The goal of many on the left is universal single payer health insurance. The simplest way to achieve this goal would be to expand Medicare for all. Currently there are around 80 votes for single payer in the House. So liberal Democrats have rsigned themselves to a series of compromises on top of the compromises.
Compromise 1. Jacob Hacker invented a political compromise known as the public option. It would simply allow individuals or businesses the option of buying in to Medicare or a Medicare like program.
Compromise 2. Some fear that this public plan would be too popular (why some elected officials would be afraid of providing people with an incredibly popular government program is beyond me). So the compromise was to restrict the public option to the Exchange. At first the Exchange will only be open to roughly 36 million people who work for small businesses or buy individual coverage.
Compromise 3. Some hospitals and health care providers are worried that Medicare underpays providers. So the public plan was further compromised and made less affordable for individuals. The public plan would pay Medicare rates plus 5-10%.
Compromise 4. Some doctors thought the public plan should not piggyback on Medicare's provider network, even though it would pay more than Medicare. To deal with these concerns the public plan was compromised again and made even less affordable. Medicare providers would be allowed to opt out of the public plan while still being allowed to accept Medicare patients.
Compromise 5. A handful of Blue Dogs complained that even the compromise Medicare-plus rates were too low. To gain their support, the public plan was again weakened and again made less affordable for average Americans. Ross' amendment would make the public plan negotiate rates not based on Medicare.
Compromise 6. Chuck Schumer in an attempt to over come the near insurmountable hurdle of 60 votes in the Senate was asked to create what would be an even greater compromise. His “level playing field” public plan would create a new government insurance provider completely separate from Medicare. It would need to independently create its own provider network and negotiate its own rates.
Compromise 7. Senator Grassley reject Schumer's compromise so Senator Conrad tried to come up with something Grassley would support. His idea was private non-profit health insurance cooperatives. Schumer offered a compromise of his compromise. The government would help set up single new national non-profit insurance company with a co-op legals structure. The federal government would maintain minor oversight through some permanent seats on its board of directors.
Compromise 8. Grassley rejected Schumer's compromise of his previous compromise. Conrad has decided to offer Grassley a complete capitulation. Conrad's proposal is simply to make some seed money available for “others” to set up co-op insurance companies if they wanted. (Who these “others” are who have the expertise, desire, skills, and time to create massive new non-profit insurance companies from scratch is a very good unanswered question.)
The co-ops would have not permanent government oversight. They would not be available nationwide or available from day one. There is zero guarantee that there would be a new co-op in your insurance market for you to sign up for. In fact, there is no guarantee that any new co-ops would ever be started or survive beyond a few years.
The worst part is health insurance co-ops have been tried repeatedly before. Most failed or turned into for-profit companies. Only handful still survive. So Conrad's “compromise” is to offer an idea which already exists and has failed.
The media falsely reports that Conrad's co-op proposal is a compromise between liberals who want a strong public option and Republicans who do not want insurance companies to face any new public competition.
It is a compromise of a compromise which was a compromise that is itself a compromise of a previous compromise from a former compromise of a much reduced compromise of the original compromise of the goal of many on the left.
At some point an idea is so reduced through repeated compromises as to be worthless. Conrad's co-ops are not an acceptable or legitimate compromise for progressives. It is a warm bucket of highly diluted spit stamped with the word reform.