A Progressive Victory?
Posted on Sat Mar 06, 2010 at 07:42:26 AM EST
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That entire line of "argument" is just demonstrably false, and either intellectually dishonest or blinded by egregious cynicism. Here are two huge public option concessions that ended up in the Senate bill as concessions to progressive activists and members of Congress 1. Four million additional Americans covered by Medicaid [. . .] 2. Twenty-five million additional Americans provided public health care[.]
Before unpacking Chris' factual claims, let me first say that if this is Chris' idea of "huge concessions," I think we have identified one of the major problems. In the scheme of things, if these two changes amount to "huge" concessions, then progressive activists should just pack it up. This was the largest Dem majority in Congress since LBJ. As I wrote in a post, Is That All There Is? But moving on to the accuracy of Chris' claims regarding the accomplishment, Chris writes:
Back in July, the health reform proposal in the House (PDF, p. 17) expanded Medicaid coverage by 11 million compared to current law. In an attempt to win over the 60 House Progressives who demanded a public option tied to Medicare rates, Speaker Pelosi increased the Medicaid coverage in the health reform proposal to 15 million more than current law. This was done entirely as a sweetner to Progressives, most of whom come from districts with a disproportionately large number of constituents who would be eligible for Medicaid expansion. Furthermore, even though it was accomplished through a slightly different policy means, that expansion of Medicaid to 15 million more people than current law remained in the Senate bill (CBO report, PDF, page 20)
What Chris is saying is that the concept of Medicaid expansion was NOT a concession to progressives, but increasing that expansion in the House bill was. And he has a link to a discussion of the final version of the House bill:
Expansion of Medicaid to 150% of FPL. All three versions of the bill passed by the committees over the summer would have expanded Medicaid to 133% of the Federal Poverty Level. Pelosi’s bill goes a step further and expands it to 150% of FPL, which is $33,075 in annual income for a family of four. This is being added as a sweetener to progressives, some of who are going to feel burned by the decision to go with the weaker public option plan.
Let's stop for a moment and absorb Chris' reasoning. Chris argues that because the House version of the health bill included a higher level of Medicaid expansion, progressives won a "huge concession." There is one little problem with Chris' formulation -- the Senate bill does not contain that "huge concession." Neither does the President's proposed fixes.
But Chris argues that this "huge concession" was "accomplished through a slightly different policy means, that expansion of Medicaid to 15 million more people than current law remained in the Senate bill (CBO report, PDF, page 20). Slightly different means Chris? Whatever do you mean? Let's look at Chris' link to the CBO report (PDF):
Starting in 2014, most nonelderly people with income below 133 percent of the FPL would be made eligible for Medicaid. [. . .] [T]here would be roughly 15 million more enrollees in Medicaid and CHIP than is projected under current law.
It's an amazing thing. I'm curious to see an explanation of how you can have the same level of enrollment in Medicaid at 133% of FPL as you do at 150% of FPL. More importantly, if Chris is right, then the "huge concession" of getting 150% of FPL in the House bill was entirely meaningless as that increases the number of insured under the Medicaid expansion NOT AT ALL according to the CBO. (For those who trust the CBO implicitly, you may want to consider this little piece of data.)
Let's consider the other huge concession won by progressives according to Chris (this one is on much more solid ground as it is in the Senate bill), Bernie Sanders' provision for $10 billion for community health centers (free clinics):
A $10 billion investment in community health centers, expected to go to $14 billion when Congress completes work on health care reform legislation, was included in a final series of changes to the Senate bill unveiled today. The provision, which would provide primary care for 25 million more Americans, was requested by Sen. Bernie Sanders (I-Vt.).
He said the additional resources will help bring about a revolution in primary health care in America and create new or expanded health centers in an additional 10,000 communities.
I'm glad Sanders was able to get this in the bill and $10 billion dollars (not going to be $14 billion as was in the House bill now) is nothing to sneeze at, but Sanders' hyperbole (as well as Chris') about providing health care to 25 million Americans is, well, absurd. Let's do the math - $10 billion equals $1 billion per year for 25 million Americans. That translates into an expenditure of $40 per year per covered individual. I guess that is providing some little bit of health care to 25 million Americans, but Chris' extravagant claim is just plain ridiculous.
It is a nice provision, but if it is all you have to brag about, and it is, at the end of the health care bargain, then you failed.
This is no slight to the efforts of all the people who did a lot more than me (not hard considering I did precisely nothing) to push for progressive health care reform. But if you can not recognize your failures, then you can never learn from them and you can never improve in your future efforts.
Chris Bowers, a staunch progressive activist, who put his heart and soul into this effort, along with millions of others, was part of that failure.
I can understand the resentment he feels when he hears people in the peanut gallery (namely me) state that their efforts were a failure. But that does not change the fact that it was indeed a failure.
And guess what, we have not even gotten to see what will be done for Stupak. It gets worse from here. Not better.
Speaking for me only
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