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Plan B, Mr. President?

Robert LaszewskiAs the State of the Union approaches Democrats are considering their health care policy options. There are lots of reports about “Plan B”—pushing through the Senate bill with a parallel corrections bill that could be passed in the Senate using reconciliation rules.

That’s as dead as the original House and Senate health care bills. Moderate Democrats have no stomach for such a legislative stunt in the face of Massachusetts and bad health care polls. Many liberals even question that strategy.

Everyone is awaiting this week’s State of the Union speech. Will the President:

  1. Embrace the call by many on the left to Democrat-up and just ram it through?
  2. Call for a scaled back bill built around modest and popular first steps that could attract bipartisan support?
  3. Just jabber in a way no one can figure out which course he really supports?

My bet is on number three.

As I have said before, I think getting even a modest bill is a long shot in this election year but it is not impossible.

I like the idea of focusing on tax credits for small business as a first priority more than trying to help the individual market. The small group market is guarantee issue and government tax credits have the impact of encouraging matching funds—government money would encourage employer contributions making coverage even more affordable for the uninsured.

Add to that a modest Medicaid expansion, the albeit tepid cost containment parts of the current bills such as the pilot programs and giving CMS more authority to implement them, modest insurance reforms like ending rescission and funding for high risk pools, proving good faith with Republicans by including tort reform, and we have a bipartisan down payment on health reform.

Democrats need to erase the bad taste voters so far have for their dead health care efforts. They could do that with this kind of modest first step health care bill. Republicans also have something to prove on health care—the Democratic problems shouldn’t be confused with any sense on the part of voters that Republicans have yet to make any constructive contribution to this debate.

In my mind, the smart political move for Democrats is to call the Republicans out on their offers to be bipartisan by putting a deal on the table Republicans couldn’t refuse.

If the Republicans take the offer, the Democrats can get beyond the health care political mess they are in. If the Republicans don’t, the Dems have the leverage they need to turn the tables on the Republicans before the November elections.

They could also, coincidentally, actually help out a few million people.

Lots of folks think there is no chance anything positive can now come out of this poisoned political environment.

I am not so cynical.

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archon41NatePeterMGSteveH Recent comment authors
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Peter
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Peter

“I doubt you could find a liberal who is willing to back away from the individual premium subsidies.” As long as politicians don’t want to reduce healthcare providers income then the number and level of subsidies will have to be greater than I would like simply because this system costs so much. But I did finally oppose this bill for it’s lack of cuts. I believe we all should have equal access to healthcare as we should education, we can argue what should be a right and what should not. As a single-pay advocate (HMO on steroids) I believe my… Read more »

archon41
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archon41

Given the present atmosphere of partisan rancor, I doubt you could find a liberal who is willing to back away from the individual premium subsidies. As an unabashed and unrepentant conservative (and we are many), I’m not inclined to yield on the notion that every American is entitled, as part of his birthright and at public expense, a broad policy of insurance of the type outlined in HR 3200 (“substance use disorder” indeed!). As for “recission,” if you remove from insurers the right to avoid coverage for material misrepresentations made in applications for insurance, you will simply be taken in… Read more »

Nate
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Nate

“There’s no deal that the Democrats can put on the table that will reduce the number of uninsured by any appreciable number that could get a single GOP vote in the Senate.” Not true at all, they could pass the Republican AHP bill the Democrats have blocked for 15 years and cut the number of insured by 5-10 million over night. The remaining uninsured are those that are uninsured by choice and won’t buy it at any reasonable price. Any proposal to outlaw recission must first start with enforcement of current insurance fraud laws. If people weren’t commiting insurance fraud… Read more »

Peter
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Peter

Being no fan of Republicans I am not impressed with any commitee that doesn’t hold congress feet to the fire – and I doubt this one will either. Both parties are looking for an out to avoid hard decisions that may hurt them politically. But let brave Republicans come forward and propose their cuts to reduce the deficit then take the political heat from their constituents. Spike expresses my view quite well. Republicans smell blood from a wounded animal and would like to go in for the kill.

MG
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MG

More proof the Republicans are lying through their teeth about controlling the deficit because they oppose any type of deficit committee that potentially might let the Bush tax cuts expire.
http://economyincrisis.org/content/republicans-criticize-deficit-panel

SteveH
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SteveH

“In my mind, the smart political move for Democrats is to call the Republicans out on their offers to be bipartisan by putting a deal on the table Republicans couldn’t refuse.” There’s no deal that the Democrats can put on the table that will reduce the number of uninsured by any appreciable number that could get a single GOP vote in the Senate. And no matter how reasonable a bill the Democrats put out, Republicans will claim it’s “Obamacare” or “socialism” or a “government takeover” of 17% of the economy. The idea that there are reasonable Republicans who are willing… Read more »

Stephen
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Stephen

I’m with Spike on this.

spike
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spike

And just to be clear, I would not be nearly as harsh in my comment if your bio didn’t present you as one of the most intelligent, insightful health policy analysts in the country. I really can’t believe how far off base your reading of the situation is. Find me one Republican that would sign a health reform bill. One. Any health reform bill that would in any way give credit to the Democrats. You give me a name of someone on the Republican side of the aisle that would sign a bill and I will freely admit I’m wrong… Read more »

spike
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spike

Seriously, I can’t even believe what I’m reading. The Democrats have to prove good faith to republicans, the smart political move is for Democrats to cal the Republicans out on their offers to be bipartisan by putting out a bill Republicans couldn’t refuse. Not to be too blunt, but are you living in a fantasy land? Have the events of the past 6 months not had the slightest impact on your understanding or opinions on health reform? Honestly, to suggest that Democrats need to hold out ANOTHER olive branch to Republicans who have clearly demonstrated zero interest in operating in… Read more »