A trigger option that doesn't suck?

http://thinkprogress.org/2009/11/27/trigger-urban-institute/

Early discussion of Olympia Snowe's trigger option faded away because Democrats feared the trigger would never be pulled, and Republicans didn't want to do anything at all. But Obama and Reid are looking for a way out of the current impasse.

Now there is a new trigger proposal that links the trigger, not to local affordability of coverage, but to national rates in the growth of health spending. The former is a trigger which probably would never be pulled, but the latter, if it's written correctly, would be much more likely to be triggered. And it could lead to a robust public option, not just the negotiated/out-out option Reid offered as a sop to moderates. It would probably make Snowe happy, and therefore win the support of the Blue Dogs Democrats and Obama. And it wouldn't need reconciliation, probably.

White House preparing for reconciliation option

After the CBO scores the Reid bill, it could hit the Senate floor next week. Clinton told the caucus of Democratic Senators – you’re going to do it, pass the bill – but Lieberman, absurdly, claims that because Clinton didn’t specifically browbeat Democratic Senators to support the public option, he was really telling them to drop it. Nelson wants the bill to have a positive vote of support not only from the CBO but also from Snowe; Landrieu wants the same things (although she admits that the bill has improved). Bayh is still wimwamming about the medical device makers; Conrad hasn’t criticized the Reid bill but won’t commit to it either.

With all this howling by the Blue Dogs, Gibbs at the White House is openly threatening the use of the reconciliation option, which would make all the Blue Dogs instantly irrelevant – he said they would use that option if they weren’t making progress the other way.

Also, Obama and a lot of House Democrats want the Stupak amendment out. Since it is not in the Reid bill, it would take 60 votes to put it in, which it won’t get.

And a classic from Driftglass – “Lindsey Graham has warned the public option will destroy private insurance. Just as public parks and gyms have destroyed for-profit fitness clubs, public beaches have destroyed private seaside resorts, public transit has destroyed the car, Segue, motorcycle, bike and scooter industries, public libraries have driven Amazon into bankruptcy, taxpayer-funded police departments have wiped out the market for private security firms, the US Armed Forces have put Blackwater out of business, community colleges have killed the Ivy League, public playgrounds have destroyed private sports franchises, public washrooms have people turning their bathrooms into extra closet space, public housing has destroyed the housing market, public drinking fountains have crushed Evian and Ice Mountain.”

With Republicans stonewalling health reform on all fronts, and doing all they can to ensure that Congress passes a bad bill that hurts as many people as possible, and indulging in mindless obstruction on judicial appointments, and on ambassadors, and on the health officials we need to fight the swine flu, and on unemployment benefits so people can eat over the holidays, and on veterans benefits, and staging a walkout of the climate change deliberations – the Democrats are talking more openly about hardball. In addition to the reconciliation option in the health care battle, they also plan to tack the repeal of Don’t Ask Don’t Tell onto the next defense authorization, which is the gambit they just used to pass the hate crimes legislation. And they will be looking for more things Obama can do without having to suck up to the Senate obstructionists.

Progress with the Blue Dogs

The only remaining possibilities for a Democratic filibuster vote are Lieberman, Landrieu, Lincoln and Nelson; hopefully none of them want to kill an effort that is popular (to include their constituents who hate insurers) and took months to set up.

Landrieu is saying the public option is “100 percent better” than when it began; actually she is bragging that her fellow Blue Dogs removed nasty provisions which were never in the bill in the first place. Whatever… She doesn’t want to simply do nothing, she likes the notion of a well-crafted trigger, and she wants to protect small businesses; she still hasn’t committed to supporting the bill, but it sounds like we might get her to block the filibuster. Florida Democrats goaded her along a bit, cancelling their invitation to let her speak at a local fundraiser because she is blocking health reform. Ouch!

Nelson also is selling the trigger idea, and wants the anti-trust exemption put back in. Lieberman doesn’t care if Democrats are hurt by a health reform collapse in 2010 because, let’s all remember, he’s not a Democrat, but Dean is turning up the heat on him, saying he has no right to filibuster, implying that his position in the caucus is on the line (possibly Reid delivered the same message). Bayh seems to be straightened out on the filibuster issue but he will push to protect medical device makers.

Right now, Nelson and Lincoln are the ones to watch. Lincoln just recently had a dinner with Obama.

By the way, girls, the one Democrat who ran on a platform of opposition to health reform: Creigh Deeds. You remember him, just lost by about 20 points?

Meanwhile the House Democrats could vote on their bill as soon as Saturday at 6pm. Boehner tried to gum up the works with a GOP “bill” which was so bad that even members of his own caucus slammed it for not solving the problem of preexisting conditions, and for only covering less than ten percent of the uninsured. Whereupon Boehner sheepishly said, um, that wasn’t the real bill, that’s just a draft that got leaked.

If this thing isn’t finished by the end of the year, they could shoot for getting it through all the major hurdles by the State of the Union.

Lieberman backs down

http://thehill.com/homenews/senate/66005-reid-reassures-the-left-lieberman-is-on-board

"But sources said Reid’s staff is telling liberal interest groups that Lieberman (Conn.) has assured Reid he will vote with Democrats in the necessary procedural vote to end debate, perhaps with intentions to change the bill."

Playing chicken with the Blue Dogs

Word has it that there are 55 Democrats ready to go with the public option, and five who will hold out until the end for maximum leverage, apparently some combination of Lieberman, Lincoln, Landrieu, Conrad, Bayh and Nelson (Baucus hasn’t surfaced in these machinations).

Lieberman is mooing that the Senate bill will cost taxpayers money, drive up premiums, increase the debt, and so forth. The media doesn’t have the guts to call him out on his lies, but Gibbs pointed out that even the CBO has refuted Lieberman. This yutz doesn’t believe in reform now, but he bragged about his health-reform cred during his race with Lamont. He doesn’t believe in voting for cloture on bills he dislikes now, but he did it plenty for Bush, including the Alito vote. He doesn’t believe in spending money now (forgetting that the Senate bill actually saves money), but he voted for all of Bush’s big-ticket bills on tax cuts and fighting wars (to include the gigantic sub contract for his home state). He’s all Mister Integrity now, although he took $3 million in bribes from the health sector and another million from the insurers. And it’s complete bullcrap to say he won’t filibuster, wait for Reid to announce the bill, and then say “oh, wait, I meant I won’t filibuster on the first vote, but I’ll definitely filibuster the final vote – gotcha!” What a craphound. Lieberman’s proposal that people like him could vote to allow the debate but not pass the bill itself is actually destructive, because it could give the Republicans just what they want, months of wasted time.

You have to wonder why Lieberman is screwing Reid over like this.. Playing chicken? Angling for changes in the bill? Seeking attention? Hoping to start a stampede of Blue Dogs away from the bill? The problem is that he has changed his coat so often that it is impossible to see what he really stands for.

Gibbs said flat-out that Connecticut will hold Lieberman accountable, and the state does favor the public option by a whopping 68-21 – but what if he isn’t running for reelection? If he does run, remember that last time it was Republican voters who put him over the top, but he still can’t completely screw the Democrats over.

As for the other Blue Dogs: Lincoln, whose constituents support the public option to the tune of 80 percent and who could toss up a primary challenger for her, still says she doesn’t like the opt-out.. Nelson wants to read the bill and see the CBO score; Conrad is also reading the language and said Reid scored points with him by including the coop idea, although his commitment to allow cloture on debate does not extend to committing to cloture on the final bill.

Bayh says he will vote to put the bill on the floor, but isn’t saying he will support cloture on the final vote. His colleagues are condemning him for claiming that the cloture vote and the vote on the bill are the same – particularly since he himself voted yes on one and then no on the other in the past. Happily, he is not angry about the public option although he is concerned about the deficit (a worry which the CBO will assuage); he is also okay with reconciliation. His own state supports the public option, like the other Blue Dog states.

Specter, annoyingly, says he’s okay with reconciliation only as a last resort. Good God, are we going to have these clowns mooing and moaning and deliberating endlessly over THAT too? After letting Bush use the same tool over and over?

Reid, the Senator from Las Vegas , is quite the gambler: he never claimed to have the 60 votes nailed down but he rolled the dice anyway (perhaps because without a win on this he might be doomed down in Vegas anyway, at election time). So he was gambling, and possibly acting to flush out the treacherous Blue Dogs earlier rather than later. And now he seems bent on calling Lieberman’s bluff. In his back pocket he has the reconciliation option: he was talking about that option even before Lieberman tried to sandbag him, and both Reid and Durbin say that reconciliation is the fail-safe. Threatening reconciliation now might keep some of the Blue Dogs in line, particularly since reconciliation would mean that the Blue Dogs would not only lose in their power play but also lose any chance at getting bribes from Reid; using reconciliation would be much easier if it was used only for the public option itself – leave the rest of the reform package for the regular bill, and dare the Blue Dogs to filibuster THAT.

Snowe is still pretty steamed: when asked what Reid would need to change in the bill, to get her back, she barked “the whole thing”. But they might think about taking Snowe’s temperature again – if she can get on board for anything at all, it gives coverage for the Blue Dogs who cooperate and puts pressure on the ones who don’t. She (and Conrad) are still talking about triggers, and might be interested in Carper’s suggestion that a public option be used in states where only one or two insurers control the market (which is most of the country), although Snowe’s trigger formula would need to be strengthened considerably in the process.

The Senators will also be looking over the House bill. The House package not only reduces the deficit by about 10 billion a year (take that, Lieberman), but it also has a big basket of goodies for the voters for 2010, while they wait for the public option to kick in later on: closing part of the doughnut hole, interim help for the uninsured, bans on lifetime limits, bans on dropping customers, extending coverage for children to the age of 27, helping low-income Medicare patients, protecting Medicare Advantage patients from getting screwed, blocking price gouging, helping displaced workers, helping early retirees, helping community health centers, and increasing number of primary care doctors.

One hazard: Kyl, on the Republican side, is dangling before us a possible compromise on the opt-in formula. Don’t get sucked in – he just wants us to make more concessions before they pull the football away again. Perhaps he is trying to launch this nonsense because the Republicans, even now, still cannot gain any political traction. House Republicans are hollering at their own leadership for failing to deliver their own health plan as promised months ago. New poll data shows that 72 percent of Americans want the choice of the public option, twice as many Americans approve of Obama’s handling of health reform as they do for the GOP’s performance, fundraising for Blue Dog candidates is dropping like a rock, and the insurers made matters worse with a disastrous gaffe in North Carolina – Blue Cross sent the locals at gigantic rate increase while simultaneously urging them to write their Senator to denounce health reform. D’oh! Mitch McConnell is hollering all over Washington that anyone who votes for cloture is really voting for the bill itself, which is nonsense -- and by the way, Senator, you can stop screeching that the Democrats should be able to pass anything they want: we have 58 Democrats, not 60, as the antics of Lieberman the extremely Independent have reminded us.

What Reid will do next

For Reid’s next trick…

Reid knows his future depends on this health bill; if he didn’t have the votes he would have gone for the trigger as Rahm pressed him to. Barring a major miscarriage, he has the votes. The Blue Dogs have been saying they can support the bill if it’s a level playing field – the Schumer version rather than the robust version – and are unlikely to block cloture. Significantly, Reid said he hasn’t asked the White House to urge Senators to get on board, because “it hasn’t been necessary”, which betokens confidence (or foolhardiness). He was also confident enough to ignore the worries of Obama and the pressure from Rahm, who knows how to bring pressure.

Tomorrow the Senate Democrats meet for lunch and Reid will work the Blue Dogs over again.

Reid will remind the Blue Dogs that this is a moderate bill, the compromise which they reached after the Democrats gave in on the single-payer, and on the robust public option, and on the unadulterated Schumer option. The public option will have to pay back its loans and play by the same rules as the private insurers; it not only allows people to opt out, but it allows states to PREVENT individuals from opting in, so nobody is being forced into anything – states can deprive people of the right to choose, which should warm any conservative’s heart.

Reid will remind the caucus that Lieberman, Lincoln, Carper and Landrieu supported cloture when Bush rammed Samuel Alito own our throats, and they should extend the same courtesy to a president from their own party.

He will remind them that a vote to block cloture is a vote to destroy both Reid and Obama, by rejecting a program that voters want; it’s a vote to create Speaker Boehner and Majority Leader McConnell, because in 2010 America will punish us for failing to pass a good bill, OR for succeeding with a bad bill that people hate.

He will remind them that if this bill is blocked, the Republicans will know they can block anything, at any time, just as they are blocking our nominees for the courts and for Surgeon General (right in the middle of a health crisis).

He will remind them that if they go with him on just one vote – cloture – they can go against him on the opt-in amendment, the trigger amendment, the strip-out-the-opt-out amendment, and the bill itself, four separate chances to prove their loyalty to their paymasters in the insurance industry (it isn’t loyalty to their constituents because the voters want the public option).

He will remind them that the liberals, for once, didn’t cave to the conservatives, and they will stand firm to the end because they’re tired of getting screwed over.

He will remind them that the options aren’t opt-out and trigger: they are opt-out now, or opt-out in conference, or opt-out in reconciliation.

He may also remind them that they need to sweeten the bill with some popular stuff for 2010, like drug discounts for seniors, tax credits for small businesses, money for folks with preexisting conditions.

And he will remind them that they claim to be Democrats, and it’s time to stop fucking with their president just to prove they can do it. Because Obama can fuck with them, and so can Rahm.

Watch Nelson, Lincoln and Bayh after the big lunch with Reid. Silence is golden. If they come out and say “hell no” now, then Reid miscalculated. If they play their cards close to their vest, then we have weeks to work them over. Baucus is now saying he was a public option fan from the beginning – he at least, believes the fix is in. Nelson says he wants the opt-in, not the opt-out, and hasn’t committed to cloture; nor have Lincoln or Bayh, so those three will get a lot of attention. Snowe criticized the bill but did not say she’d block cloture. Meanwhile liberal Senators are working it from the other side, showing that a bill WITHOUT the public option might not even get 50 votes (although threatening a filibuster could backfire by causing the Blue Dogs to use the same threat).

Then Reid will spend weeks working on the holdouts, if need be, aided by Obama.

The opt-out notion, apparently Schumer’s brain-child, was a huge creative leap, like the one LBJ exploited in the late 1950s to get our first civil rights bill passed (actually that bill required 3-4 political miracles from Johnson, not just one). Reid is actually sending two or three versions of the reform package to the CBO for scoring, which hopefully will come under Obama’s $900 billion threshold; apparently the alternatives to be scored do include some language regarding coops (I’m unclear what that is) but they do NOT include Snowe’s trigger plan, which is insulting to Snowe but necessary to prevent the Blue Dogs from selling out to her again. There are also elements of the old Baucus bill which the liberals may want removed.

Snowe’s trigger was doomed even before Reid stomped it flat today – Reid must have known that so many liberals would fight it that it might not even have gotten 50 votes, let alone 60. Note that neither Snowe nor the White House made a real effort to sell the trigger idea, whereas Schumer has been marketing the opt-out to death for weeks. Of course Snowe is still feebly touting the trigger now, claiming on very thin evidence that it would lead to a broad bipartisan compromise (no, seriously!).

And stop whining about Obama, folks. His strategy all along was to go with the trigger in the first bill, and keep out of the picture until everything is settled at the last minute in conference – it’s safer that way, it preserves momentum, and they only have to rely on balky Blue Dogs once instead of twice (although it was highly unlikely a Dog would vote yes the first time and then screw Obama on the conference report). Obama’s only sin here was being slow to shift strategy now that the public option is back from the dead, and some pardonable reservations about Reid’s ability to pull this off. Now that Reid has jumped in, the White House is backing him up: Obama always wanted the public option in the first place, and soon he will bring his considerable firepower to the cause.

The GOP thought they killed this dead, and now they are terrified. They are screeching that Reid, Mister Caspar Milquetoast himself, who looks like a retired mailman, is a PARTISAN BULLY!! Snowe, when she isn’t trying to resurrect the trigger plan, is bragging that she is trying to slow the process down, which is a dead giveaway that all those weeks of Baucus sucking up to her were wasted.


So watch to see what leaks out of Reid’s big lunch meeting tomorrow.

Reasons to stop worrying about Snowe’s trigger

Here’s another reason why the Snowe trigger option is unlikely to go anywhere. In addition to the fact that it is really bad policy which consumers will hate, and is aimed almost entirely a single Senator…. Remember that we haven’t had a serious public discussion of the trigger yet.

There are a lot of problems with the trigger plans which folks like Snowe have proposed. They give the private insurers a free pass by raising the affordability threshold, for example by including federal aid and leaving out some of the out of pocket payments, and not accounting for inflation. We also haven’t discussed how to establish realistic performance metrics, apply them promptly, and pull the trigger promptly when needed. Then we get to the other nasty stuff: you can’t require people to buy unaffordable coverage, and the insurers will continue to jack up rates just as they promised.

Somebody should tell Rahm to stop mooning over Olympia’s picture and face the fact that opening a discussion on the Snowe trigger could add weeks or even months to the process. Reid and Pelosi are aiming to pass similar bills regarding the public option, to forestall squabbling later on, and make things go swiftly: with the public option things would happen pretty quickly, but with the trigger option, we would have to have a long discussion about how it would work, and then the House would still reject it. I think Rahm needs to realize that his strategy is out of date, now that the public option has risen from the dead.

Pelosi has acknowledged that she may have to dial down her plan from the robust option to the Schumer option and is okay with the opt-out; Clyburn expects a bill on the floor next week. In the Senate it was the idiotic AHIP attack that brought the public option back to life, and as of Saturday they are still leaning toward the public option with the opt-out, notwithstanding all the rumors regarding the White House and the trigger. The one or two Senators still dithering probably include Lincoln, Baucus, Bayh, and Nelson who actually said at one point that he couldn’t vote for a bill that had no GOP support, which is idiotic (and hopefully a reference to the bill only, not to cloture).

both Houses moving toward the middle -- the Schumer public option

Reid plans to unveil his bill early next week. That dramatically increases the odds that we will see opt-out, not trigger. Schumer has spent weeks selling the opt-out to Senators, with considerable success. But the last we heard of the Snowe trigger, it was a crappy deal in the extreme, and nobody has either (a) repaired the bill to make it workable, or (b) started selling it, especially to suspicious liberals. And the Snowe trigger can’t be fixed, packaged and sold all in the next 48 hours.

Reid is canvassing the Senators this weekend. The trick is that he can’t go out there and say “I’m counting votes for both the opt-out and the trigger”, because somebody like Baucus can easily con Reid out of his shorts by saying “I’ll give you cloture on the trigger but not on the opt-out”.

Also, as I intimated earlier, House and Senate leaders want to pass bills that are close together on the public option, to make the conference easier. That means opt-out, because the Snowe trigger would be stomped to death instantly in the House.

The House is considering a trigger – NOT the Snowe trigger, which starts with nothing and shifts up to the public option, but a hybrid trigger which starts with the Schumer public option and then triggers up to the robust, Medicare public option. House leaders says the White House likes it. Currently the House is not discussing the Snowe trigger or the opt-out, although Pelosi is trying to get the SENATE to go for the opt-out, by speaking positively about it.

My proposal would have been to use the opt-out, and then use the Snowe trigger IN the opt-out – for the states that opt out, the Snowe trigger could drag them back into the Schumer plan if too many people are going uninsured. That plan would get more support in the Senate. But hey, they didn’t ask me.

So we could have the House passing the Schumer public option with the option of shifting upward to the robust option, while the Senate passes the Schumer option with the option of a few states opting out. Got it?

So both Houses possibly are tiptoeing toward the Schumer plan, from opposite directions.

White House shoots down trigger rumor again

The White House has specifically refuted the TPM report that they are pressuring Reid to switch from the opt-out to the trigger. Dan Pfeiffer: "The report is false. The White House continues to work with the Senate on the merging of the two bills. We are making good progress toward enacting comprehensive health reform." The White House denied it once already, but the denial was vague so they denied it again. That is actually the first time the White House has come out overtly and said they’re working to get the public option passed.

The trigger notion would have flown in the face of the White House’s clear effort to (a) get a good bill, by (b) letting the legislators figure it out for themselves and do their own nose-counting.

Keep in mind that the original rumor had a bad smell from the start – it was also rumored that Pelosi was secretly seeking the trigger too, which we know is bullcrap. Some janitor or pastry chef with a White House extension is making mischief with some leakage.

At best, the earlier leak was some White House staffer forcing people to take a hard look at the trigger, so they can see that it is indeed a really crappy proposal, and that it isn’t worth it to make that big a concession just for one Republican, in an effort to straighten out Senate Blue Dogs, or scare liberals into working harder for a strong public option.

This was NOT a White House panic attack – if they fear that Reid has gotten his math wrong again on this no-margin vote, particularly after blowing the doctor-fix measure, they still have the reconciliation option in their back pocket. They have a good fallback plan, they don’t need a crappy one.

And Booman echoes a sentiment expressed earlier: Reid wouldn’t have floated the opt-out trial balloon if he didn’t have the votes AND White House approval.

Obama told the press he’s looking for a “serious public option”, which Snowe’s proposal certainly was not. Just because Obama has, in the past, shown polite interest in the trigger – or at least Snowe, or at least in bipartisanship – doesn’t mean he is going to cripple his signature presidential legacy, and undermine his vulnerable Majority Leader, and probably lose anyway because guys like Rocky would balk, all for one woman.

The opt-out plan is still on track, and we know this because of the Blue Dog that didn’t bark.

It seems that initially Reid didn’t have the votes nailed down for cloture and simply gambled that when he announced his plan, the Blue Dogs wouldn’t object. And he was right, they didn’t – the Blue Dogs that didn’t bark (although they growled a bit). Apparently Reid knew they wouldn’t, based on some consultations which indicated that the Blue Dogs would support cloture if they had a chance to offer, and vote for, an amendment stripping OUT the public option, thereby appeasing their conservative constituents. And the most unnerving moderates have, in the past, expressed willingness to consider the public option: Ben Nelson and Conrad have expressed willingness to support some form of it, Bayh said he’s an agnostic on it, Landrieu and Lieberman and Pryor have promised to support cloture (the one I want to hear from is Lincoln).

The Huffington Post published a really badly-written piece saying that Reid is only one or two votes away from either (a) securing 60 votes on cloture, or (b) securing 60 votes on the actual health care bill. My guess is that he is still working to nail down two on cloture – some combination of Lincoln, Nelson, Baucus and Bayh.

And remember that this latest trial balloon, the opt-out, did get almost universal positive reactions, whereas when the trigger-option trial balloon was floated weeks ago, it crashed to the ground, full of holes. People just don’t like it (although, annoyingly, Blue Dogs might).

And there has been no effort to fix Snowe’s orginal trigger plan, to make it workable and marketable. If someone at the White House had really wanted the trigger, they could have come along and said “here is how we alter Snowe’s plan, to make the threshold lower and the trigger more of a hair-trigger”, and then marketed the idea. But they didn’t. Instead they let Schumer, the real leader in the Senate for my money, spend weeks marketing the opt-out. If, in the next week, you see someone like Nelson or Bayh come out with an improved trigger, then we can adjust our estimates.

Another leaker, anonymous of course, asserts that Senate leaders not only are doing a nose count on the trigger, but have found that the trigger plan is closer to getting 60, being only 1-2 votes way. Funny how the opt-out seems to be at almost exactly the same point – sounds like a tie to me. You could argue that the nose counts for the good opt-out could be 60 while the bad trigger could come out to 61, but the trigger still a bad proposal, which means Obama will tell Reid not to even allow it to come to a vote.

Obama did say at one point that it is the conference report, not the initial Senate vote, that is important. However, existing Senate rules, and the Honest Leadership and Open Government Act of 2007, make it hard for a conference committee to add new material that wasn’t passed in either house originally. As I understand it (not being a parliamentarian), if the House passes the robust public option, and the Senate passes the trigger option, it is hard to pull a switcheroo in conference and add the opt-out instead. Not impossible, but hard – for one thing you would need 60 votes in the Senate again. That would not be a problem if the House had the opt-out, but that would involve Pelosi persuading her already-angry caucus to give in on both the robust option and the opt-out. So getting the opt-out into the original Senate bill is optimal.

And we don’t want to misinterpret Pelosi’s struggle in the House. She is not having trouble with the robust plan because House members dislike it. She is having trouble because the Senate is clearly moving toward the Schumer plan – the fence-sitters in the House don’t want to go on record for a liberal plan that isn’t going to go anywhere on the other side of the hill. She could have nailed down the robust option if Reid had waited a bit, but it hardly matters – the robust option was never going to get through the Senate successfully. The centrists are saying they want to go slow in the legislative process. My take is – that’s fine, commit NOW to cloture and we’ll vote next January if you want.

And Tim Pawlenty says that if the opt-out is passed, he will lead a crusade to get ultra-blue Minnesota to opt out. Either he really is that clueless about his home state, or he’s just posturing for national attention.

Reid has the votes for the opt-out public option

The health care formula which Reid is reportedly favoring for the Senate bill calls for the more conservative, Schumer version of the public option, probably run by a nonprofit board with federal seed money, with the added feature of an opt-out: after a couple of years states can bail out of the public option. Who has the power to make the opt-out happen – governors, legislators etc – is not clear. It gives conservative Democrats a fig leaf – hey, we’re leaving up to the state capitol, state’s rights!

Remember that Reid is a timid, timid, timid little Milquetoast of a man. Reid is even more timid after the recent fiasco on the doctor-salary measure, which made him look like he can’t lead his caucus or count to 60 (just imagine if Reid and Pelosi had traded jobs this year -- health reform would be law already). He’s not going to jump out with something like this opt-out thing unless he has checked his caucus, and checked them again, and again, to ensure he has everybody nailed down on the cloture issue.

So unless someone screws him over, he's got it.

The cloture question was tested almost immediately. Baucus went completely nuts when he heard Reid’s plans, because Reid is wiping out Baucus’ two-month effort to schmooze Olympia Snowe. Baucus tried to round up conservative Democrats to persuade them to oppose the public option. Keep in mind that only one Democrat is needed to step out and say “I will oppose cloture on the public option”, and the public option is dead. But not one did. Not even Baucus himself. Nelson and Conrad grumbled, but they didn’t threaten to join Team Red on a filibuster.

And it is very unlikely that a Senator is going to remain silent until the day of the vote and then suddenly screw over the President: they will haggle for their price. Silence is golden, no news is good news. Specter and ABC confirm that Reid has 60 on cloture, although a Senate aide tried to poopoo the story. Landrieu is still spouting nonsense about the public option but she has indicated that she will support cloture, as will Pryor. Nelson isn’t happy but didn’t threaten a block on cloture. Conrad already said the Schumer version of the plan could pass, which suggests it’s unlikely that he would block cloture. The only public rejection of the new Reid plan was from the Republican, Snowe, whom we probably don’t need now. Collins, Snowe, Bayh, Landrieu, Wyden and Lieberman are meeting privately to wring their hands worrying about the plan, but none have said “hell, no” to it. Perhaps they’re just humouring Snowe while she licks her wounds.

There are two people we do want to watch closely right now. Bayh says he opposes a federal public option and wouldn’t vote for cloture on a bill that hurts his state -- youch. And Lincoln has vaguely supported the public option in the past, I think, but now she is insisting that she won’t support a solely government-funded public option and that Arkansas doesn’t want it (incorrect), which hopefully is just weasel-wording which would allow her to vote, at least, for cloture.

Because the public option will be in the original merged bill, there will be a vote on an amendment to remove it. This will give Blue Dogs the chance to vote in favor of stripping out the public option (bad), for cloture (good), and against the final bill (bad), so they can say they voted against the public option two out of three times – but it’s the cloture vote that matters, because that gets the victory threshold down from 60 to 50.

Those who were clamouring for Obama to draw a line in the sand on the public option before, must remember that as soon as he committed himself, ANY on the Blue Dogs could crush him with a “no” vote on cloture. He would effectively be putting his balls in their hands: as soon as he committed, they could hold him hostage. Thus the reticence.

In the House Pelosi is fighting the Blue Dogs (who should like the public option because it’s cheap and covers more people) to get a robust public option through the House; this would give Pelosi leverage in conference, and give guys like Conrad something to grandstand against (although again, Conrad should also like the plan because his good buddies the CBO say it’s cheap). Democrats are also pushing the notion that the public option is similar to Medicare, which people understand and approve of (it wouldn’t be crazy to simply let people buy into Medicare, which is actually a budget-neutral option).

Out in the media, the Democrats are taking off the gloves. Obama is running a new ad slamming Steele for lying about health reform, and slapped down Grassley for claiming that Obama is spreading “propaganda” on health reform. Reid and Leahy are working on stripping the insurers of their anti-trust exemption, a plan which has wide, wide support among the public – 65 percent for, 21 against. But my favorite smackdown of the day occurred in the Senate, where a conservative lobbyist made the ghastly mistake of claiming that the current health reform plan will move us toward a European system and increase bankruptcies, and ran into a nasty buzz-saw named Al Franken, who asked: how many medical crises led to bankruptcies in Switzerland last year? Zero. How many in France ? Zero. How many in Germany ? Zero. So STFU.

CBO, Blue Dogs still liking the public option

Senate Blue Dogs are beginning to realize that if they pass an individual mandate without the public option, their constituents could toss them out of office. Landrieu said she’s not inclined to join a filibuster, which is huge since she’s arguably the Democrat most resistant to the public option. Ben Nelson isn’t ready to commit to cloture yet, but he is now saying that the public option is popular but the opt-in and opt-out options are even more popular. Baucus is saying that he likes the public option personally and wants to keep the insurers honest, and he seems to be talking about which public option we should have, rather than whether to have it at all. Some think that even Snowe could vote for cloture. Two Senators, Udall and Bennet, are keeping up the pressure on the Blue Dogs by openly calling on the other Senators to commit to cloture.

The CBO gave reformers a big boost by scoring the liberal, robust public-option plan and giving it a very low price tag, below $900 billion. Pelosi, armed with that, will ask her caucus to take that liberal public option to the House floor, which will keep up the pressure on the Senate and give reformers more negotiating room to their right. Even better, Reid is saying he wants to look at the CBO numbers before deciding on the public option – which suggests that the good CBO score will give the public option momentum in both Houses.

Reid, Dodd and Baucus will wait a couple of days before tackling the public option issue, addressing the less volatile issues in the meantime. Reid’s weird “we’re leaning toward talking about the public option” suggests that some form of the public option will be in the merged bill, which is very important because it is much easier to pass it as part of the original bill, rather than trying to tack it on as an amendment which is much easier to block with a filibuster. Reid did sound a bit pusillanimous in the way he addressed this issue, and his wobbly leadership has become so obvious that even liberals are getting in his face: Ron Wyden just pushed back at a message from the Senate leadership claiming that under the current plan anyone can switch to the public coverage. But Reid knows that if he comes out looking wobbly, he loses his job, so he’s got to man up soon.

Along the same lines, Senate aides have been begging for weeks, for Obama to jump into the fight publicly: they say a lot of the Blue Dogs could be brought into line that way (although he may not have all that much leverage over them), and it could pump up Obama’s poll numbers (and party fundraising) as well – a lot of Democrats and independents are withdrawing from Obama because he’s not pushing enough.

The GOP saw the poll data this week, and they must have been stunned to learn that the public option is three times as popular as the Republican party.

Let me hit that point again: the public option is three times as popular as the Republican party.

Nevertheless they have their attack/evade/delay strategy ready again, although New Gingrich is promising that if health reform passes, the GOP will work to repeal it later, which suggests the GOP expects to lose this battle. Insurance lobbyists have new massive ad campaign aimed at seniors, claiming that Obama will allow Obama not only to deny Medicare coverage, but also to put your “intimate” details out where the public can see them.

But here’s the real measure of Republican desperation on health reform: Tom Coburn is one of the biggest gay-bashers in Washington, screeching that gays have infiltrated the centers of power, that their agenda is the greatest threat to our freedoms, that their agenda is abortion and promiscuity; he bellows about rampant lesbianism and gay porn, and advocated reporting all positive HIV tests to the public authorities. Now Coburn is crawling back to the gay community, begging for their help on health care, claiming that big gummint will kill people by rationing AIDS medicine. That’s like Hermann Goering asking for the Jews to speak in his favour at Nuremburg.

Blue Dogs warming to the opt-out

Okay, okay, here's the short version.

The public option is getting more support from the polls and the media. The Congressional Blue Dogs, facing more pressure from their constituents, are starting to “frame” their position, saying they will not accept a public option linked to Medicare, but are warming up to the opt-out proposal, although Lieberman is still playing with fire by screwing with Obama both on health care and on czars. Other Democratic strategists are reminding the Republicans (and the Blue Dogs) that they have other tools they can win with – the conference report and reconciliation (although so far they are not talking up the notion of having people vote yes on cloture and then no on the bill itself); even the Republicans are starting to admit tacitly that the Democrats may very well stick together on the public option. Reid is talking tough about delivering the goods, presumably because he knows he can’t survive if they pass a crappy wimpy bill; Obama, who also realizes the need for a strong bill, is still hanging back, but will soon need to step in and lead, for a number of reasons – but when he does, a lot of people will fall in line.

Now, a whole lot of details about all this.

A new ABC poll shows, again, that the American people want the public option, not bipartisanship for its own sake, and the NY Times also endorsed the public option.

Reid is running ads all over Nevada, claiming he’s guy who can “deliver in a way that no one else can”. So with the problems he already has back home, he knows he can’t deliver a crappy bill, so perhaps his tough talk in the ad betokens his confidence that a good bill is coming. In Washington Reid is, annoyingly, still playing more of a birthing coach that a leader, still mooing about the 60-vote barrier, but still, there’s that ad. So perhaps for him it’s about the bill itself, rather than him doing a lap around the rotunda wearing a Superman cape. The ad is a good sign.

Obama does want the public option – he wouldn’t be pushing Pelosi to keep pushing the House bill to the left if he was just going to cave. He has been noncommittal all summer in order to make talks with the Republicans possible and keep the Finance committee from collapsing, but a lot of people – includingCongressional Democrats – want to see Obama honest-to-God lead, and not just because of the health care issue. The good news is that when he does step in, some wobbly Blue Dogs will finally fall in line. Hopefully, enough of them.

As we learned from the Medicare Catastrophic Coverage Act of 1988, the American people will indeed rebel against a bad health care plan. The MCCA was so bad it was repealed after a year. By the same token, if we do have an individual mandate, but do NOT have the public option, then millions of people will be forced to buy from the private insurers, who have just PROMISED us all gigantic rate increases. Under those circumstances, a rebellion – right during the 2010 midterms -- is certain. Add to that the fact that Obama has made clear that he doesn’t want to sign a bad bill, i.e. one that would start a REAL national teabagger riot. All this leads inescapably to the conclusion that Obama is unlikely to sign anything that looks even remotely like the Baucus fiasco, or triggers.
Axelrod is still talking about solving all this in the House-Senate conference, which could be risky. Hopefully the White House is just reminding the Republicans of how many paths to victory there are for Obama – just like Harkin is ostentatiously wheeling out the reconciliation weapon. Read on:

Democrats are test-driving the reconciliation process, which they can use to pass health reform with 50 votes if getting 60 for cloture proves problematic. They are testing out the reconciliation process by using it on a different issue, shifting student loan money away from subsidizing private lending and toward Pell Grants, which would move about $9 billion a year from bankers to students. This will be a great test of the reconciliation prospects for health care, because a lot of the same people are involved: Harkin is pushing for the student loan bill, the Republicans and a couple of Blue Dogs oppose it, and the Senate parliamentarian will have to rule on what passes and what doesn’t – this would be a good time to gauge his mood on the whole reconciliation concept. And publicly flirting with the reconciliation mechanism sends a message to the Blue Dogs: “If you screw Obama over in the first floor vote, not only are you going to bring the wrath of the whole party down no your heads, but you’re going to lose anyway because we have this second mechanism we can use to go around you.”

Baucus, the most conservative of the big three Senators currently hashing out the language for the Senate health reform bill, seems to be warming to the opt-out option. He reeled off the list of options, the “most pure” plan involving a public option linked to Medicare, and the many “less pure” plans such as Schumer’s public option plan, the opt-out, the opt-in, the coops, the triggers. He implied that the “most pure” version – the one linked to Medicare – was the nonstarter, echoing the sentiment of fellow Blue Dog Kent Conrad; in fact, other conservative Democrats are beginning to subtly draw that line – it’s the Medicare-linked public option they won’t go for, which is a very good sign. Baucus expressed particular interest in the opt-out. So it sounds as though the conservative Democrats are warming up to the notion that giving Obama the opt-out package would be a good compromise between the more robust public option, and openly defying the President. They seem to be realizing that defying a popular president in order to block a popular legislative effort is suicidal. Senate liberals are leaning on the Blue Dogs, to the tune of “you don’t want to be the one person who kills reform and cripples the party and the president, do you?”

Interestingly, it still sounds as though the Democratic leaders are not making much of an effort to persuade Blue Dogs to have their cake and eat it too – vote yes on cloture and then no on the bill itself. It sounds as though they’re shooting for 60 on the actual bill. Not sure why – the split-the-difference notion allows you to get a better bill and still get to 60. But as long as their talking opt-out rather than clinging to Baucus’ idiotic coops or Snowe’s fatally flawed trigger, we’re okay.

The various Blue Dogs are dragging this out as long as possible – as soon as they commit to a position, they no longer get all the attention, which is pretty childish; and as long as the three Senators are behind closed doors hashing out the bill, the Blue Dogs aren’t getting the ego massaging and schmoozing they need so desperately. Lincoln may have been speaking kindly of the trigger option in an effort to block the more liberal opt-out, but in the meantime her Arkansans back home, who have said in the polls that they want the public option, slapped her silly on the issue in a recent forum. Lincoln isn’t the only Blue Dog facing liberal pressure back home: Carper, Nelson and Conrad are also facing potential revolts from home-state Democrats, Mainers are putting pressure on Snowe and Collins. Specter, interestingly, is touting the public option, perhaps feeling the pressure from Sestak back in Pennsylvania. Conrad may be leaving himself room to back Obama after all, by specifying, as I noted, that it’s the Medicare-based public option he can’t vote for although he stills prefers coops and triggers; Obama worked him over in the Oval today.

Pretty soon Democratic Senators are going to be asking Lieberman – “Why are you insisting on an investigation of Obama’s “czars”, when you didn’t investigate Bush’s czars when you had the same oversight job? If you’re going to give preferential treatment to the Republicans, why don’t you just take off the mask and join the GOP?” This actually gives me hope here – Lieberman can’t be stupid enough to defy Obama on czars and then defy him again on health care, because he knows he’d be thrown out of the Democratic caucus. Hopefully he’s tacking to the right on czars so he can then tack to the left on cloture for health reform.

I think the Republicans know how much trouble they’re in. It is now emerging that Senate Republicans don’t expect any Blue Dog Democrats to block passage of the health reform bill, even if there is a public option included. The Republicans might even lose Snowe and Collins, who could conceivably support cloture. So now the only remaining strategies for the GOP are delay (they demand several weeks of debate, which the Democrats rejected) and more lies about tax increases, seniors getting denied care, some new variation on the death-panel bullcrap, etc etc.

Senate narrows it down to public option, opt-out, and trigger

Apparently the Senate leadership has narrowed it down to a public option, an opt-out, and a trigger; I think the opt-out is the most likely.

When the Senate leaders emerged from the Democratic caucus meeting, they were boasting that the caucus was united, but today it emerges that there was more squabbling about the public option than we were originally told. Rockefeller joined Schumer in publicly pressuring Reid to include the public option in the original merged bill, but it sounds as though Reid wanted to leave it out, and then try to add it as an amendment later, which is stupid because it could be filibustered.

Here’s the key: as it stands now, Tom Harkin says that the Senators have narrowed it all down to three options: a full public option, a public-option with an opt-out feature, and Snowe’s trigger. The trick is that if you present people with three options, they are more likely to choose the middle one, in this case the opt-out, which would be an acceptable outcome.

A problem with the deliberations in the Senate is that the 10-15 Blue Dog Democrats, along with a few centrist Republicans like Snowe, ALL want to be the star of the show, the deciding vote. We rewarded Snowe for playing hard to get, with months of adoring attention, and now a dozen other Senators want to be schmoozed and courted in the same way. To my way of thinking, liberals like Rockefeller held their noses and voted for the execrable Baucus bill; now the Blue Dogs need to hold their noses and vote for cloture, at least, even if they don’t vote for the bill itself. Mark Pryor says he can’t see any Democrat joining a filibuster, and he damn well better be right.

One bit of good news: Lieberman says he’s inclined to support cloture but he hasn’t decided yet. I guess he hasn’t decided whether he wants to be thrown out of the Democratic caucus, either.

House Democrats are talking about a negotiated public option, with a trigger that would potentially launch a Medicare-linked public option later on; that plan is actually to the left of all three Senate options, so it’s a longshot.

The insurers aren’t even trying to act in a reasonable way, to sway the debate. Guardian, an insurance firm, has cancelled all coverage in New York state rather than cover ONE muscular dystrophy patient. A Guardian executive referred to such patients as “dogs” which the firm could simply “get rid of”.

Is Reid going wobbly on using the cloture option?

Washington insiders expect a health bill by Thanksgiving or New Year’s, depending on Obama’s travel.

The polls continue to show support for health reform. Only 18 percent of Americans believe the line that America has the best health care in the world; even among Republicans the number is only 28 percent. Olympia Snowe’s home state wants the public option by a margin of 58-29. And support will increase even more since Obama is turning out his grassroots troops to mobilize for health reform.

But we’re still overcoming the media’s laziness in reporting the issue accurately: in addition to the media’s parrotting dishonest wingnut talking points about death panels and benefit cuts for seniors, there is a strong likelihood that one reason the White House wanted Rockefeller and the liberals to vote for the Baucus bill, was that the media was likely to portray a defeat of the Baucus bill as a defeat for Obama and reform, instead of a rejection of a crappy bill.

One thing that could help goose the public option forward, is the fact that a lot of people are leery of having an individual mandate WITHOUT also having the public option: that really puts us all at the mercy of the insurers who just boasted that they are going to jack up our rates. Now: according to Senate rules, if they hold a House-Senate conference to reconcile the two versions of the bill, and both versions have the individual mandate in it, then it will be extremely difficult to take it out – you’d need 60 votes, and you know the Republicans would all fight to keep it in. So then the negotiators in the conference would be put on the spot: since we can’t take out the individual mandate, don’t we need the public option even more?

Other options include allowing states to opt in or out of the public option, or allowing states to choose from a list of options including local coops. The liberals at least want something that isn’t too weak. Some have suggested a combination, such as an opt-in with a trigger. Obama and Reid apparently have been talking about the trigger option with Snowe, but hopefully they were just buttering her up. Baucus’ plan is coming under more fire – with costs for a family of four at around $700 a month, around 17 million could be priced out of the market. Things we want to look for include: strong subsidies, protection against high out-of-pocket costs, controlling providers (drugs, hospitals, manufacturers), making the system strong and national with power to control insurers, opening the plan to those already employed, taxing the Cadillac plans, strong mandates for both individuals and employers, capping rate hikes.

The problem here appears to be Reid.

Reid says he prefers the public option but he keeps going wobbly on us; first he said he needed 50 votes to act, then when we got 50 he needed 60, and now that he gets 60 he says he won’t enforce discipline and will just seek a reform bill that can get 60 votes on its own, rather than demanding that Democrats support cloture. He doesn’t even want to ASK the Democrats to stick to the team on cloture. Alan Grayson is among the Democrats screaming at him to man up (I think that Lieberman, at least, should be brought to heel). Even if Reid wins reelection next year, how about making Schumer majority leader?

Reports say that in the last few weeks Reid has, in fact, started intensive talks with liberals, trying to figure out how to pass the public option, but hasn’t closed in on a strategy yet. He seems to be focusing on doing it in conference, which is risky.

So he wants it, to he's too polite to ask.

Lyndon Johnson wept.

Lacking such adult supervision, Landrieu is spewing nonsense about people believing the public option is free health care – I’m more interested in her stance on cloture. Conrad is stressing his opposition to a public option linked to Medicare – he’s setting himself up to vote for some OTHER kind of public option, which is a pleasant surprise. Ben Nelson says he will be a team player as long as his party doesn’t go too far to the left…which is where, exactly? Lieberman is a probable “no” on the public option, but again, what about cloture? He must know that even a very lenient Reid would have Lieberman at the top of the “punish me” list.

(On a happier note, Blue Dog Mark Pryor says he’s on board for cloture, and Specter urged the other Democrats to do likewise, although they were reluctant)

It was reported that Snowe will be invited to some of the sessions in which the bills will be merged; then Reid’s office firmly shot down the idea. Snowe is still selling the trigger idea; I don’t think she would be pushing this unless she was afraid that a real public option could pass. She dislikes the opt-out option. The GOP is not punishing her officially, although wingnut sites like Redstate are slamming her. But let’s all remember: if you pass a bill with a public option you might lose Snowe, but without the public option you lose the House of Representatives.

The rest of the GOP is doing the same old same old – lie, delay, lie, delay. McConnell says he wants a couple of MONTHS for debate, and the rest of Team Red is screeching lies about more gummint and more taxes – which they wouldn’t be doing if they had a valid argument to use.

Four things for Obama to do

1. Herd the Blue Dogs.

The two guys supposed to herd the conservative Democrats are Reid and Durbin, but now Reid is whining that he doesn’t want a bill that will split the Democratic caucus. Emanuel needs to slap him around and remind him that a huge majority of the Democratic caucus wants the public option, and it’s time for the other side to start making concessions the way they have.

Likewise Durbin. Senate Democrats rank themselves by seniority, but Republicans do it by party loyalty: this gives the GOP a huge advantage, because they know their troops will always follow their leaders on procedural votes like cloture. In effect it gives them 10 extra votes, the difference between 50 and 60. The petition to have the Democrats do what the Republicans do – strip the committee chairs of Senators who don’t follow their leaders on cloture – has almost 80,000 signatures, but Reid’s deputy Durbin has already said they won’t strip committee chairs. So he needs slapping around too.

A key thing to watch for is whether the Blue Dogs are coordinating behind the scenes. Nobody wants to be the one guy who kills health reform, but if there is a little posse of three or four, obstruction becomes easier – treachery loves company. So far, no Democrat has publicly expressed willingness to support a filibuster, but we need to keep it that way.

Another thing to watch the Blue Dogs for, is hiding behind Snowe’s skirts. They could agree to vote for a bill she likes, which could be good, but they could also refuse to vote for a bill she does NOT like. This is pusillanimous and they should be crushed without mercy if they do so.

People to watch include the Democrats who opposed the public option in the Finance Committee, including Lincoln who said her vote on the Baucus bill doesn’t guarantee a “yes” vote on the floor bill, and Conrad, who interestingly has stopped bashing the public option and now is only bashing the ROBUST public option, the most liberal version of it. Carper, author of the opt-in plan, is also considering the opt-out plan, and if he likes it he could also sway guys like Ben Nelson and Bayh who also like it. Collins could conceivably back the Baucus bill – could she back a public option too?

Now the HELP bill and the Finance bill will be merged; once they merge the bills and send the new composite bill to the floor (they’re shooting for the last week of October), the decision on the public option won’t change on the floor: it would take 60 votes to take it out, or to put it in. The people who will decide this will be Baucus and Dodd, who will cancel each other out, Reid who will defer to the White House, and the real “decider”, the White House. Obama wants the public option – Rockefeller publicly reiterated that today -- but a great deal depends on (a) whether Obama has obtained commitments from the Blue Dogs to support cloture, and (b) whether he really wants to go the reconciliation route. If the answer to both questions is “no”, then something other than a full-bore public option may happen. Obama will not allow a bad bill even to be voted on, let alone reach his desk, so that rules out the Baucus bill, the trigger option (unless it is strengthened a great deal), and the coop. Two other options might be: reconciliation (messy), leaving the public option battle until the conference (risky), the opt-in plan (risky), and the opt-out plan. The opt-out is perhaps the best option; even with 22 Republican governors, 13 states with Republican legislatures not including nonpartisan Nebraska, and 9 states that are all GOP run, few states would really opt out.

House leaders are maneuvering for maximum advantage, trimming their plan down from $1.2 trillion down to $900 billion. They are talking about passage of a House bill by Thanksgiving, but they might do better to slow down, wait for Obama to get whatever he can from the Senate, and then vote for it in the House as is, so that no conference is needed.

Speaking of the conference: Obama has clearly read the Senate rules – that’s why he slid the reconciliation instruction into the April budget bill, to open the door for reconciliation later. One key provision: according to Senate rules, if both the House and Senate bills have the public option in it, the House-Senate conference can NOT remove it. But it can still be filibustered.

2. Spank Lieberman and Baucus

Lieberman was saying that the opt-out plan is worth looking at, but now he is actually to the right of the Republican, Snowe, on the Baucus bill, and parroting the discredited insurance-industry talking points from AHIP. Keep in mind that when Bush was pushing the Alito nomination, Lieberman voted for cloture and then against Alito – if he is unwilling to extend the same courtesy to Obama that he extended to Bush, Reid absolutely must throw him out of the Democratic caucus. Lieberman may try to take the lead on repealing Don’t Ask Don’t Tell, hoping to buy himself a reprieve by arguing that he supported his party on one out of two initiatives, but sorry, not good enough. You don’t get to be a Democrat only when it’s convenient. Thomas Paine called guys like that “sunshine patriots”, who flee for the hills when it starts raining.

Astoundingly, Baucus, after stage-managing the three-month disaster in the Finance Committee on health reform, wants to take charge of the legislation climate change and clean energy.

No. Way. In. Hell.

Not only do we need to keep him away from climate change, we still need to remind people why his health reform bill sucks. His formula for coops was slammed by the CBO, who said hardly anyone would use the coops, and it contains way too many provisions which leave us at the mercy of the insurers.

3. Watch for some fakery by the Republicans.

Don’t you think it’s a little odd that, right after sources leak the “fact” that the Republicans threatened to strip Snowe of a key committee seat if she votes for the Baucus bill, she votes for it anyway? Ya think maybe Snowe, who still disapproves of the public option, is setting Reid up for an impassioned speech – Oh, Harry, Harry, Harry, I have thrown aside my Republican friends for you! Keep the Baucus bill as is, lest my tragic sacrifice be in vain!” Then she clutches her pearls and flings herself on a divan or a settee with a case of the vapors. Reid is just the guy to fall for such nonsense.

Of course, having made this threat against Snowe, the GOP will now look foolish if they don’t follow through.

4. Keep stomping the AHIP report to death

The AHIP report, sponsored by the insurers, is backfiring badly; now that they have publicly threatened to raise all our rates, a public option is even more likely. They essentially made the case for the reform better than the reformers have, and gave top cover for some liberals who feared that the Baucus bill would be seen (understandably) as too far to the right. The accountants who prepared the AHIP report admitted that they cherry-picked the data, only looking at four provisions that are expensive. So it was all bullcrap anyway.

Health insurers take off the mask and threaten…you

Insurers are making no effort whatsoever to dial back their worst excesses in the ramp-up to the big reform votes. Pregnancy, domestic violence, fat babies as disqualifying preexisting conditions, jacking up rates….These guys seem to be positive they can stop reform. Makes you wonder.

But their already-discredited AHIP report is likely to backfire. With this report, drafted at the behest of the insurance industry, they have effectively threatened all of America that even if the reform bill contains a mandate which will provide them with millions of new customers, they will still jack up all our premiums. This gives a strong impetus to setting up a public option, to save American families a ton of money. It also makes Pelosi’s windfall profits tax more likely to pass. Some are also proposing a cap on premiums. Even Republican leaders are warning their members not to campaign on the report if they have also taken a ton of insurance money for their campaigns. Watch the Blue Dog Senators on this – extortionists themelves, they know blackmail when they see it.

Meanwhile the CBO report has dealt a serious blow to the idea of health care coops; the only vote it adds to the tally is possibly Conrad’s.

The trigger option is less unpopular than the coop option, but the trigger won’t work either – Snowe tried, and she overplayed her hand. The Democrats seemingly have already conceded that many of the major provisions of the health reform package won’t go into effect for years, and they don’t want the trigger nonsense to delay things even more. They’ve conceded enough and they know it.

So Senators are back at work urgently seeking a public-option formula that can attain 60 votes for cloture, if not for the actual bill; then when Reid merges the HELP and Finance bills, they will toss out the Baucus coop plan in favour of the public option.

As the coop and trigger options slowly expire, the public option opt-out formula, the most promising of all the compromise proposals, is gaining momentum. White House polling possibly discovered that opt-out will sell, liberals will accept it, Krugman likes it, and Carper may support it; probably Lieberman too.

Obama has rounded up more Republican supporters of health reform, Chuck Hagel and Bush’s HHS Secretary, Louis Sullivan. However, Bill Nelson has said no to opt-out, and likes the trigger better. How about both? Or at least cloture? He’s undoubtedly worried that Florida could opt out. I think a lot of these Blue Dog knuckleheads are dragging this out forever, because once they commit and the Senate votes, they will deservedly become relative non-entities again.

And more justification for urgency: a new Consumers Union report says Americans are skipping doctor visits, procedures, tests, prescriptions, and even taking expired drugs to save money; a quarter of us have been unable to pay for medical bills or prescriptions.

Ben Nelson is amenable to the opt-out compromise

Schumer and Carper talked to a “large number” of Senators about the public option opt-out proposal last night, and the plan seems to be winning Senate Democrats over in a hurry. Nelson already said he likes the idea of leaving it up to the states; this is huge because Nelson is arguably the Democrat most likely to screw Obama over on cloture. Wyden isn’t crazy about it (he hates the insurers so much that he wants them whacked even more), but I think he’d vote for it. A Baucus aide seemed to think Baucus could be persuaded; I think the Blue Dogs are looking for a way out.

Conrad said he doesn’t know enough about the opt-out plan, but he likes the opt-in plan and its author, Carper. Surely Conrad wouldn’t defy his party and support a Republican filibuster just on the difference between an opt-out and an opt-in. Conrad also voted for the Cantwell formula and said some good things about the Schumer formula even though he voted against it.

Meanwhile liberals (with a few exceptions like Larry O’Donnell and Firedoglake) like the opt-out because it’s much better than some of the other compromises being floated. Howard Dean has just endorsed it also.

And here’s a reason why very few states will actually opt out: the Finance Committee bill, and the others bills too I think, expand Medicaid eligibility, but the federal government doesn’t pay for all of the increase – the cash-strapped states must cough up more money. If a state opts out of the public option, they would get a bigger bill for those Medicaid patients, without ALSO getting the public option money, and they’d also lose the increase in tax revenue which other states would get by shifting people from tax-free health compensation to taxable wages. So very few states will opt out. And notice that all those Republican governors who condemned the stimulus money…took the stimulus money. So they’ll take the public option too – if they want to survive in office.

More reasons to be cheerful:

First, eight thousand people have already signed the petition to Harry Reid – any Democratic Senator who supports a Republican filibuster on health care loses his committee chair…Oops! It’s now 14,000 and rising.

Second, McConnell asked Bob Dole not to support the health care reform effort. Dole blew him off. Dole, the architect of the Kill-Hillarycare effort in 1994.

Third, the Baucus bill goes to a vote Tuesday. More and more nasty details are emerging about the bill: for example, the plan has an annual cap of $11,900, not including premiums. Also, hospitals are slamming the Baucus bill because Baucus made a commitment to them, that the percentage of Americans covered under the plan would reach a certain level. And then he broke his word. Once the Baucus bill passes, Obama and Reid will throw almost all of its key provisions, including the state-level coops, in the trash.

Fourth, according to the latest Quinnipiac poll, not only do Americans want the public option, by a wide margin – 38 percent of conservatives want it. Could the opt-out plan win some Republican votes?

And one word of warning: some folks think that when the Democrats try to get those 60 votes against cloture, the sticking point may be, not the public option, but the methods of paying for the overall reform package.

And another: Howard Dean pointed out that the public option probably won’t be going full blast until 2013, but they might need to give some folks, like seniors, an early “in”, in time for the midterms.

Five stunning developments

The CBO slams Baucus' coop plan, the Democrats have a fiendish plan to pass health reform, the Democratic leaders are growing some balls, the Godfather of GOP Obstruction on health care has switched sides, and the GOP wingnuts plan a revolution next week.

WOW.

FIRST: the CBO says the Baucus bill is so bad that people will turn down free money

As Baucus, ever so slowly, completes his work on the Finance bill, he’s just having a rough time of it. He is now facing attacks from his home-state Democrats, just like Nelson and Conrad, in no small part because nobody wants a crappy bill with watered-down coverage (Obama feels the same way). His troubles are not surprising when you look at all the people Baucus has offended: Rockefeller, the health care subcommittee chairman who wasn’t included in the Gang Of Six (whom Baucus isn’t even talking to these days), Wyden who was double-crossed on his amendment (Baucus gave the CBO the time to score his whole bill but not Wyden’s tiny amendment, which is bullcrap), plus angering liberals, Democrats, reform advocates….

Baucus’ bill may not have the supporters he needs. Some believe the Baucus bill could lose Rockefeller, Wyden, Lincoln and Snowe, although losing Snowe might actually help: if Snowe votes against the Finance bill, her preferred language (like the trigger) may not be in the floor bill -- the logic being that if she can’t even support Baucus’ bill, she certainly won’t be on board for the more liberal floor bill, and can safely be ignored. The whole purpose of the arch-conservative Baucus monstrosity was to win over people like Snowe, and if that fails, the Baucus bill has no further relevance: the next task is merely to figure out which public option can get 60 for cloture.

Things got considerably worse for Baucus when the CBO took at look at his bill. The bill will leave 25 million uninsured, and if there is a year in which coverage bumps up the deficit, coverage gets cut the following year.

And here’s the amazing part. The CBO didn’t just say that the coops are a lousy idea that will have no impact on the market (i.e. the entire bill is a waste of time since the coops are the whole point). The CBO said the market penetration would be so pathetically small that, out of Baucus’ tiny $6 billion seed-money fund for the coops, only half the money would even be claimed – people wouldn’t even take the free money to set the coops up!

Also amazing – Baucus doesn’t even realize that the CBO slammed his bill – he claimed the CBO score was very good news. Even in Montana – how did this guy get to be Senator?

SECOND – an fiendish, evil, ingenious plan to pass health reform

As we move toward a Senate floor bill, we’re seeing more trial balloons. The Wall Street Journal is trying to push the Carper plan for state-run insurance systems – each state either opts for a coop, a public option, or an expansion of state employee plans for everybody. Allegedly the plan would allow states to band together; they can’t, however, link it to Medicare rates, which would cost them a lot of Democrat votes on the Hill. It makes HHS the arbiter – regardless of which party controls the department. Ben Nelson likes the idea. Conrad called it “constructive”. Stabenow and Menendez could accept state option. Guys like Schumer hate it. Snowe also dislikes it.

Again, there are so many problems with a state-by-state approach. Coverage would be a patchwork mess, with good care in some places and lousy care in others, the kind of crappy plan Obama can’t approve. Some states are broke; most states aren’t equipped to run an insurance system; some states are run by Republicans who don’t want to do anything (so the wingnuts who want gummint to go away in their red states may get their wish); some states could just put up an “exchange” that is nothing more than a website, or an exchange that doesn’t actually work to get people covered, negotiate, collect data; and as we know all too well, all state governments are susceptible to bribes from deep-pocketed insurers.

So where’s the amazing part? A new scheme that’s floating around Washington – pass a public option, but give the individual states the power to opt OUT of the plan. In other words, instead of the Carper plan, which potentially would start with zero states covered and then go upward as states approve health plans, the new scheme starts from 50 states covered and then goes DOWN only when state legislatures and governors KILL the health coverage. This way, Blue Dogs like Nelson can vote for the public option (or at least for cloture) and then kick the real decision back to the state legislature, where the local legislators would have a very hard time voting to cancel coverage for all their constituents. Some worry that liberals might fight this idea, but that would be stupid and already Schumer, who knows an ingenious scheme when he sees one, said he likes it.

THIRD – the Democrats grow some balls

The liberals are becoming more vocal. The House bill will be quite liberal: Pelosi tried to talk the liberals down from the Medicare-linked public option to the negotiated public option, and even then liberals were furious. So going even further to the right in conference – say, no state-run plans, coops, triggers – won’t happen. In the Senate, Boxer is now insisting publicly that the bill have the public option, and liberal Senators are reportedly pressing Reid to commit publicly to putting the public option in the original floor bill (of course Reid might at least want to wait until Finance is done before throwing their bill in the trash). Democratic leaders are pushing the moderates to back cloture, and the moderates are beginning to realize that it’s a good idea to vote for the final bill even it it means a bit of trouble back home – because at root they are still Democrats. Few want to take that active step of voting to kill reform and destroy their president.

The centrists pull right, the liberals pull left. One reason why the centrists seem to have the upper hand in this tug of war, pushing the reform bill ever further to the right, is that people believe centrists when they say they could vote down a reform bill, but nobody believes any liberal threat to do the same – everyone believes that in the end liberals will accept half a loaf. That’s another reason why the floor bill must be right from the start: get the public option in the merge bill as soon as Reid has trashed the Finance committee bill.

But even if the liberals accept half a loaf, they can exact revenge later.

And that’s the amazing part: Democrats with balls. Senate Democrats are now talking openly about punishing Democrats who violate party discipline on cloture in the health care effort, by stripping them of their committee chairs. Baucus would undoubtedly be the first one to get tumbrelled to the guillotine.

And what makes this even more amazing? Joe Lieberman. Lieberman is already living on borrowed time. He switched from Democrat to Independent and even backed McCain for President. Obama still let him keep his job as chairman of the Homeland Security and Governmental Affairs Committee. But now, when he’s not obstructing Obama’s health care effort, he is making ugly noises about using his position as chair of the aforementioned committee…to investigate Obama’s mythical czars. Yes, the word you’re looking for here is chutzpah. Or perhaps meshugenah. Right after we pass health care reform, look for Lieberman to be the first chairman to be stripped of his chair.

FOURTH – the GOP leader who killed health care in 1994 has recanted

The GOP argument against reform is leaking even more air. Critics are pointing out that the GOP is arguing, simultaneously, that the government must not be involved in health care, and that Medicare must never be cut, which are mutually contradictory. People are noticing that the biggest critics of health care outside Washington are people who (a) don’t understand the issues, or (b) are worried because reform means that their own government-run Medicare will be cut, so they’re not exactly die-hard foes of Big Gummint. And GOP leaders are beginning to realize that if the plan passes, they will be forced to show the American people how Big Gummint Care failed, and they won’t be able to.

But where’s the amazing part? Bob Dole! He was the guy who crafted the strategy to kill health reform in 1994. Of all the people who speak out for health reform....He is now saying that the opposition to Obamacare is rank partisan politics and that Congressional Republicans should STFU and get with the program. He even panned his own 1994 effort: “Politics took over, and you lost”.

FIFTH – wingnuts demand Obama resign in a week, or the revolution begins

The loony right is still talking violent revolution. The wingnuts have a new internet threat against Obama: resign in a week or there will be war. “Our Dear Leader and co.…leave now and give us our country back…If you stay, ‘We, The People’ will systematically dismantle you, destroy you and reclaim what is rightfully ours. …We are angry and we are ready to take back the rights of the people. We will fight and We will win. …Dead line for your national response: October 15, 2009…Thank you to all patriots who support our cause. … Be prepared for when the fateful day of the declaration of war is nationally announced.”

http://www.splcenter.org/blog/2009/10/07/leave-or-else-youtube-video-warns-obama/

Well, I guess the abject, dangerous insanity of Republicans isn’t so stunning, is it? So, four stunning developments, then.

CBO: Baucus' coops won't work

From the AP:

The alternative to government-sold health care, a proposal for nonprofit co-ops that would compete with private companies, was judged largely ineffective by budget officials. Such arrangements "seem unlikely to establish a significant medical presence in many areas of the country," they wrote.

They said the same thing in an earlier markup, I think, and for obvious reasons -- state-level coops really are a stupid idea. The only potential utility in such a proposal was to win over a single Senator, Snowe, and it may not even achieve that.

Who to watch in the next few days

OBAMA. The latest Gallup poll shows that support for health reform increased, and the latest AP poll shows Obama’s approvals are rising; likewise his approvals for handling the economy and health care. His approvals among the all-important independents is up too. Obama steps directly into the health care fray this week, Finance or no Finance: Senate Democrats do want Obama to steer on key issues such as the public option. But some of his key efforts are happening out of our view: in addition to lobbying Senate Blue Dogs to support cloture, Obama is also working behind the scenes to attract non-Washington Republicans to the cause. As a result, more Republicans are coming out for health reform: three former Senate GOP leaders, Mike Bloomberg, former HHS boss Tommy Thompson, and now Arnold Schwarzenegger. Buncha communists, right?

PETER ORSZAG. The White House team helping to shape the Senate bill will be Rahm Emanuel, health care adviser Nancy Ann DeParle, and OMB chief Peter Orszag. Having Emanuel in the room means we could get a trigger option; having Orszag in the room means a lean system which could win over deficit hawks like Bayh and Conrad. Orszag also said that the public option isn’t essential, and that he was okay with triggers and coops, so we’ll need to watch him to see how wobbly he really is. The GOP is watching him too: they demand that he be there for the Finance Committee vote on the Baucus bill, so they may be planning to ambush him.

HARRY REID. Reid is already beginning the effort to merge the two Senate bills; he’s not even waiting for Finance to vote anymore. Finance is delaying its vote, either due to Baucus’ glacial pace of operations as chairman, or because Baucus doesn’t have the votes to pass it. The Blue Dogs are demanding 72 hours to read floor bill before voting; I’m surprised they didn’t demand 72 years. Fine, gives Obama more time for arm-twisting. Meanwhile, Reid is moving forward.

CHUCK SCHUMER. Today we heard a cautionary tale about state-level health care plans, from the guy who ran the Texas plan. He said Texas tried to set up a state-run exchange, but it failed because because the plan was so small that the private insurers could undercut it and cherry-pick it to death, targeting companies with young, health employees and dumping the older folks out. The public exchange was swamped with old, sick people, prices rose, and it collapsed. Such cherry-picking by insurers also killed the systems in Florida, North Carolina and California . This is why we need a national plan, even if it’s just a coop, and we need provisions to prevent the insurers from gaming the system or exploiting adverse selection. If we reach a compromise on a plan that is a coop, but a national-level coop, watch for Schumer to be the architect of the deal, possibly working with Conrad.

KENT CONRAD The North Dakota Democratic party has passed a resolution demanding single payer, or at the very least the public option. It was unanimous. This is by way of putting more pressure on Conrad – vote with us or you’ll get a primary challenge! -- right after the Nebraska Democrats launched the same ambush against Ben Nelson.

RON WYDEN. Wyden wants to break the grip of the insurers. Wyden and other Democrats are furious at Baucus and Conrad for their obstructive behaviour in the Finance Committee. He and Rockefeller and Cantwell have been threatening to vote against the Baucus bill – perhaps they can force Obama to take a harder line on the public option on the Senate floor, in exchange for their acquiescence on the Baucus bill now. Wyden will vote for the public option if it comes to a vote.

BEN NELSON. A recent poll shows that if Ben Nelson supports a filibuster on health care, his support among Nebraska Democrats drops a staggering 17 points, thus paving the way for a long-overdue primary challenge. But Ben Nelson claims his leadership hasn’t even approached him on the cloture issue, which is bullcrap: he could still be planning to screw Obama over.

ALAN FRUMIN. He’s the Senate parliamentarian, and will rule on some critical issues once the health reform bill hits the Senate floor. He will uphold the rule that a conference report can be filibustered, which will put more pressure on Obama and Reid to hold the Senate Democrats together. He will probably support the notion that the Democrats, if need be, can overcome a filibuster not only by cloture or reconciliation, but also by leaving the bill on the agenda indefinitely, with nothing else on the agenda, so no other business can be conducted (the Republicans would try to play chicken and wait them out, but that’s a losing proposition). He may also have to rule on a tactic which the Republicans tried to use in 2005: the Democrats could threaten to use a chair ruling to kill a filibuster on the grounds that using the filibuster in such a case would be unconstitutional.



And of course THE REPUBLICANS; the air is slowing leaking out for them, and they know it:

Snowe is pushing to weaken insurance exchanges by forcing exchanges to allow any company into the exchange even if they have sky-high prices and lousy coverage like the existing firms. She is clearly not serious about either reform or bipartisanship. So she’s finally tipped her hand, and her influence will drop accordingly. Meanwhile GOP leaders are insisting that even if Snowe supports reform, it’s still not a bipartisan effort. As if anyone cares.

Earlier, the Republicans, on orders from their masters in the insurance industry, forced Democrats to amend the Baucus bill by adding an individual mandate forcing people to buy insurance. Now they are arguing exactly the opposite – now mandates allegedly are a bad idea -- in an effort to slow things down even further. Let’s just sit there and admire their chutzpah: slamming the Democrats for including something the Republicans demanded in the first place.

The conservatives are arguing, simultaneously, that “government can’t possibly compete with private enterprise”, and that “private enterprise can’t possibly compete with government.” Um, if government care is really that crappy, no will choose the public option, will they? You would think the Republicans would love to see the Democrats fall on their faces, right? But actually, the Republicans aren’t afraid that government health care will fail. They are afraid it will succeed. And if fact both of the arguments are wrong. As Bob Cesca pointed out, taking a private cab in New York costs four times as much as the public subway, but there are still more than 10,000 cabs on the streets – they didn’t disappear the minute the public trains began to run. .

Rasmussen, the Republican pollster, gets busted for lying again. At the same time, another right-leaning pollster, Strategic Vision, is also busted for cooking the books.

Fox anchor Shepherd Smith finally loses it and totally blows apart a Republican politician who was spewing lies about the “government takeover” of health care.

Republicans sucking up to the female voters again? The National Republican Congressional Committee just said "If Nancy Pelosi's failed economic policies are any indicator of the effect she may have on Afghanistan , taxpayers can only hope McChrystal is able to put her in her place." Another uppity liberal broad.

Limbaugh is trying to buy the St. Louis Rams. This guy is a drug addict who has failed in one field of endeavour after another, whose one brief flirtation with higher education was a laughable disaster, who only survives as a “pundit” because he never comes out of his sound booth where a real opponent could challenge his lies and his bullcrap, and who only has all those listeners because his company offers the show for free in many markets, in exchange for preferential advertising agreements. The man lacks the aptitude to lead flies to a pile of shit, and he’s going to turn around a team which is arguably the worst in football? And how could any black player possibly work for that guy? Or anybody who believes in labor unions? Or anybody with a brain?

Yet again, Republican governors who slammed the stimulus bill are now begging for stimulus money. As Kos implied today -- How about this? Any state whose Senators voted “no” on the stimulus gets no stimulus money. Call it The Hypocrisy Clause.

Pelosi is shooting for passage by Thanksgiving, so within milliseconds the Republican will make fools of themselves with a new wave of obstruction tactics, just so they can brag that they threw the timetable off track.