Monday, February 22, 2010

Health Care: Obama Drops Public Option... But We Can Still Bring It Back

OK, so the word is out. We have a plan from Mr. President. Ezra Klein (H/T TalkLeft) summarizes nicely how Obama's new plan will fix the Senate health care bill:

• Eliminating the Nebraska FMAP provision and providing significant additional Federal financing to all States for the expansion of Medicaid;
• Closing the Medicare prescription drug “donut hole” coverage gap;
• Strengthening the Senate bill’s provisions that make insurance affordable for individuals and families;
• Strengthening the provisions to fight fraud, waste, and abuse in Medicare and Medicaid;
• Increasing the threshold for the excise tax on the most expensive health plans from $23,000 for a family plan to $27,500 and starting it in 2018 for all plans;
• Improving insurance protections for consumers and creating a new Health Insurance Rate Authority to provide Federal assistance and oversight to States in conducting reviews of unreasonable rate increases and other unfair practices of insurance plans.

So do you notice something missing? I do. The New York Times does. The Huffington Post does.

Despite the recent surge of support in the Senate for a government-run health insurance option, President Obama chose not to include one of the most popular elements of reform in the plan he is presenting to a bipartisan group of lawmakers Thursday.

The Obama plan explicitly bridges the differences between Senate and House legislation on issues both large and small, but on the public option -- which is included in the House bill, but not in the Senate's -- Obama is entirely silent.

OK, so where do I begin? First off, I am glad Obama isn't giving up on health care. It needs to be done, it needs to be done this year, and it needs to be done ASAP.

It's good to see the provision blacking egregious insurance rate hikes in the proposal. That is absolutely necessary.

However, it sucks to see Obama leave out one of the most effective ways to rein in the HMO madness. Why no public option, Mr. President? It's been gaining momentum lately. At least 18 Senators have signed the pledge already to include it, Chuck Schumer is pushing to include it in the reconciliation package, and Harry Reid is ready to start the reconciliation process to pass it.

So why won't Obama advocate for it... Especially when Kathleen Sebelius said last week that the Administration would push for it if there was an opening in the Senate? Well, guess what? The opening is NOW!

But fear not, all is not lost. The public option is clearly not "dead".

Indeed, after months of watching Obama say generally that he supports the public option while doing little to see it implemented into law, backers of the idea were unsurprised it was left out of his final offer.

"We didn't expect one," said Darcy Burner, head of the Progressive Caucus Policy Foundation.

Last week's surge had fired up a demoralized Democratic base, giving the health care reform effort an extra push as Obama tried to drag it across the finish line. But if the final bill is to include a public option, leaders in Congress and outside organizations advocating on its behalf will need to do it without Obama. "Congress and the people of the United States will have to lead in truly taking on the insurance companies," Burner said.

Obama's decision not to push for the public option does not preclude it from being included. Indeed, any member of the Senate can introduce it as an amendment to a package moving through under the rules of reconciliation, a parliamentary process that precludes a filibuster.

So moving forward, we have a game plan. Get Congress to agree on passing the Senate health care bill with the reconciliation fix. Urge Democratic Congressional leaders to stay strong on the public option. Push Obama to push the public option. And hopefully, we'll end up with a good bill.

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