Obamacare

Deal or No Deal?

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Deal time!

After an several days of negotiations between moderate and liberal Democrats, reports are coming in that the Senate has struck a deal on health care reform. But the strength and specifics of the deal are still highly uncertain.

Details are still somewhat sketchy, but the outline seems to be that the liberals will agree to let their beloved public option go in exchange for an expansion of Medicare that lets those as young as 55 buy in, the creation of a new national health plan put in place by the Office of Personnel Management and run by regional non-profits that would be set up by health insurers (got that?), and strict new insurance regulations that would require health insurers to spend at least 90 percent of all premium dollars collected on medical care for customers. Senate aides told TPM that the deal would trigger the creation a public plan should OPM fail to get insurance companies to create the non-profit plans.

Still, it's not clear how firm or final the deal is: According to the Washington Post, "the deal represents only an agreement among the 10 negotiators to send the new package to congressional budget analysts, not an agreement to support its elements." Presumably, this means that legislators are leaving room change their minds, especially if the CBO returns a politically problematic score.

It's also not clear whether this deal actually secures the necessary 60 votes for passage. There's still significant question about whether it will bring Lieberman—who has up until now expressed the strongest opposition to the public option—into the fold. In a press release this morning, he reiterated his opposition to any sort of public plan, even triggered, so his vote still is far from a lock.

But after the failure of Ben Nelson's abortion-funding amendment, which would have restricted federal dollars from being used to purchase insurance plans that cover abortion, Nelson is far from a sure vote. And Olympia Snowe, the favorite Republican to provide a yes should Democrats fail to bring all 60 of their caucus members on board, has already expressed skepticism about the deal.

And, of course, there are plenty of stakeholders who are unhappy with the terms being floated for the current deal, and may campaign against it. In particular, according to NPR, hospitals, doctors, and insurers are resisting the proposed Medicare expansion. In other words, a deal may be taking shape, but it's far from done.

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  1. If they add a miniature American flag amendment to Nelson’s abortion amendment, I think they’ve got a deal.

  2. Senate aides told TPM that the deal would trigger the creation a public plan should OPM fail to get insurance companies to create the non-profit plans.

    So the govt is rewarded w/ more power if it fails? I wouldn’t expect success.

  3. I don’t see how they can get a deal that bans abortion funding and eliminates the public option. But if they don’t get those two things, they lose Lieberman, Nelson and Snow.

    At some point I wonder if a few Senators have read the polls and realize this thing is a disaster and are just going through the motions figuring they can blame killing it on someone else. I really don’t think many of them want to run in 2010 with this albetrose around their necks. Better for it to fail and have the whole thing go away.

  4. Johnny,

    Well, in theory, the burden is more on the insurance companies, who have some incentive to take actions that would prevent the creation of a public plan.

    1. I doubt that with the regulations which will shackle private industries they are going to be capable of meeting the requirements placed on them by government.

  5. So you let more older people get the medicare which gets more folks to pressure their congresscritter to pass the bill. Then you put rules in that will keep private companies from joining the govt pool. This guarantees the formation of the public option. Sounds to me like they know exactly what they’re doing and single payer is where they’re going.

  6. The other issue is the requirement to buy insurance. That is going to cause a revolt. No one outside the left fever swamps and Congress supports that or thinks it is a good idea. If they pass that requirement, they are going to live to regret it.

  7. John, if they take out the mandate they will lose the insurance industry and the resulting ad campaign will shut everything down. So it is either lose the bill or lose their next election. These fools rather pass this bill.

    1. Some would. But I would never underestimate the survival instinct of these critters. I bet a lot of them are quietly hoping and working to make sure the bill dies and someone else takes the blame for it.

      Actually getting to 60 votes really screwed the Democrats in some ways. If they only had 55 votes, they could kill the thing and blame it on the evil Republicans and their nitwit supporters would beleive it. But with 60 votes, even their supporters won’t buy that.

      1. “If they only had 55 votes, they could kill the thing and blame it on the evil Republicans and their nitwit supporters would beleive it. But with 60 votes, even their supporters won’t buy that.”

        and though i love mixed government as much as anyone on here, part of me wanted the dems to have full owenership of government. If a party is going to massively expand the power of government I want it squarly associated with rhetoric that states such… im tired of “small government” republics saying they are for free enterpise, do the exact opposite, then when shit hits the fan the public blaming it on free enterprise.

        1. I agree with you. People voted for the Dems, let them own government and thus responsibility. Most of the time “bipartisianship” just means avoiding responsibility for your policies and positions.

          I don’t have any sympathy for the Dems or the country. The Dems wanted power and the people put them in there. So, both of them can now live with the consiquences.

  8. I don’t think I’ve ever seen a picture of Harry Reid where he doesn’t look like a sniveling little weasel. I suppose that could be because he is one.

    1. The two behind him look particularly “mobesque”.

      1. Talk about a rogues gallery (sorry Sarah).

  9. It really does take a genius to figure all this stuff out, but it looks like they’ve finally fixed our problems with healthcare.

    Honestly, I might have understood raising the age of eligibility, but lowering the age of eligibility for Medicare? That’s too ingenious for me.

    “…the outline seems to be that the liberals will agree to let their beloved public option go in exchange for an expansion of Medicare that lets those as young as 55 buy in,…”

    They’re making the age of eligibility lower.

    They’re lowering it.

    Lower.

    1. that lets those as young as 55 buy in,

      This is the operative phrase here. Obviously they’re hoping to raise some money for the Medicare system. “Buy” in? That must be a joke – what in hell do they think people have been doing all their working lives, if not buying in to the system?

  10. Next thing you know they’ll save Social Security by lowering the age of eligibility. WTF?!

  11. It’s a win-win-win scenario. The bill dies? Those dastardly Republicans! The bill passes and is a disaster? The bill should have been stronger; we need single-payer! The bill passes and they manage to hide the economic effects long enough until a Republican administration? Those dastardly Republicans!

    Lowering the eligibility for Medicare is fairly stupid, even as a feint. Not politically, of course, with AARP in the mix.

  12. Requiring for-profit companies to set up non-profit cooperatives in order to be allowed to stay in business?

    Sounds perfectly constitutional to me!

    (You know “provide for the general welfare”?)

    It’s really amazing how the US Constitution has been turned into a document that could empower (indeed, require!) a full Marxist totalitarian state.

    For the children.

  13. Nice pic of Reid invoking Satan.

  14. The medicare expansion is the worst bit. With Medicare costs already projected into the tens of trillions over the next few decades, adding millions of additional patients to its rolls will just bankrupt us sooner.

    1. Not to mention what Medicare already does to the cost of healthcare to the privately insured and the uninsured (people who pay cash).

      If only the government actually paid the costs of the people on their programs, everybody else wouldn’t have to shell out for the shortfall.

      …like a bunch of shoplifters, those patients are, and most of them don’t even know it.

      They’re trying to solve the problem of high costs to the privately insured and uninsured by increasing the magnitude of the cause of the problem! It’s absurd.

      There’s some logic to it. I remember when the committee decided to fund the expansion of coverage through Medicaid and Medicare specifically because it costs the tax payer less than paying for private coverage. …but that’s just because the government programs only pay for a fraction of the healthcare its members consume. So, like I said, I know there’s some logic to it, but the results are still completely absurd.

  15. ‘If they add a miniature American flag amendment to Nelson’s abortion amendment, I think they’ve got a deal.’

    The reference to the joke about ‘abortions for some, miniature American flags for others,’ seems to suggest that Nelson was simply introducing abortion into an abortion-neutral bill – adding stuff about abortions and flags in order to pacify voters.

    In fact, abortion was in the bill before the Nelson amendment, and it is in the bill now after the amendment was rejected. The difference is that, with the Nelson amendment defeated, the Senate bill will provide for federal support and subsidy for abortion – with accounting gimmicks specially designed to fool dumb voters into thinking it’s abortion-neutral.

    Singling out Nelson, as if he took this nice neutral health bill and injected abortion into it, is silly.

    Abortion will be covered in the bill one way or the other – the only question is whether the bill will preserve previous federal policy against supporting elective abortions (the approach of the defeated Nelson amendment and of the House bill) or abrogating that policy and allowing federal support for abortions (the Senate bill’s approach).

  16. As I have pointed out before, the Libertarian Party has specifically come out against federal funding for abortion. They cite it as a specific example of bad federal spending ? a Party blogger went out of his way to denounce Biden specifically for his support for elective abortion funding.

  17. Why doesn’t some clever congressperson propose a “trigger” that would dismantle the public option if it fails to realize the cost savings its proponents claim will occur?

    Oh wait, it’s only private industry that needs threats to keep costs down, not government.

  18. strict new insurance regulations that would require health insurers to spend at least 90 percent of all premium dollars collected on medical care for customers.

    I was operating under the delusion that revenue from premiums does not, by itself, cover operating expenses; it is supplemented by investment income. Maybe health insurance is different.

    Or is the ninety per cent number intended to be a restriction on administrative expenses?

    —–

    And-

    Expanding Medicare looks like a pretty good (“good” meaning “effective” as opposed to “beneficial”), although truncated, substitute for the public option, to me.

  19. I think Harry Reid looks good with that halo. He’s our Saviour, don’tcha *know.

    *one of many

  20. Please disregard that wayward asterisk

    stupid keyboard

    1. “The Sad Ballad of the Wayward Asterisk”

  21. Maybe I could get a Stimulus grant to establish a “Home for Wayward Asterisks”. I can use them as forced labor on my “ranch”.

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