Progressive Bargaining With A Dem President

Greg Sargent reports on this letter from Progressive Block leaders Representatives Raul Grijalva and Lynn Woolsey:

Dear President Obama:

Thank you for continuing to work with Members of Congress to draft a health reform bill that will provide the real health care reform this country needs.

We look forward to meeting with you regarding retaining a robust public option in any final health reform bill and request that that meeting take place as soon as possible.

[MORE . . .]

Public opinion polls continue to show that a majority of Americans want the choice ofa robust public plan and we stand in solidarity with them. We continue to support the robust public option that was reported out of the Committees on Ways and Means and Education and Labor and will not vote for a weakened bill on the House Floor or returning from a Conference with the Senate.

Any bill that does not provide, at a minimum, a public option built on the Medicare provider system and with reimbursement based on Medicare rates-not negotiated rates-is unacceptable. A plan with negotiated rates would ensure higher costs for the public plan, and would do nothing to achieve the goal of providing choice and competition to keep rates down. The public plan with set rates saves $75 billion, which could be lost if rates are negotiated with providers. Further, this public option must be available immediately and must not be contingent upon any trigger.

Mr. President, the need for reform is urgent. Every day, 14,000 Americans lose their health care coverage. We must have health care reform that will effectively bring down costs and significantly expand access. A health reform bill without a robust public option will not achieve the health reform this country so desperately needs. We cannot vote for anything less.

We look forward to meeting with you to discuss the importance of your support for a robust public plan, which we encourage you to reiterate in your address to the Joint Session of Congress on Wednesday.

Lynn Woolsey

Raul Grijalva

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  • Display: Sort:
    What they're asking for (none / 0) (#1)
    by andgarden on Thu Sep 03, 2009 at 05:02:06 PM EST
    is even stronger than what was reported out of energy and commerce, which didi not retain Medicare reimbursement rates in the public plain.

    This letter is written to the President, but I'm guessing the message is directed at House leadership. They will be passing their own bill soon.

    If they stick with this approach, (none / 0) (#8)
    by MO Blue on Thu Sep 03, 2009 at 05:34:25 PM EST
    they could actually wind up with a viable public option. All they would need to do is open up the eligibility more.

    Anything less than a public option built on the Medicare provider system and with reimbursement based on Medicare rates-not negotiated rates-would IMO be structured to fail.


    woo hoo (but) (none / 0) (#2)
    by Capt Howdy on Thu Sep 03, 2009 at 05:02:51 PM EST
    should come with a pronouncement breakdown.

    Spanish is an easy language (none / 0) (#3)
    by Steve M on Thu Sep 03, 2009 at 05:08:58 PM EST
    There is only one way to pronounce a given word, once you know the rules.  Much better than English in that regard.  In this case the pronunciation is gree-HAHL-vah.

    Except Xavier Becerra is pronounced (5.00 / 2) (#5)
    by magster on Thu Sep 03, 2009 at 05:27:08 PM EST
    I wish the same 60-65 congresspeople... (none / 0) (#4)
    by magster on Thu Sep 03, 2009 at 05:24:13 PM EST
    ...had co-signed this letter.


    Diana DeGette announced in a radio show I was listening to this morning on my way to work that she would not vote for a bill that excluded a public option.  She hadn't signed that letter or committed to FDL's whip count previous to today, so she is one more on our side.

    think people are reading onto that incorrectly (5.00 / 3) (#6)
    by Big Tent Democrat on Thu Sep 03, 2009 at 05:27:23 PM EST
    Everyone is still scattered all over the country.

    coordinating a letter would be near impossible.

    these are the co-chairs.


    You could do it in the Senate (none / 0) (#7)
    by andgarden on Thu Sep 03, 2009 at 05:33:40 PM EST
    because all Senators have autopens.

    Lots of House Chiefs of Staff have their boss's signature down tho.


    Pelosi just made a strong statement (none / 0) (#9)
    by magster on Thu Sep 03, 2009 at 05:48:23 PM EST
    I think her statements (5.00 / 1) (#11)
    by dk on Thu Sep 03, 2009 at 05:57:56 PM EST
    leaves wiggle room for a trigger.  I could, of course, be wrong.  If I'm right, though, the question will then become what are the conditions for the trigger.

    Well (none / 0) (#12)
    by Ga6thDem on Thu Sep 03, 2009 at 06:26:20 PM EST
    I dont have much faith in Ms. Pelosi so I feel the same way you do.

    Yup. I heard her on C-SPAN (none / 0) (#16)
    by oldpro on Thu Sep 03, 2009 at 07:42:42 PM EST
    and I agree...she can be rolled with a trigger...IF she can hold the votes together in the caucus.

    The clue was that she went on and on about President Obama's wonderful leadership.  Twice.

    Whatever he decides, I think she'll roll.  Once again, who will want to kill the President's number one domestic priority?  Again?


    Fabulous (none / 0) (#10)
    by andgarden on Thu Sep 03, 2009 at 05:52:32 PM EST
    This (none / 0) (#13)
    by Ga6thDem on Thu Sep 03, 2009 at 06:26:54 PM EST
    is an excellent letter. It lays out exactly what they want. I hope they keep this up.

    I will say again (none / 0) (#14)
    by TeresaInSnow2 on Thu Sep 03, 2009 at 06:46:50 PM EST
    that I don't know about other states, but in states like mine where 57% of doctors have said they've stopped taking Medicare patients because of the reimbursement rate, Medicare as it stands isn't a very good answer:

    Here's a link from 2002.  I've seen more recent ones, but somehow can't find them today:



    And here's an editorial written by the director of a large clinic in Washington State in regards to his experience with Medicare:

    You can say, "greedy doctors," but that argument doesn't matter. Doctors don't have to take Medicare patients.

    Congress either has to regulate reimbursements for all insurance or increase Medicare reimbursement.  If neither is done, adding even 10 million additional patients to a Medicare-like system will only make patient's access to doctors even worse (at least in my state).

    If you think it's a win that they are not considering better reimbursement rates for the Public Option than Medicare provides, it may be an empty victory.  The public option may become just another form of "junk insurance".  You're in it, all right, but you can't find a doctor.

    A couple of things to (5.00 / 1) (#15)
    by MO Blue on Thu Sep 03, 2009 at 06:59:42 PM EST
    consider. It is my understanding that at least one House bill and the Senate bill contains a provision to increase the Medicare rates in rural areas. That provision would actually go into effect in 2010. Also, IIRC the actual rate structure in the strongest House bill sets the rates as Medicare +5.

    People go where the money is. (none / 0) (#17)
    by Fabian on Fri Sep 04, 2009 at 06:36:49 AM EST
    If a substantial portion of the market is Medicare-like, then providers will move into that market.  Especially if the insurance companies make it less and less attractive to purchase their products.