It’s worth pointing out again — for the millionth time — the disconnect between Republicans’ and conservative Democrats’ constant yammering about deficits and budget-busters and spending us into bankruptcy, and those same lawmakers’ opposition to the public option — and their crusade to compromise it into nothing.
Jacob Hacker at The New Republic has some strong and very on-point thoughts on this subject:
The public option in the Senate bill, it should be emphasized, is a compromise of a compromise already. The first compromise was to have the public plan negotiate its rates directly with providers, rather than set them based on Medicare’s rates. This compromise meant that the Congressional Budget Office was unlikely to score the public plan as producing the huge savings that it projected for a plan that used Medicare-based rates. Whether CBO was right in discounting the negotiated-rate plan’s savings is another matter–as I have written on this site, it’s likely underestimating the cost-containment potential–but the CBO’s numbers rule on Capitol Hill.
The second compromise was to allow states that did not want to have the public plan operating within their borders to “opt out” with the passage of a state law. How many states will take advantage of this option is unclear, but it’s certain to reduce the impact of the public plan even further. Indeed, the CBO is now projecting—again, pessimistically in my view–that only a few million Americans will enroll in the public plan. Yet none of this has apparently appeased the handful of hold-outs. Emboldened by the White House’s lack of clarity and pressure on the issue, they are digging in their heels and spewing false claims about the public plan (for example, that it’s a budget buster when there are no special government subsidies for it and the CBO projects it will exert downward pressure on private premiums, thus lowering the price tag of reform). Hence the new push to find some kind of middle road.
The problem is that the “middle-ground” ideas that are currently flying around aren’t in the middle at all.
Daily Kos’s McJoan runs down the latest of these “compromises”:
[Sherrod] Brown described it as a take-off of the Federal Employee Health Benefits Plan. With the Office of Personnel Management as the administrator, the program would be separate from the Department of Health and Human Services, which regulates the insurance marketplace.
“It would be a national, not-for-profit,” Brown said. “(The Office of Personnel Management) would administer it. It would be any number of national not-for-profits that would compete nationally and they would take the place – more conservative members hope – of the public option. They would be in states and be running a kind of lookalike to a public option.”
The nonprofit insurance companies would “go to OPM and say I want to compete and then you show them you’ve got standing to compete,” Brown said.
Existing insurance companies could participate as long as their plan is not-for-profit, he said….
Brown, however, said he is not a convert to the latest proposal. Supporters of the public option have already compromised enough, he said.
It’s not a public option. It’s essentially an exchange within the exchange. Now maybe it’s a good substitution for the exchanges–just open up the FEHBP to people instead of creating, in the House’s case a national exchange, or in the Senate version multiple exchanges. If they got rid of the exchanges in return for this, it would get rid of the Ben Nelson/Bart Stupak political problem (though it would still extend the Hyde problem to millions of women) by getting rid of the need for their amendment.
But it’s still not a public option, like most of the “compromises” we’ve seen floated in the Senate.
The Confluence links to a live stream of Senate debate which is going on over the weekend.