talk policy too. But I'm not being entirely forthcoming about my social democratic roots.

    Parent
    Thanks anyhow (none / 0) (#16)
    by lambert on Wed Oct 07, 2009 at 08:32:41 PM EST
    I mean, whatever, dude. The massive suckitude of the policy remains, regardless of how one identifies.

    Parent
    this one is Clintonian, (none / 0) (#4)
    by jeffinalabama on Wed Oct 07, 2009 at 06:48:44 PM EST
    as in 'Big Dog.' Get something like this that is moderately acceptible, then modify it in the future.

    Geez, I am not a BTD sycophant, but lately we agree a lot.

    But NOT on College football. I do hope Tebow is okay. Big Cranium at LSU's head is exploding on how to set up his defense, though...

    So, this is 1992, then? (none / 0) (#17)
    by lambert on Wed Oct 07, 2009 at 08:34:00 PM EST
    Good to know.

    Parent
    A real public option (none / 0) (#10)
    by oldpro on Wed Oct 07, 2009 at 08:03:21 PM EST
    with opt out is acceptable from this senate.

    Let's get to conference with it.  Works for me.

    Your mistake is in assuming that (5.00 / 1) (#14)
    by Anne on Wed Oct 07, 2009 at 08:29:07 PM EST
    whatever option - if indeed there is one - ends up with the word "public" in front of it will be "real."

    Honestly, as hard as some members of the Senate have been working to draw up something - anything - that they can call "public" and that still manages to be a boon to the insurance industry, there is no way in hell that we are going to get a "real" public option.

    If anything they were dreaming up were so great, they'd have the balls to make it go into effect in January of 2010, instead of putting it off for another three years.

    "Real," my a$$.

    Parent

    It's just a fight over words (none / 0) (#18)
    by lambert on Wed Oct 07, 2009 at 08:38:20 PM EST
    As soon as Baucus and the rest figure out that all "progressives" really want is the words "public option" so that they can declare victory, everything's going to be jake with the angels. In fact, it probably is already.

    Parent
    Don't tell me words mean nothing (5.00 / 2) (#19)
    by Salo on Wed Oct 07, 2009 at 08:44:25 PM EST
    Lol where have I heard that before.

    Parent
    No, fights over words have real consequences (none / 0) (#42)
    by lambert on Thu Oct 08, 2009 at 10:33:38 PM EST
    But the consequence isn't necessarily going to be health care.

    Parent
    Your mistake is in assuming that (none / 0) (#29)
    by oldpro on Wed Oct 07, 2009 at 11:05:16 PM EST
    I said what I meant...or that I meant what I said...or something like that.

    Never mind.

    Parent

    Truly (none / 0) (#30)
    by gyrfalcon on Wed Oct 07, 2009 at 11:07:32 PM EST
    it's not possible to get something like this up and running next year.  It's just not.  Realistically, it's a choice between starting it just before the 2012 elections or just after.  I know which one I'd choose because no matter how good it is, the intial implementation is going to be a big mess.

    Parent
    Pelosi asking PC to suck it up once again (none / 0) (#12)
    by MO Blue on Wed Oct 07, 2009 at 08:15:46 PM EST
    No surprise here. The weaker the bill coming out the House, the less chance of a public option in the Senate.

    In an interview with me, Dem Rep. Raul Grijalva described the scene in frustrated tones. He said House leaders acknowledged the popularity within the Dem caucus of the robust public option, but asked them to consider a public option where reimbursment rates are negotiated individually with providers. That's a solution Blue Dogs favor but liberals reject.

    "Unfortunately, the discussion was about negotiated rates," Grijalva told me. "We continue to be very much opposed to that." link

    If the House passes a public option with negotiated rates, the Federalist Option if adopted in the Senate, will also be based on negotiated rates.

    Is Nancy communicating (none / 0) (#20)
    by waldenpond on Wed Oct 07, 2009 at 08:46:59 PM EST
    with Reid at all?  A Federal plan that has individual states negotiating rates?  Yeah, that'll be efficient.

    Parent
    That's not the proposal (5.00 / 1) (#24)
    by Big Tent Democrat on Wed Oct 07, 2009 at 08:59:50 PM EST
    A FEDERAL plan negotiating rates.

    Parent
    Medicare +5 (5.00 / 1) (#25)
    by Big Tent Democrat on Wed Oct 07, 2009 at 09:00:10 PM EST
    as the rate BTW.

    Parent
    The Dems threw out caring about (none / 0) (#23)
    by MO Blue on Wed Oct 07, 2009 at 08:54:53 PM EST
    efficiency about the same time they threw out what would provide the most affordable health care.

     

    Parent

    It's efficiently delivering profit... (none / 0) (#43)
    by lambert on Thu Oct 08, 2009 at 10:34:48 PM EST
    ... to the health insurance companies.

    That's what you had in mind, right?

    Parent

    Terrible Plan (none / 0) (#26)
    by lcdrrek on Wed Oct 07, 2009 at 09:14:14 PM EST
    I posted this on Bob Cesca's Awesome Blog! just a short time ago:

    I think this is a HORRIBLE idea. Without the benefit of statistics, I would venture to guess that this will not make any improvement in the numbers of citizens who would benefit from Health Care reform.

    I would think that every state in the South and Southwest would "opt out". These states primarily have Republican Governors and Legislatures. If you can't get them to accept increased unemployment(Perry, Jindal, and every other Southern Governor) funding and money for high speed rail (Jindal).

    I would venture to guess that the citizens of the South and Southwest are probably the ones who need health care coverage the most. They will suffer the most with this option.

    South & Southwest (none / 0) (#27)
    by Ramo on Wed Oct 07, 2009 at 09:43:26 PM EST
    The only states where the GOP have a trifecta in this region are (IIRC):
    SC, GA, TX, and AZ

    We're likely to AZ-Gov in the next elections, and have a decent chance at the TX-House, GA-Gov, and SC-Gov.

    Parent

    Heh so now we're down to discussing (none / 0) (#36)
    by cawaltz on Thu Oct 08, 2009 at 07:51:24 AM EST
    which states it is acceptable to toss under the bus? Swell. I'm venturing the GOP are about to take Va. If I were Deeds I'd throw a Hail Mary and attempt to take advantage of this plan. Polls show most Americans want some sort of public option. He certainly can't do much worse then he's already doing.

    Parent
    Presumably... (none / 0) (#39)
    by Ramo on Thu Oct 08, 2009 at 08:50:54 AM EST
    ... states would be able to get back out of the bus if they changed their leadership.  I'm hopeful that my state (TX) could flip by the time the exchanges come online.

    BTW, the VA-Sen is still Dem.  I was making the point that all is not lost in the South & Southwest, as the previous poster asserted.

    Parent

    I they need it the most and (none / 0) (#31)
    by oldpro on Wed Oct 07, 2009 at 11:10:53 PM EST
    would suffer the most, then maybe those voters will wake the H@ll up at some election....?

    Parent
    Not likely! (none / 0) (#32)
    by lcdrrek on Wed Oct 07, 2009 at 11:51:44 PM EST
    Just take a look at electoral patterns since 1974.  The South has consistently trended to the right with the election of Nixon.  Just take a look at the "Tea Baggers".  Who are they???  White Southerners.

    This demographic has consistently voted against itself.  Poor white Southerners have been convinced by the Republicans that the answer is to continue and elect the very people who continue to "hold them down".  

    I would like to believe that they would someday wake up but I don't have much hope of that occuring.

    Parent

    Yup...and not only the white (5.00 / 1) (#34)
    by oldpro on Thu Oct 08, 2009 at 01:23:48 AM EST
    southerners...others as well.

    Once you are convinced you are a victim, you are more easily propagandized.  The southern myths re "the recent unplesantness" and the fundamentalist religious fervor play a big role among all races in the south, underscoring victimhood.  Combined with low educational achievement, low taxes, fewer services and values of a dubious nature...quite the political cocktail.

    Parent

    People make choices (none / 0) (#33)
    by MO Blue on Thu Oct 08, 2009 at 12:40:42 AM EST
    and choices have consequences.

    If there is a chance that the rest of the country could pay lower premiums and get more for their money, should they be denied that opportunity because a relatively small portion of the country makes poor choices.

    Parent

    Well (none / 0) (#38)
    by cawaltz on Thu Oct 08, 2009 at 07:53:59 AM EST
    if we get opted out then I definitely think we should be allowed to opt out of any taxes levied to cover this.

    Parent
    States would only be opting out of (none / 0) (#40)
    by MO Blue on Thu Oct 08, 2009 at 09:12:01 AM EST
    the public option and would still get the exchange. Also, unless you are receiving Medicare (budget cuts) the only tax you would pay under the Senate plan would be the Excise Tax for failing to purchase insurance. The taxes imposed upon high valued policies and medical equipment would probably cause everyone's insurance premium to go up.

    Some states opted out of the stimulus money and are now begging to get it, so there is a chance this would work like that. Also, there is a chance that people in your state might decide that they deserve better state representatives (Gov & Congress). It happened here in MO. Baby Blunt cut Medicaid and angered the citizenry so much that even the Republicans wouldn't vote for him.

    Then again the "public option" passed will probably be such weak tea that it may never get off the ground or fail within the first few years.

     

    Parent

    or maybe (none / 0) (#37)
    by cawaltz on Thu Oct 08, 2009 at 07:52:46 AM EST
    they'll blame the party that abandoned them for abandoning them. I know I will.

    Parent
    Well, I already did that! (none / 0) (#41)
    by oldpro on Thu Oct 08, 2009 at 12:54:29 PM EST
    A party that cannot even hold a full rollcall of states at their national nominating convention is not the party for me.

    I don't mind so much that 'the fix was in.'  What got me was they were afraid to test it in a public rollcall.

    The irony was dripping off the charade of nominating the 'transparancy candidate!'

    Where is Michael Moore when you need him?  Oh.  Right.

    We all have our blind spots, I suppose.

    Parent

    will GOP Gov. of CA speak up in favor (none / 0) (#28)
    by oculus on Wed Oct 07, 2009 at 10:46:11 PM EST
    Of this?

    The Federalist Option Gaining Steam? | 43 comments (43 topical)

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