Urban Institute Think Tank Needs More Thinking; Less Being In The Tank

The Urban Institute has been searving some extra good veal lately. They have a new report out endorsing the idea of a super-hard trigger for a robust Medicare-style public option. While it is theoretically possible to design a “useful” triggered public option, it is also theoretically possible to sway Republican senators to votes for a Medicare-for-all bill with a truly beautiful haiku read on the Senate floor. (Between these two scenarios, I would advise progressive Democrats to spend their time studying the immortal style of Basho because I suspect the latter has more hope of succeeding than the former.)

I call this the “magical robust theoretically super-awesome trigger.” It is purely a fantasy of health care wonks that does not have a prayer of ever becoming law. Expect to hear more of this general idea in the coming weeks. The validators will wave around this complete fantasy trigger to help prepare the base for the eventual sellout with a completely worthless fig leaf trigger meant to kill the public option.

There is zero indication that there is sufficient support for this “magical robust theoretically super-awesome trigger” in the Senate. The handful of senators who claim to support a trigger also claim to be strongly opposed to a government run public option. They would never support a trigger with a serious change of being pulled, especially if it would produce a robust public option. In fact, most indications are that this trigger would have even less support than the current, "level playing field" public option without a trigger. Senators like Kent Conrad seem willing to accept the current public option, but are completely opposed to the idea of there ever being a public option tied to Medicare rates.

Even if this “magical robust theoretically super awesome trigger” passed into a law I have zero confidence that it would survive in the long term. If you were an insurance company, would you spend billions trying to bring down premiums and be willing to forgo billions in profits to avoid triggering the public option, or would you rather spend a few million to lobby to have the trigger quietly crippled with a small rider in some omnibus appropriations bill? I think the answer is clear.

I refuse to believe anyone following the health care debate would not know that this magical trigger has no chance. This report will not serve any useful policy function. The Urban Institute must know that the only use of this report will be to allow people to say “even the Urban Institute thinks the trigger is a good idea.” This is what it sounds like when veal moos.