Senate Health Care Bill Clears Hurdle, Progressive Opposition Grows

Early this morning the Senate voted to end the period of filibuster on the health care legislation by a vote of 60-40. Not surprisingly, the vote broke down along party lines with all the Senators who caucus with Democrats voting to end the filibuster. This is a big step in moving this legislation forward as Democrats and the White House are pressing for a final vote before Christmas.

It is no secret that this legislation has devolved into a complete mess. Republicans are still against any kind of reform, Moderate Democrats have worked to strip the bill of the public option and Medicare buy-in, and Progressive activists are now split on whether to support or kill the Senate version of the bill.

While there is still some good discussion on the pros and cons of the legislation there are some revealing moments that show just how ugly this debate has become. Take this item from last night when the ailing Senator Robert Byrd (D-WV) was wheeled into the Chamber to vote at 1am. Byrd's presence was not necessarily required for his vote to count, but the Republicans insisted that he travel to the Chamber to cast his vote in person.

Before Byrd arrived for the vote, Sen. Tom Coburn (R-OK) took to the Senate floor and indicated that Americans "pray that someone can't make the vote tonight". Watch:



Ezra Klein reacts to this incident:

The Senate hasn't just lost a bit of its collegiality. It's become heartlessly ferocious -- a place where the death of an honored friend presents an opportunity to kill his legislation, and in which the infirmity of an ailing colleague is seen as a potential path to procedural victory.

While Republicans continue to oppose any type of health care reform, Progressives are also divided after Sen. Joe Lieberman's (I-CT) successful attempt to strip out the Medicare buy-in and the public option from the Senate legislation. Howard Dean has been very vocal in his calls to "kill the bill" and other progressives are also also advocating that health care talks turn to reconciliation in order to save robust reforms to the system.

Jane Hamsher at Firedoglake has been working very hard on the issue of reform for many months now and has compiled a "Top 10" list of reasons why progressives should oppose the Senate Bill. Here they are:

Top 10 Reasons to Kill Senate Health Care Bill

1. Forces you to pay up to 8% of your income to private insurance corporations — whether you want to or not.
2. If you refuse to buy the insurance, you’ll have to pay penalties of up to 2% of your annual income to the IRS.
3. Many will be forced to buy poor-quality insurance they can’t afford to use, with $11,900 in annual out-of-pocket expenses over and above their annual premiums.
4. Massive restriction on a woman’s right to choose, designed to trigger a challenge to Roe v. Wade in the Supreme Court.
5. Paid for by taxes on the middle class insurance plan you have right now through your employer, causing them to cut back benefits and increase co-pays.
6. Many of the taxes to pay for the bill start now, but most Americans won’t see any benefits — like an end to discrimination against those with preexisting conditions — until 2014 when the program begins.
7. Allows insurance companies to charge people who are older 300% more than others.
8. Grants monopolies to drug companies that will keep generic versions of expensive biotech drugs from ever coming to market.
9. No re-importation of prescription drugs, which would save consumers $100 billion over 10 years.
10. The cost of medical care will continue to rise, and insurance premiums for a family of four will rise an average of $1,000 a year — meaning in 10 years, your family’s insurance premium will be $10,000 more annually than it is right now.

Lieberman Torpedoes Health Care Legislation, Progressives Split on the Way Forward

Under the threats from Sen. Joe Lieberman (I-CT) and at the insistence of Chief of Staff Rahm Emanuel, the Senate has dropped the Medicare buy-in provision from the health care legislation.

Lieberman's reversal on his support for such a buy-in has been all over the blogosphere and has cast a shadow on whether he has been acting in good faith or if he is simply trying to stick it to liberals.

It so happens that the New York Times put up an interesting piece that included this (emphasis mine):

Mr. Lieberman had supported the Medicare buy-in proposal in the past — both as the Democrats’ vice presidential nominee in 2000 and in more recent discussions about the health care system. In an interview this year, he reiterated his support for the concept.

But in the interview, Mr. Lieberman said that he grew apprehensive when a formal proposal began to take shape. He said he worried that the program would lead to financial trouble and contribute to the instability of the existing Medicare program.

And he said he was particularly troubled by the overly enthusiastic reaction to the proposal by some liberals, including Representative Anthony Weiner, Democrat of New York, who champions a fully government-run health care system.

“Congressman Weiner made a comment that Medicare-buy in is better than a public option, it’s the beginning of a road to single-payer,” Mr. Lieberman said. “Jacob Hacker, who’s a Yale professor who is actually the man who created the public option, said, ‘This is a dream. This is better than a public option. This is a giant step.’”

So by Lieberman's own admission, he opposed (at least in part) this piece of the health care legislation because liberals were enthusiastic about it. Did Lieberman not think that liberals would be enthusiastic about such a proposal when he supported it just three months ago? It is ludicrous to think that Lieberman is objecting to this on principled grounds. It is much more likely that his love affair with the insurance industry combined with his vehement disgust toward liberals, has led him to take pause.

The White House, which is more concerned with passing any version of health care legislation regardless of the strength of the public option, naturally urged the Senate Dems to capitulate in order to move the process forward. All of these developments have made the prospect of robust health care reform a bad joke and progressives are expressing their rage not only at Lieberman, but at Emanuel as well. Check out this new ad by the Progressive Change Campaign Committee:



With these recent developments, progressives are split on their support for this bill. Howard Dean has come out and voiced his support for killing the Senate version of the bill and going back to the House for reconciliation. Others, like Chris Bowers at OpenLeft, are questioning if progressive support for "killing the bill" will actually backfire and end up helping the Senate legislation pass.

What Lieberman has done with placing himself in a pivotal opposing position on this piece of legislation, is force the hand of the White House to give in to his demands in order to move this process forward. It matters not to the White House how robust the reforms are in this legislation, as long as some kind of reforms get to the President's desk.

There is much talk among progressives over who is going to suffer politically for watering down this legislation in the midterm and 2012 elections. While political consequences have their place in these discussions it should not obscure the fact that the real suffering is going to take place with the ordinary citizen who will continue to get denied health care coverage by their insurance company, who will continue to see premiums rise, and who will continue to incur debt in the absence of affordable coverage. There is something wrong when thousands of people regularly show up for free health care clinics in the so-called "greatest country on Earth" because it is their only affordable option.

Shame on this incessant capitulation to the status quo.



This piece is also posted here.

Lieberman Reverses Self On Medicare Buy-in, Insurance Stocks Soar

In case you were looking for something to make your stomach turn at the start of your week, I want to point to the recent comments made by Sen. Joe Lieberman (I-CT).

Over the weekend, Lieberman told Sen. Majority Leader Harry Reid (D-NV) that he would vote against any health care legislation that would include the Medicare buy-in compromise and that would contain a public option.

This is interesting consider that Lieberman supported a Medicare buy-in in 2000:

He said during the interview that the fastest growing group of
uninsured are those 55 to 65. For that reason, the ticket proposes
an expansion of Medicare to allow those and older to buy into the
public program. There would still be a buy-in price but it would be
less than buying private insurance, he said.

and from an interview with the Connecticut Post in September of this year:

Lieberman added that he supports mandating that no one can be denied coverage because of pre-existing conditions and that everyone be required to have health insurance.

As to how 47 million uninsured will afford coverage, Lieberman said only 12 million don't have insurance because they cannot afford it.

By allowing citizens who are not eligible for Medicare or Medicaid to buy in for a rate below the private market, the government can extend coverage to more of those who are currently uninsured, he said.

Why the sudden change? Ezra Klein has some ideas:

Incoherence is no crime, of course. But it is telling. Lieberman could have simply opposed the public option because it implied too much government involvement in the marketplace. Instead, he opposed it based on things that wouldn't happen, or weren't happening, and never softened his position as those statements were successively exposed as fraudulent. That, again, suggests something more fundamental than a policy argument.

Or take Lieberman's procedural decisions. The Medicare buy-in compromise was developed by the so-called "Team of Ten": the five liberals and five moderates that Harry Reid asked to meet and develop a path forward. Lieberman was asked to join the original group. He skipped the meetings, eventually being replaced by Tom Carper. That puts his opposition in a different category than Nelson and Snowe, both of whom dug deep into the process, working on issues and in groups and signaling clearly what they could and could not support.

[...]

If you had attempted to forecast Lieberman's behavior based on his past positions, you would have failed. His support for Medicare buy-in, and for various other health-care bills, would quickly have misled you. If you had attempted to forecast his behavior based on the attitudes of his constituents, you would also have failed. They support the public option and oppose health-care reform, while Lieberman professes to believe the opposite. But if you had attempted to forecast Lieberman's positions based on his ongoing grudge match with the liberals who defeated him in the 2006 primary, you'd have nailed it perfectly. He has, at every point, taken aim at the policies that liberals support, even when they are policies that Lieberman himself has supported.

Lieberman's obstructionism certainly points more toward his seemingly insatiable appetite for sticking it to liberals rather than a principled objection to the current legislation. How does the White House respond? By telling Sen. Reid to compromise with Lieberman:

The White House is encouraging Senate Majority Leader Harry Reid (D-Nev.) to cut a deal with Sen. Joe Lieberman (I-Conn.), which would mean eliminating the proposed Medicare expansion in the health reform bill, according to an official close to the negotiations.

But Reid is described as so frustrated with Lieberman that he is not ready to sacrifice a key element of the health care bill, and first wants to see the Congressional Budget Office cost analysis of the Medicare buy-in. The analysis is expected early this week.

The White House is denying the report but as Jane Hamsher observes:

It’s quite convenient that what Joe Lieberman is demanding — no public option, no Medicare buy-in — happens to look just like the Senate Finance Committee bill that the White House wrote with Baucus...Joe gets his way by giving Obama what he wanted anyway. Sweet.

Wall Street thinks it is sweet too:

Wells Fargo Securities analyst Matthew Perry said Lieberman’s comments are good news for managed-care stocks as anything that delays health-care reform is a positive for the group.

“Every time the reform seems less likely that it will happen, the entire group trades higher,” said Perry, who has advised his clients to buy shares of Wellcare Health Plans Inc. (WCG), recently up 1.3% to $36.74, and Humana Inc. (HUM), up 1% to $42.26.

Among the other recent gainers in the sector, Aetna rose 2.7% to $32.65, Cigna Corp. (CI) added 2.3% to $36.41 and Well Point Inc. (WLP) gained 2.7% to $58.07. Meanwhile, UnitedHealth Group Inc. (UNH) added 1.6% to $30.99.

UPDATE: Video of Lieberman supporting a Medicare buy-in just three months ago:

Breaking: Senate Democrats Reach a Compromise on Health Care Bill

Reports are surfacing that Senate Democrats have reached a compromise on the Health Care legislation. From Talking Points Memo:

An aide briefed on the negotiations among the gang of 10 offers up the rundown of the most important aspects of the public option compromise being sent to CBO.

If this trade-off carries the day, the opt out public option is gone.

In its place will be many of the alternatives we've been hearing about, including a Medicare expansion and a triggered, federally-based public option.

[...]

As with the process Senate Majority Leader Harry Reid undertook in merging the Senate Finance Committee and Senate HELP Committee bills, CBO will evaluate a menu of options, some of them interchangeable, so there's no certainty that this list won't change in the coming days. However, a senior leadership aide says that all of the options sent to CBO include the (triggered) public plan. Reid and other senators declined to offer specifics earlier tonight, as part of an agreement with CBO not to publicly discuss the policy options on the table while actuaries analyze competing ideas.

Now it's a question of what the CBO says, and then: will Joe Lieberman object to the trigger. This trigger seems awfully hard to pull. But he's said he'd object to any kind of government insurance option--even triggered--in the past.

Real details are still emerging on what this compromise exactly entails, but I don't have a good feeling about what this is going to mean for meaningful reforms to our health care system.