Yes!

[Political Waves]

Old wiggly Harry Reid is the Progressive hero of the moment; he's resurrected the Option from the Senate bills and made the announcement today that the Public Option lives. It's hard to argue with three-quarters of the nation -- especially those who have followed the horror stories the industry has given us about babies too thin, or too fat, or born with cleft palate or whatever unhappy glitch that's being called a pre-existing condition ... straight out of the womb and NOT GOOD ENOUGH ... until there's just no end to the black hole of fraud they've perpetrated on the average Joe/Jane and family. They've got nobody to thank but themselves.

First article is about Reid and the Option; second is Krugman telling us what it will look like and lifting our hopes -- last one is about the Dems pushing for active signs of help next year, giving them something to run on ... and I'm firmly in their corner.
Unless we have some visible signs of relief to stop the Great Disenchanted from punishing this president for the mess he inherited, we'll have more wingnuts in Congress next year -- and the VERY FIRST thing they're going to do is write up an article of impeachment. Count on it. That squeal of obstructive political mechanization would take us on into 2012 when someone being very quiet at present ... like Jebby, for instance ... steps up on the Right and looks like the last bastion of sanity.

Don't stop signing those petitions or making those phone calls -- it's been over 40 years since something this remarkable happened; we need to see this through to a signature ... then we can exhale!

Jude



Reid: "The Public Option With An Opt-Out Is The One That's Fair"
HuffPo
10-26-09
http://www.huffingtonpost.com/2009/10/26/reid-the-public-option-wi_n_334284.html

 
The public option lives.

Senate Majority Leader Harry Reid (D-Nev.) announced Monday that the bill he will bring to the Senate floor will include a public health insurance option that individual states could decline to participate in.

"I've concluded --with the support of the White House, Senators Dodd and Baucus -- that the best way to move forward is to include a public option with the opt-out provision for states," said Reid, referring to the Senate health and finance committee representatives, respectively, Sen. Chris Dodd (D-Conn.) and Sen. Max Baucus (D-Mont.). "The public option, with an opt-out, is the one that's fair."

[open link for video]

Reid has been pushing the so-called opt-out public option for the last several days and has spoken to nearly all 60 members of the Democratic caucus. He needs 60 votes to end an expected Republican filibuster and move the bill to the floor.

"We've spent countless hours over the last few days in consultation with senators who've shown a genuine desire to reform the health care system. And I believe there's a strong consensus to move forward in this direction," Reid said.

By including the public option in the bill before it goes to the floor, Reid is offering conservative Democrats a fig leaf of sorts. They can cast a vote in favor of ending a GOP filibuster -- when 60 votes are required -- but then vote against the public option later when the matter is debated on the floor, and only 50 votes are needed for victory. The move is also a gift to liberals, as the specific provision won't need to reach the traditional 60-vote threshold that is so often the death of genuine reform legislation.

Reid's move is a risky one, as a Senate Democratic leadership aide acknowledged Saturday to HuffPost. "The leadership understands that pushing for a public option is a somewhat risky strategy, but we may be within striking distance. A signal from the president could be enough to put us over the top," said the aide.

CNN reports that White House Press Secretary Robert Gibbs said in a written statement that President Obama is "pleased that the Senate has decided to include a public option for health coverage." CNN also reports: "An administration official went so far as to call Reid's move 'dangerous' but quickly followed by saying Reid knows his caucus better than anyone and will therefore have the support of the White House."

With high risk comes high reward, however. The public option's inclusion in the final bill would be one of the most significant progressive legislative achievements since the Great Society. The White House and centrist and conservative Democrats have been frustrated by liberals' strong demand for it, arguing that there is much more to health care than simply the public option and that only 10 to 12 million would be eligible to participate in it. Over the summer, Obama called it a mere "sliver" of reform.

Progressives, however, see the public option as the most realistic way to move the United States toward universal health care. Even those who are not eligible would benefit indirectly, they argue, as health insurance companies would be forced to reduce premiums to stay competitive.

The insurance industry sees the threat of the public option clearly. Karen Ignagni, President and CEO of the lobby group America's Health Insurance Plans (AHIP), blasted Reid's decision.

"A new government-run plan would underpay doctors and hospitals rather than driving real reforms that bring down costs and improve quality. The American people want health care reform that will reduce costs and this plan doesn't do that," she said in a statement. "The divisive debate about a government-run plan is a roadblock to reform. It's time we focus instead on broad-based reforms that will ensure the affordability and sustainability of our health care system."

But the public option is not just longed for by liberals. Recent polls have shown that roughly six in 10 Americans want a public plan that would compete with private insurance. Those polls were heard loudly in Congress. "All the national polls show a wide majority of Americans support the public option," Reid noted.

Reid appears to be within just a few votes of the 60 he needs. Putting the public option into the bill forces those holdouts to show their cards, and dares them to oppose their own leader on the party's most ambitious reform effort in nearly half a century.

Sen. Mary Landrieu (D-La.), a public option opponent, has said that while she disagrees with the policy in question, she isn't inclined to join Republicans in sinking the entire reform effort over it.

"I'm not right now inclined to support any filibuster," she told HuffPost last week. The refusal of the GOP to participate meaningfully in negotiations has soured her on joining them in a filibuster. "For the Republican Party to kind of step out of the game is very unfortunate," she said. "I'm not going to be joining people that don't want progress."

Sen. Ben Nelson (D-Neb.), another public option foe, wouldn't commit when asked last week. "I believe in playing chess, but that's about three moves ahead of me, and I'm not prepared to make those moves until I see some other moves in between," he told HuffPost.

Sen. Mark Pryor (D-Ark.), a conservative Democrat, sounded as if he could embrace Reid's strategy after meeting with the leader last week. "I'm open to a public option," he said.

Progressives oppose the opt-out provision that Reid intends to include to win conservative support, arguing that Americans in conservative states that may opt out are in just as much need of a public option as are residents of blue states.

Sen. Lamar Alexander, a Republican leader from Tennessee, said on the Senate floor Monday, in advance of Reid's announcement, that the opt-out provision isn't to be taken seriously. Medicaid, he noted, has an opt-out provision, but not one state has opted out. Public health insurance, in other words, is too popular for states to opt out.

At a meeting at the White House on Thursday evening, Reid told the president that he intended to push forward with the national public option with an opt-out provision. Obama, several sources said, indicated a preference for a "trigger" instead: the public option would only be brought into existence if the insurance industry failed to meet certain criteria in a certain period of time.

Yale professor Jacob Hacker, the intellectual father of the public option, however, dismissed the trigger.

"The trigger is an inside-the-beltway sleight of hand that would protect private insurers from the real competition that a strong public health insurance option would create," he said. "It is unworkable in the current Senate bills, unwise as public policy, and unwanted by the substantial majority of Americans who say they want a straight-up public option." ++


After Reform Passes
PAUL KRUGMAN, NYT
October 25, 2009
http://www.nytimes.com/2009/10/26/opinion/26krugman.html

So, how well will health reform work after it passes?

There's a part of me that can't believe I'm asking that question. After all, serious health reform has long seemed like an impossible dream. And it could yet go all wrong.

But the teabaggers have come and gone, as have the cries of "death panels" and the demonstrations by Medicare recipients demanding that the government stay out of health care. And reform is still on track. Right now it looks highly likely that Congress will, indeed, send a health care bill to the president's desk. Then what?

Conservatives insist (and hope) that reform will fail, and that there will be a huge popular backlash. Some progressives worry that they might be right, that the imperfections of reform - what we're about to get will be far from ideal - will be so severe as to undermine public support. And many critics complain, with some justice, that the planned reform won't do much to contain rising costs.

But the experience in Massachusetts, which passed major health reform back in 2006, should dampen conservative hopes and soothe progressive fears.

Like the bill that will probably emerge from Congress, the Massachusetts reform mainly relies on a combination of regulation and subsidies to chivy a mostly private system into providing near-universal coverage. It is, to be frank, a bit of a Rube Goldberg device - a complicated way of achieving something that could have been done much more simply with a Medicare-type program. Yet it has gone a long way toward achieving the goal of health insurance for all, although it's not quite there: according to state estimates, only 2.6 percent of residents remain uninsured.

This expansion of coverage has tremendous significance in human terms. The Kaiser Commission on Medicaid and the Uninsured recently did a focus-group study of Massachusetts residents and reported that "Health reform enabled many of these individuals to take care of their medical needs, to start seeing a doctor, and in some cases to regain their health and control over their lives." Even those who probably would have been insured without reform felt "peace of mind knowing they could obtain health coverage if they lost access to their employer-sponsored coverage."

And reform remains popular. Earlier this year, many conservatives, citing misleading poll results, claimed that public support for the Massachusetts reform had plunged. Newer, more careful polling paints a very different picture. The key finding: an overwhelming 79 percent of the public think the reform should be continued, while only 11 percent think it should be repealed.

Interestingly, another recent poll shows similar support among the state's physicians: 75 percent want to continue the policies; only 7 percent want to see them reversed.

There are, of course, major problems remaining in Massachusetts. In particular, while employers are required to provide a minimum standard of coverage, in a number of cases this standard seems to be too low, with lower-income workers still unable to afford necessary care. And the Massachusetts plan hasn't yet done anything significant to contain costs.

But just as reform advocates predicted, the move to more or less universal care seems to have helped prepare the ground for further reform, with a special state commission recommending changes in the payment system that could contain costs by reducing the incentives for excessive care. And it should be noted that Hawaii, which doesn't have universal coverage but does have a long-standing employer mandate, has been far more successful than the rest of the nation at cost control.

So what does this say about national health reform?

To be sure, Massachusetts isn't fully representative of America as a whole. Even before reform, it had relatively broad insurance coverage, in part because of a large union movement. And the state has a tradition of strong insurance regulation, which has probably made it easier to run a system that depends crucially on having regulators ride herd on insurers.

So national reform's chances will be better if it contains elements lacking in Massachusetts - in particular, a real public option to keep insurers honest (and fend off charges that the individual mandate is just an insurance-industry profit grab). We can only hope that reports that the Obama administration is trying to block a public option are overblown.

Still, if the Massachusetts experience is any guide, health care reform will have broad public support once it's in place and the scare stories are proved false. The new health care system will be criticized; people will demand changes and improvements; but only a small minority will want reform reversed.

This thing is going to work. ++


Dems push for benefits to start by 2010
Carrie Budoff Brown, Politico
October 25, 2009
http://dyn.politico.com/printstory.cfm?uuid=8E2ADEC2-18FE-70B2-A83F7BB1FC15ECD2

Democrats are pushing Senate leaders and the White House to speed up key benefits in the health reform bill to 2010, eager to give the party something to show taxpayers for their $900 billion investment in an election year.

The most significant changes to the health care system wouldn’t kick in until 2013 — two election cycles away. With Republicans expected to make next year a referendum on health care reform, Democrats are quietly lobbying to push up the effective dates on popular programs, so they'll have something to run on in the congressional midterm elections.

Democrats are anxious to mix the good with the bad since some of the pain would be phased in early, including more than $100 billion in industry fees that critics say could be passed on to consumers.

“We want to be able, within the cost framework and the implementation framework, to have as much start as early as possible, even though we know all of it can’t,” said Sen. Debbie Stabenow (D-Mich.), a Finance Committee member who is working with other senators on the effort. “And the White House wants to have as much as possible to start.”

Under the Democratic wish list, senior citizens would receive discounts on brand-name drugs next year. Small businesses that provide insurance would see tax credits. And a $5 billion high-risk pool would cover people with preexisting conditions.

Democratic strategists expect the 2010 election to present a stark contrast between the parties, particularly if the health care bill receives minimal Republicans support. The front-load strategy could help blunt GOP attacks on the bill as a toxic mix of higher taxes, rising premiums and cuts to Medicare.

The strategy also could ease some of the disappointment among voters who expect more immediate reforms than the bill can deliver, including on the much-debated public insurance option. Democrats in both the House and the Senate are closing in on finding the votes to include some form of a public option in the bill, but a government-run insurance plan would likely be one of the last pieces to kick in fully, if it passes.

“Democrats will be the party that passed health care reform, and Republicans will be the party that tries to repeal it,” said Jim Kessler, vice president for policy at the centrist Third Way. “The challenge on health care has always been to demonstrate to the middle class that this bill is really for them and that it will provide them stable coverage that they can count on through thick and thin.

“It’s important to have a few things to point to that go into effect right away,” Kessler said. “This is a case where good policy and good politics coincide.”

Texas Sen. John Cornyn, chairman of the National Republican Senatorial Committee, said the strategy was a transparent attempt to paper over the less palatable aspects of the bill.

There are billions in new taxes on insurers, device manufacturers, and pharmaceutical companies that come due in 2010.

Starting in 2013, insurers that offer family plans worth more than $21,000 per year would pay a tax, which unions say would hit middle class families. Beginning in 2014, the penalty on people who do not purchase insurance would kick in. The changes to Medicare funding, which Democrats say is aimed at redirecting wasteful spending but Republicans say would hit senior citizens, would be implemented immediately.

“I can understand their desire to have some fig leaf to protect them against understandable voter concern about the fact that insurance premiums are going to go up. You are taking half-trillion dollars from Medicare and you are going to raise taxes on middle class families,” Cornyn said. “Those are unpopular positions, so I can understand their desire to front-load and show something for it.”

A Kaiser Family Foundation poll released last week showed Democrats risk disappointing voters with the delayed timetable, which lawmakers view as necessary given the complexity of implementing the reforms.

The survey found voters are unaware that the major components — $450 billion in subsidies to purchase coverage and a menu of insurance market reforms — wouldn't kick in for four years. Forty-nine percent of respondents said they expected people to begin receiving financial assistance to buy coverage this year or next. Fifty-one percent said they expected insurers to begin accepting customers regardless of preexisting conditions this year or next.

The Senate Finance Committee has already posted a one-page memo on its website titled “What You Get Right Away: Immediate Relief for Families and Small Businesses.” The Health, Education, Labor and Pensions Committee, which also passed a health care bill, prepared its own list of immediate benefits.

Both documents read like a blueprint of Democratic talking points for the 2010 elections.

“It helps to have more to run on in the midterms and to prime the pump for 2012,” said a senior Democratic aide of the front-load strategy. “Also, you want to have real, practical effects folks can feel right away so the issue is a clear tangible — not just rhetorical — victory. It’s a big part of this.”

Stabenow said she is working with other senators to influence the closed-door negotiations among Senate Majority Leader Harry Reid (D-Nev.), White House chief of staff Rahm Emanuel, Finance Committee Chairman Max Baucus (D-Mont.) and Sen. Chris Dodd (D-Conn.), who is representing the HELP committee. In several cases, the HELP bill offers earlier effective dates on key provisions — and Stabenow and others are pressing Reid to go with the more immediate approach.

“We want to have as much front-ended as possible,” Stabenow said.

The Senate HELP bill would immediately require family policies to cover young adults until age 26, while the Finance bill sets up a “young invincible” policy beginning in 2013.

Both Senate bills establish a reinsurance fund that protects early retirees from losing their health care coverage, but only the HELP bill kicks into effect immediately. Pushed by Stabenow and Sen. John Kerry (D-Mass.), the fund would cover catastrophic claims of retirees between 55 and 64 who receive coverage through employer-based plans.

Insurance companies would be required to report the proportion of premium dollars that are spent on items other than medical care. Hospitals would need to itemize charges so consumers could compare prices. States would be compelled to establish an insurance ombudsman office that would intervene with companies on behalf of consumers.

Under both bills, people who have been denied insurance due to pre-existing conditions or who have been uninsured for six months could seek coverage in a high-risk pool available in 2010.

Out-of-pocket costs for prevention and wellness programs under Medicare would be eliminated in 2010 under the HELP bill and 2011 in the Finance bill.

“Anything that we can do to realize reforms that won’t take money upfront and at the same time create real relief for families, we are for,” said New Jersey Sen. Robert Menendez, chairman of the Democratic Senatorial Campaign Committee. ++


"I'm asking you to believe. Not just in my ability to bring about real change in Washington ... I'm asking you to believe in yours."
~ Barack Obama

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