You've probably read about the idea of bypassing a House-Senate conference on the Health Insurance Premium Assistance Bill so that President Obama can tout it in his State of the Union address. apparently, House liberals are not pleased with the notion:

Two well respected House liberals — Jan Schakowsky and Jerrold Nadler — expressed skepticism about the current public option compromises emerging from the Senate, and vowed that House Dems would not be railroaded into swallowing the Senate bill. “It would be a mistake to think that the House leadership will go into any kind of conference committee with the expectation that we’re just gonna sign on to the Senate bill,” Schakowsky told me. “The House intends to negotiate with the Senate. We expect those deliberations to be vigorous. The House is not simply going to sign on the dotted line.” [. . .] “The House is not going to be dictated to,” Nadler told me.

We'll see. Giving Obama the chance to include "health care reform" as an "accomplishment" in his speech is one of the lousiest reasons I have ever heard for such a thing.

Speaking for me only

I've gotten oh so bored with the whole "Obama, Love Him Or Leave Him" stuff, but Glenn Greenwald wrote a good post about all of it. Anyway, as regular readers know, sometimes I support the President, sometimes I criticize him. Depends on whether he adopts policies I agree with or not.

I also never miss an opportunity to republish this post:

How about that?

Sen. Joe Lieberman (I-CT) is a must have vote. He just gave his Democratic colleagues some breathing room. Lieberman said he's open to both the Medicare buy-in idea, and a separate proposal to extend the private system that insures federal employees to individuals and small businesses.

Who'da thunk it?

Speaking for me only

Heh:

Sen. Olympia Snowe (R-ME) says a Medicare buy-in approach will be a hard sell with her. She told reporters this afternoon that she's not inclined to support the idea, currently being discussed by liberal and conservative Democrats seeking a compromise on the public option. [. . .] She's expressed her doubts to Senate Majority Leader Harry Reid. "I told him I have concerns," she said. "The Medicare buy in is problematic." A reporter asked if that meant she's not inclined to support the idea. "Correct," she said.

Now what? Hey, I have an idea, reconciliation.

Speaking for me only

Even if I agreed with this column from Ezra Klein, and I do not, what is the point of writing a column NOW urging that employer health insurance costs be taxed? It has as much chance of passage as single payer. And even if it was a good time, do you find this convincing?

[H]ealth-care coverage is not a benefit. It's a wage deduction. When premium costs go up, wages go down. When premium costs go down, wages go up. Yet workers don't know that.

(Emphasis supplied.) They "don't know it" because it is not true. Health care coverage is indeed a benefit and it is ridiculous to state it is not. Should it be? Probably not. But that is like arguing that a pension or vacation time is not a benefit. Obviously both are. Whether it should be a tax-subsidized benefit is another question and I think there is a good argument that it should not be, IF we were starting a system from scratch. But we are not. More . . .

One of the more frustrating aspects of Village Wonk blogging on the health care issue is the disconnect between the political ramifications of imposing an individual mandate without offering those you are forcing to buy insurance an affordable option. In their mind, the solution is to write about increasing the subsidy levels. Of course, they know that when President Obama said the bill could not cost more than $900 billion, that foreclosed a realistic subsidy level (might as well say let's do single payer or Wyden-Bennett. Never going to happen.) Besides that, they ignored how this approach merely was more feeding of the beast known as the health insurance industry and served to undermine their other pillar of concern - cost controls.

I have criticized them for this for months and months. Now we have a new and important wrinkle - the Medicare buy-in. Some continue to have faith in the Exchange idea. I have long stated I do not. I do believe that a Medicare buy-in available to persons eligible for the Exchange (which would be everyone whom the individual mandate will force to buy insurance) would solve both the cost containment problem and the political problem of forcing people to buy insurance. Jon Cohn writes:

One of the changes being pushed by the liberals would lower the age of eligibility for Medicare to 55, from 65. Another would expand Medicaid to cover people with incomes up to 150 percent of the poverty level (up to $33,075 for a family of four). The Senate bill, as it now stands, would expand Medicaid to cover people up to 133 percent of the poverty level ($29,327 for a family of four.)

A third liberal proposal would require insurers to spend a specified share of premiums — about 90 percent — on clinical services and activities that improve the quality of care. This would, in effect, limit the profits that insurers could make. [ . . .] Senator Sherrod Brown, Democrat of Ohio, is taking the lead in drafting the proposal to let people 55 to 64 “buy into” Medicare. In May, Senator John D. Rockefeller IV, Democrat of West Virginia, introduced a bill to provide access to Medicare for people in that age group. “I’ve been for that since 2001,” he said.

(Emphasis supplied.) I hope Senators Brown and Rockefeller are writing a provision that states that anyone of any age subject to the mandate (which means everyone who goes into the Exchange) will have the Medicare buy-in option. Otherwise, the mandate should be scrapped. Another possibility, it seems to me, would be to allow states to opt out of allowing their residents to buy in to Medicare. I'm sure North Dakotans will appreciate that.

Speaking for me only

Let's hope Ezra has good sources:

Sources who have been briefed on the negotiations say that Medicare buy-in is attracting the most interest.

(Emphasis supplied.) Medicare for Some? That's a start towards Medicare for All. Take out the mandates, increase Medicare eligibility, use the House funding model and I can support this health insurance premium assistance bill.

Speaking for me only

Ezra Klein writes two good posts. In the first one, he writes:

[s]o far as health-care reform goes, the public option is fairly simple, and undeniably prominent [only 30% of Americans think they can explain it.] Imagine how many could explain the exchanges, or the mandate, or the benefit package ...

Further, I doubt 10% even know the words exchange or mandate have anything to do with the health care bill. That rude awakening is the biggest political pitfall for Democrats. There is no support for a mandate or the Exchange because no one has been honest about these provisions. The second post from Ezra states:

Politico:

There appeared to be serious consideration of a new proposal on the table: a national health plan similar to the Federal Employee Health Benefits Plan, which provides insurance to members of Congress and federal workers. It would be administered by the Office of Personnel Management, which oversees the federal plan, and all of the insurance options would be not-for-profit.

Devil in the detail as always, but this seems a viable way to run an Exchange. The Federal Employee Health Benefits Plans negotiate very well. Should also solve the Stupak Amendment problem. This is not a Public Option of course, but since the federal government could, in theory, negotiate the rates and benefits on par with what federal employees get, the expansion of health insurance to 30 million Americans can be done in a positive way. Of course this is not health care reform, but it could be acceptable health insurance assistance.

It's perfectly obvious that health care reform will not happen with this bill. But this could be an acceptable health insurance assistance bill. Let's see the details.

Speaking for me only

Will the Village Wonk bloggers try and explain why a progressive should not accept the removal of the Exchange from the health care "reform" bill in order to avoid the consequences of Ben Nelson and Bart Stupak's insistence on the Stupak Amendment? So quick to jettison the public option, will they be as eager to say good bye to the Exchange? Ben Nelson makes the question a pressing one:

The defeat of his amendment would be politically significant because Nelson has pledged to vote with Republicans to filibuster the health bill if it did not include the Stupak language. [. . .] Stupak’s measure would restrict women who receive federal subsidies from buying abortion coverage on insurance exchanges set up by the government.

Remove the Exchange and the Stupak Amendment has no reason to exist. Who will stand in the way of this "practical" and "pragmatic" solution? After all, the Exchange is so limited as to be "meaningless," even if you believe in its magic "reform" powers. I call on the Village Wonk bloggers to be grownups about this - let go of the Exchange.

Speaking for me only

Like Chris Bowers, Senator Arlen Specter (D-PA) is still fighting for the public option.

Would love to see some fight from Joe Sestak on the issue. The rationales for supporting Sestak are becoming less apparent by the day.

Speaking for me only