Policy

Did Progressives Even Know What Was In the Health Care Reform Bill?

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As I noted last week, since Joe Lieberman forced Democrats to ditch the Medicare buy-in compromise, some of the most intense opposition to the health care bill has come from the left. And as lefty opposition to the bill has intensified, something incredibly frustrating has happened: progressive criticism has come to mirror the criticism that's come from market-oriented skeptics.

So now we're in a bizarre situation in which Democracy for America, which formed out of the remnants of Howard Dean's presidential campaign, is urging Democrats to kill the bill and saying things like "the bill doesn't actually "cover" 30 million more Americans - instead it makes them criminals if they don't buy insurance from the same companies that got us into this mess." And DailyKos founder Markos Moulitsas is launching attacks against the plan because it too closely resembles the Massachusetts plan — and is thus likely to share its problems.

Here's the thing: None of this is news. I've said as much myself for months, as have basically all of the policy-savvy critics of the bill. Yet the liberal left is only now airing these debates — after the bill is more or less done.

What does this mean? I see two possibilities: The most likely is that progressives are latching on to these criticisms because they're now so angry that they're ready to do anything to kill the bill — including admit what they had to have known all along, which is that these criticisms actually have a lot of merit.

The second, while less likely, is more disturbing: Many progressives who backed this bill throughout the year had no idea what was in it. They hated Republicans, heard endless public-option hosannas from their leaders, and believed they'd found a way to start the move toward single payer.

My guess is that, for the most part, they did know, and simply ignored the criticisms they're now making in hopes that they could bargain their way toward a plan that they hoped would stick it to the insurance companies and put the country on the path to single payer. But still, I wonder how much they actually understood the bills they supported: The versions of the bills supported still had insurance mandates (which would've resulted in lots of people buying private insurance) as well as all of the problems that the Massachusetts plan had. And the addition of the Medicare buy-in or the sort of public plan they could've actually gotten — ie: the kind in which payments aren't tied to Medicare rates — wouldn't have invalidated any of these criticisms (indeed, according to CBO, the negotiated-rate public plan would've been a minor force in the insurance market, as its premiums would've been slightly higher than private premiums). In other words, the criticisms they're lobbing toward the bill now still applied to the versions they campaigned for.

I'll admit I find it at least a little bit amusing to see the left fighting over these criticisms, but it's also incredibly frustrating to see them come at such a late date. At this point, it's basically academic; the bill is all but a done deal. Where were these criticisms when they might've mattered?