Mary Landrieu Joins Snowe in Fight for the Trigger

Sen. Mary Landrieu (D-LA) has never been a fan of the public option. We now know that she is actively working to kill the public option with help of Olympia Snowe (R-ME) and, of course, the trigger.

"What we have to move forward thinking about is, as the president has said, people keeping what they have if they like it, having more choices, reforming the private market," Landrieu said. "And if we can achieve that through private-sector reform, that's wonderful. And if not, then there should be a mechanism that basically, I guess, guarantees it, which would be a well-crafted trigger."

Given Snowe's and Landrieu's extreme opposition to the idea of a real public option, we know a “well-crafted trigger” must mean one that is designed to never be pulled. Snowe's original trigger amendment was crafted in a way to insure that it was never pulled. This should not be surprising. Snowe has repeatedly stated that she is so strongly against a real public option that she would filibuster the bill she helped write if it included one. She claims her inspiration for the public option trigger is the public plan trigger in Medicare Part D, which, guess what, has never been pulled.

The trigger is not a compromise. It is not the threat of a public option. It is not the possibility of a public option. It is not an eventual public option. It is nothing more than a ruse to pretend that they did not completely kill the public option.

Snowe Will Not Offer Trigger Amendment

The AP is reporting that Olympia Snowe (R-ME) does not plan to offer a public option trigger amendment, because it does not have the votes to pass. With Snowe planning to vote against Reid's bill, it would be ideal if we can remove some of the other terrible compromises that were added to win her support.

Sen. Olympia Snowe, R-Maine, has been the leading proponent of the "trigger" approach but she told The Associated Press in an interview Friday that she didn't plan to offer it as an amendment because it didn't have the votes to prevail. Snowe is the only Republican in Congress to have supported Democrats' health care legislation, voting "yes" in the Finance Committee. But she said Friday she couldn't support Reid's current version.

11 Ways The House Bill Is Much Better Than The Baucus Bill

The Harry Reid is in the process of merging the two Senate bills, but what the final Senate product will be is still a secret. For the most part, the bill from the Senate Finance Committee (SFC) is expected to serve as the base that the new Senate bill is being built upon. It is by far the worse of the two Senate committee bills.

Here is a compare/contrast between the new House version and the Baucus version of the Senate bill. The House bill is superior in many ways:

1. It covers more people. The Senate Finance Committee (SFC) bill, written by Max Baucus, would only provide coverage to an additional 29 million people. The House bill with extend coverage to roughly 36 million individuals. That is 7 million more people.


2. Contains a public health insurance option. The SFC bill did not contain a public option.


3. Employer mandate instead of "free rider” provision. The “free rider” provision is a terrible and probably unworkable idea that would hurt low-income Americans.


4. Stronger, better regulated exchange. At the insistence of Olympia Snowe, the SFC's exchange was made basically worthless, the equivalent of a health care yellow pages. The House bill will let the exchange use its power to help hold down premiums and get the best deal for customers.


5. Lower out-of-pocket cap. The House bill places an annual out-of-pocket limit on expenses for individuals at $5,000 and families at $10,000. The SFC places the annual limit at $5,950 for individuals and $11,900 for families


6. Higher quality insurance plans. In the House bill's lowest qualified plans must have an actuarial value of 70 percent. In the SFC bill, the lowest qualified plans must only have an actuarial value of 65 percent.


7. More generous affordablity tax credits. The House bill will provide working class American families more help affording health insurance than the SFC bill will.


8. Tighter age ratings. The House bill will only allow insurance companies to charge older people twice as much as younger individuals. The SFC bill would let insurance companies charge older people four times as much. The health insurance lobby has been pushing hard for an age rating of 5:1.


9. Minimum medical loss ratio. In the House bill, there is a minimum medical loss ratio of at least 85%. An insurance company needs to use 85 cents of every dollar it brings in through premiums to pay for claims. The SFC bill does not have a minimum medical loss ratio.


10. One national exchange instead of state-based exchanges. Creating a single national exchange is better than having states create 50 different state-based exchanges like the SFC bill. It should increase efficiency and bring down cost.


11. Better ombudsman. Both bills would create a new health care ombudsman office (or offices) to help people deal with insurance companies. In the SFC bill, people would only be allowed to seek help from the ombudsman if their internal appeals last more than three months, or they were facing a life-threatening situation. The House bill puts no restrictions on when a person could seek help from the ombudsman.

These are not the only eleven ways the House bill is significantly better than the bill written by Baucus, they are just some of the most glaring examples.

Reid Defies Snowe, Chooses Helping Americans Over Veneer Of Bipartisanship

I'm glad to see that Senate Majority Leader has decided to be a real leader and defy Olympia Snowe (R-ME). There is no reason to have a 60 member caucus if you are unable or unwilling to use it to fulfill the top priority of the Democratic party with the best reform bill possible. It is long past time to dethrone Empress Snowe.

It is important that the Senate bill going into conference committee contain a public option, even if it is one far weaker than it should be. But the bigger news seems to be that Snowe will no longer drive the bill, since she will not support a bill with a public option. Her demand that the bill contain a trigger was only one of her many ill conceived proposals.

I hope that including the opt-out public option is just the first of the positive changes which are made because Reid no longer needs to shape the bill to meet Snowe's every whim. Unfortunately, it seems the Senate bill with still contain the very stupid free rider provision, which Snowe wanted, instead of a mild employer mandate. This is a provision that desperately needs to be improved going forward.

There are areas that should be revisited now that Snowe is no longer on board: Strengthening the exchange so that it can negotiate to help individuals get a better bargain on their health insurance is a critical improvement previously opposed by Snowe. John Kingsdale, who runs the current Massachusetts exchange, said that if the exchanges remain how Snowe wants them, it will be a “policy disaster.”

I would like to see the “national plans,” which would gut a state's ability to properly regulate health insurance, revisited. Increasing the actuarial value of the “bronze level” (lowest minimum qualified insurance plans) and expanding Cantwell's “basic health plan” proposal were both ideas opposed by Snowe, but can ideally now be improved. Strengthening the new ombudsman's office and setting a minimum medical loss ratio for health insurance are two additional changes that should be made.

If Reid can convince his caucus to vote as a bloc on cloture, it would be a display of true leadership. Losing Snowe, and being able to pass a bill with only a simple majority, would be the single best development for health care reform yet--far better news than even the addition of a very weak public option with an opt-out. A bill that can pass the Senate without Snowe's vote will likely be a much better bill in the end. Reid has laid down a good marker today, now he needs to deliver.

$100 Billion For Second Chances

Republican Senator Olympia Snowe really thinks the health insurance industry deserves another chance to behave. This is why Snowe supports the trigger. Just how strongly does Snowe feel about giving the insurance companies another chance? She thinks it is so important that she wants to waste $100 billion of your tax payer money on this second chance for large, for-profit health insurance corporations.

The CBO says a strong public option would save around $110 billion. Snowe has repeatedly stated that she is completely against this serious cost saver. Snowe admits the CBO has scored her trigger as only saving between $10-$15 billion. (That is assuming that the trigger is not neutered some time in the next five years, which is the most likely outcome.) Snowe is demanding we waste $100 billion of your tax dollars by giving the private health insurance companies another chance to get their act together.

To gain her support, Snowe is insisting that the country waste $100 billion for the explicit purpose of protecting the private health insurance industry from public competition. That money could be used to reduce the deficit, make health insurance more affordable for millions of Americans, and/or reduce taxes. Snowe thinks protecting the health insurance companies is more important than providing people with more affordable health insurance or reducing the national debt.

Keep in mind that the senator demanding the nation waste $100 billion only for the purpose of protecting the nearly worthless private health insurance industry is considered to be one of the most “reasonable” and “moderate” Republicans in Washington. Dropping the $100 billion randomly from a few thousand hot air balloons is a more reasonable and moderate use of the money. With my proposal, at least a few regular Americans who could really use some help might get some of the money, instead of every single dollar of it being funneled directly to the health insurance corporations.

Obama Fighting For To Kill Public Option With Snowe's Trigger

Talking Points Memo is reporting that Obama is now actively working to kill the public option.

Multiple sources tell TPMDC that Senate Majority Leader Harry Reid is very close to rounding up 60 members in support of a public option with an opt out clause, and are continuing to push skeptical members. But they also say that the White House is pushing back against the idea, in a bid to retain the support of Sen. Olympia Snowe (R-ME).

Given the reports that Reid is within a vote or two of being able to pass a bill that includes a national public option with an opt-out, a full-court press by both Reid and Obama should be sufficient to insure health care reform contains a public option. Democrats clearly seem to have the power to get a public option with an opt-out provision passed through the Senate using regular order (or, of course, using reconciliation).

Reid and Obama both claim they want a real public option. Now they have a chance to deliver.

The grassroots, House members, senators, and policy experts have all called Snowe's trigger idea worthless. A public option has strong majority support, and is favored overwhelming among self-identified Democrats. If Reid and Obama reject this chance to deliver on both of their promises to provide Americans with a the choice of a public option, it will stand as a monumental betrayal.

If the public option is sacrificed, just to possibly win the support of one unnecessary Republican vote, Harry Reid might as well resign and officially declare Olympia Snowe Senate Majority Leader. In the next few days, if there is a “trigger,” we will know Reid's continued "leadership" is less than worthless to progressives.

Snowe War On States' Rights In Health Care

For a Republican, Olympia Snowe seems to have a real disdain for states' rights when it comes to health care reform. At every turn she has been trying to take power away from the states and give it to the federal government. She has been one of the biggest supporters of the “national plans” strongly favored by the health insurance lobby. This would allow insurance companies to sell "national plans" in any state, and these plans would be exempt by federal law from needing to meet state regulations about coverage. Effectively, Snowe wants to completely gut the health insurance consumer protections put in to place by the state legislatures.

Snowe voted against Cantwell's amendment which would allow states to create a “basic health plan” for people making between 133%-200% of FPL, if the state wanted to. The state legislatures would need to pass a law to create a “basic health plan,” and the federal government would only let them if they could prove it would provide better or equal quality care. It would also need to save both the federal government and the new enrollees money to be approved for funding. Snowe voted against letting states experiment with a plan that would save the federal government serious money. Denying the states the right to pursue a different, cheaper strategy for helping to provide health insurance seems like an insane violation of states' rights, fiscal conservatism, and basic logic.

Snowe, shockingly, also opposes the public option opt-in and the state-based public option. This is really perplexing because Snowe claims to support the idea of a national trigger. The idea if the insurance companies don't meet some criteria it would then cause the public option to be available in that state.

For all practical purposes, a national public option with a state opt-in clause is the same as a trigger. Under both scenarios, the public option will not be available on “day one.” The only difference is who is setting the criteria for the trigger. With Snowe's trigger it is the federal government telling states when the conditions are meet to justify the addition of a public option. With the opt-in, individual state legislatures have the power to set their own “trigger” criteria. The states get to decide when and if the insurance companies have failed and the market now needs a public option. Snowe does not want the states to have that right.

Secondly, her opposition to the idea of state-based public options is a massive federal government encroachment into state matters. As Sen. Bingaman has pointed out states already have the power to set up public plans if they want to. There is nothing currently stopping states from creating a public plan today. To say your are against state-based public options must mean you want to strip existing rights from the states.

It is always shocking to me how Republicans talk a good game about states' rights, but are always trying to strip states of power at the behest of powerful lobbying groups, like the health insurance industry. I guess I should not be surprised that Empress Snowe wants to use the federal government to take power away from the states. If someone else had power, it would infringe on her absolute reign.

Will Reid Dare Defy Empress Snowe On The Public Option Opt-Out

ABC is reporting Reid is leaning towards putting a national, weak, "level playing field" public option with an opt-out provision in the merged bill. The move could be a result of real leadership, terror at the thought of losing his election, courage, profound personal conviction, incredible pressure from inside the caucus, necessity, or a combination of all of the above. Whatever the reason, Reid seems to believe he can get the 60 votes needed for cloture on a bill that includes a weak public option with an opt-out, even if the whole caucus would not end up voting for the bill itself:

Reid is now convinced that Democratic critics of the public option will support him when it counts – on the procedural motion, which requires 60 votes, to defeat a certain GOP-led filibuster of the bill. Once the filibuster is beaten, it only takes 51 votes to pass the bill.

This move would be in direct defiance of Empress Snowe's decree that the bill must not have a public option, even with an opt out:

"Would [inclusion of a public option] be enough for you to vote against the cloture motion?" a reporter asked Snowe on her way off the Senate floor Thursday afternoon.

"On the public option? I'd say I'm against a public option, so yes," Snowe said.

"But would it be enough for you to say, 'I'm not going to proceed to this bill?'" the reporter pressed. Snowe nodded on her way into the elevator.

Snowe said she also opposes the opt-out version of the public plan, which would allow individual states to remove their residents from the federal exchange. "I don't support that," she said.

Sen. Max Baucus (D-MT) has spent months wooing Snowe by integrating her terrible ideas into the Senate Finance Committee bill. Even a few days ago, Baucus was pushing to water down the bill further to make it more to her liking. It's being reported that, at the thought of losing his prized token Republican support for his bill, “Baucus went to DEFCON 1."

Would Harry Reid really defy Snowe? As with all things related to Reid, I suggest waiting until there is solid proof before casting judgment.

Update: Baucus really wants to keep Snowe on board and/or kill the public option. TPM is reporting that he went to conservative Democratic senators to try to whip them up against the public option with opt out.

This, apparently, didn't sit well with Senate Finance Committee Chairman Max Baucus, who is determined to keep Sen. Olympia Snowe's vote.

"Baucus met with moderates this morning and got them nervous." Or tried at least. Snowe clearly laid down her mark. And Sen. Ben Nelson (D-NE) didn't seem particularly pleased. But of all the Senate's conservative Democrats, none have yet rebelled.

Snowe Says Jump, Baucus Says How High

I previously wrote about how Olympia Snowe (R-ME) was trying to make health care “affordable” by reducing the minimum definition of what qualifies as “insurance.” Her solution to the fact that real health insurance would still be unaffordable for millions if the nation adopted the bill she wrote: let everyone buy worthless junk insurance. This is probably one of the worst ways to make insurance “affordable,” and it seems that Baucus now thinks it is great idea.

Three weeks ago, Baucus properly rejected this terrible idea when he voted against an amendment by Sen. Enzi (R-WY) to reduce the actuarial value of the lowest quality plans (bronze level) from 65% to 60%. Now that Sen. Snowe seriously wants this modification, Baucus is singing a different tune.

On a conference call with reporters, Baucus said lowering the “so-called bronze plan, down to 60 would also help address affordability.” He talked about possibly reducing the actuarial value of the bronze plan and increasing the number of people who could buy the catastrophic insurance called “young invincible” plans. The exact changes Snowe told Ezra Klein she wanted made:

Just thinking out loud here, maybe you make the “young invincible plans” more available to people, or bring down the bronze plans to 60 percent [of expected actuarial value].

Empress Snowe made a decree and Democrats rush around trying to make it happen. The Democrats' desperate attempts to adopt all of Snowe's (a member of a powerless minority party) terrible ideas is sickening. She has been slowly ruining reform with her demands. Her unneeded vote is not worth the terrible compromises she has demanded. Senate Democrats need to stop bowing to her whims and put together the best bill they can to help the American people.

Polling shows the Americans just don't really care that a bill is “bipartisan.” What they want is real reform with a public option, which will make life for regular people in this country better.

Snowe Strikes Again, Universal Underinsurance

The cost of securing the support of one unneeded Republicans senator keeps growing. To add to the list of other terrible ideas that Sen. Olympia Snowe (R-ME) is urging be part of health care reform, here is a new one courtesy an interview with Ezra Klein.

What are your personal concerns going forward?

I’m still struggling with affordability. The Congressional Budget Office has produced charts showing that the American people will achieve savings, but we have to make sure that is the case. Just thinking out loud here, maybe you make the “young invincible plans” more available to people, or bring down the bronze plans to 60 percent [of expected actuarial value].

This is probably the single worst way to deal with the issue of “affordability.” Instead of providing everyone with affordable, quality health insurance, her solution is to provide people with affordable, high deductible, worthless junk insurance.

In the aggregate this will not make health care more affordable on average for Americans. It will just allow people to pay less in premiums. Unfortunately, millions of Americans will still be driven into medical bankruptcy because the “insurance” they have does not fully cover their medical needs. Regular people can't afford the roughly $12,000 yearly in-network out of pocket cap they'll have to pay if they had a serious medical problem. This is the kind of “solution” that will hit the people who most need help.

What Snowe does not want is universal health care; she simply wants to cheaply provide people something labeled “health insurance.” Letting people buy “insurance” that still does not protect them from finance ruin is not just terrible policy, but also immoral. Defining down coverage until it is practically meaningless is not the solution to the problem of affordability. Real reform that actually drives down cost (like drug re-importation, high minimum medical loss ratios, or a robust public option) is how to really help people, not just pretend you did.

The No Individual Mandate "Justification" For Lack Of Public Option

Sen Tom Harkin (D-IA) has been a strong advocate for the public option. On a recent call with reporters,

Harkin says a so-called “public option” will be in the senate bill. ”And especially if we’re going to have a mandate that everyone has to buy insurance, then certainly it would be bordering on the unconscionable to mandate that you have to buy insurance from a private company,” Harkin says. “At least, then, by having a public option out there, people at least have the choice of a private or a public option.”

Today, House Speaker Nancy Pelosi made a similar connection between the public option and the individual mandate:

Pelosi came closer than any member of the Democratic leadership has thusfar to suggesting that the individual mandate should be conditional on the inclusion of a public option. Pelosi declined to elaborate when pressed by TPMDC on whether Congress would revisit the individual mandate if the public option can't survive the Senate. But her implication was fairly clear.

The House, she said, "will not force America's middle income families to negotiate with insurance companies."

This is a theme I have heard a lot from the left side of this debate. If there is no public option, an individual mandate is completely unacceptable. If Democrats pass a law forcing people to buy expensive insurance from private companies, it could quickly turn into a political disaster. But for supporters of the public option, there is a dangerous flip side to this argument. That is, without an individual mandate, there does not need to be a public option. It is concerning that this might be the “out” for Democrats if they are killing the public option.

It is important to note that Olympia Snowe is both against a public option and an individual mandate. She already got the individual mandate weakened in committee, and might seek to weaken it further, or eliminate it altogether. The White House has already signaled that they are prepared to do almost anything that Snowe wants.

A health care reform bill without a public option and without an individual mandate is the type of bastard arrangement likely to please almost no one outside the Senate. The fear of losing an individual mandate already has the insurance companies freaking out. The hospitals are very concerned because they made a deal to accept payment cuts in exchange for the promise of near universal coverage. Grassroots progressives demand a public option in order to provide viable competition to the for-profit private plans, and the vast majority of Americans favor the idea. Many health care policy experts agree that an individual mandate is needed to achieve universal coverage (although the Senate Finance bill's insufficient subsidies make anything close to universal coverage impossible regardless of if there is a mandate). But increasingly, I see this set up as a way for Democrats to "justify" their failure to pass a real public option.

My Apology To Former Republican Senator Lincoln Chafee

I would like to sincerely apologize to former Republican senator Lincoln Chafee of Rhode Island. Like many progressives I cheered when you lost to Democratic senator Sheldon Whitehouse in 2006. (I do like Whitehouse, by the way, and think he has done a good job.) I never personally disliked you. You were always very moderate by the standards of the Republican Party, but you were still a Republican.

At the time, I was operating under the misguided notion that if Democrats won elections, they would be in power. I thought that once in power, Democrats would try to fulfill their campaign promises. I confess I was pretty foolish in my youth.

I now see that it does not matter how many Democrats are elected. The Democratic leadership values “bipartisanship” above principles, the needs of working class Americans, or keeping their promises. The Democratic party in Washington insists on handing over complete control to whichever Republican senator will take it.

If, back in 2006, I had know that electing a Democratic president, 60 senators, and controlling huge margins in the House meant that I would live under the absolute reign of Empress Olympia Snowe, I would never have rooted for your defeat.

The senator that Democrats hand complete control over to must be a Republican. Look at the example of deposed King Arlen Specter. Back when he was a 41st Republican, the Senate was his oyster. All power rested in his hands. He could strip $100 billion in needed aid to states with a simple command. Now that he switched parties, no one cares about his positions, or that he strongly supports a public option. If Snowe ever switched parties, she would suffer the same fate. Formerly quasi-bipartisan is not good enough. The Democrats insist power must be given over to a Republican.

If I had know Democrats for some reason would instantly forfeit all their power to the least insanely conservative Republican senator, I would have worked hard to help you keep your seat. I would much prefer to be living under the mercy of a King Chafee instead of Empress Snowe.

Please accept my heartfelt apology, former Sen. Chafee. I foolishly thought electing Democrats would mean Democrats would be in power.

The Public Option Trigger: Naïveté, Insanity, or Trickery?

Olympia Snowe and Rahm Emanuel are both pushing hard for their “trigger” idea recently. The idea is the public option would only go into effect if the health insurance industry kept raising people's rates at a rapid pace. (I believe, after studying the trigger created by Snowe, that it was designed to never be pulled. I also agree with Robert Reich that the whole concept of “triggers” just doesn't work in a town filled with highly paid lobbyists, but let's leave that issue aside for now.)

The whole concept of a “trigger” is at least perpetrated on the idea that the for-profit health insurance companies can stop themselves from raising Americans' premiums. It rests on the belief that the insurance industry will promise to stop ripping people off, and they deserve another chance to prove that they can.

The recent “study” released by AHIP makes even the concept of a trigger patently absurd. In their study, AHIP not only promised to keep increasing people's premiums, but promised to do it at an even faster pace. They asserted that they were powerless to do anything to stop the increase. AHIP is telling Congress that they will not stop, they can not stop.

AHIP's own study makes a trigger predicated on insurance industry moderation look insane. There is no mystery now about what will happen in the future. The health insurance industry itself admitted that they will fail to bring down premiums if the Baucus bill is enacted.

At best, all a trigger will do is force Americans to endure several more years of skyrocketing insurance premiums. At worst (and most likely), it will give the lobbyists for the for-profit insurance companies several years to work on crippling or removing the trigger, so that there will never be a public option.

Supporting a “trigger” on the hope that insurance companies would promise to shape up sounds like naiveté. Supporting a “trigger” after the insurance companies promised to increase pre

All Hail Empress Snowe

I know many on the left have taken to calling Republican Senator Olympia Snowe, President Snowe. This has been in response to the Democratic party leadership willingness to do almost anything to gain/keep Snowe's support for health care reform. Frankly, this does not fully encompass just how much power has been handed over to Snowe.

Mr. Reid will gather the group in his office, on the second floor of the Capitol for its first official meeting on Wednesday. The group includes Senator Max Baucus, Democrat of Montana, the Finance Committee chairman, Senator Christopher J. Dodd, Democrat of Connecticut, who was acting chairman of the HELP committee when it passed its health care bill and representatives from the White House.

Jim Manley, a spokesman for Mr. Reid, said that Senator Olympia J. Snowe of Maine, the lone Republican on the Finance Committee to vote in favor of the bill, would be invited to future sessions. And Mr. Manley said the Democratic leader was prepared to go to substantial lengths to hold Ms. Snowe’s support.

“He is prepared to do what he can to keep her on board while putting together a bill that can get the 60 votes necessary to overcome a Republican filibuster,” Mr. Manley said.

After all, many presidents (Nixon, Clinton, Truman, Johnson) have tried and failed to get the health care bill they wanted passed the United States Senate. Snowe is basically being told that she can write whatever health care bill she wants. This is more say than has been offered to any president in the past 100 years.

You see Snowe has achieved a level of power far in excess of that of a mere president in our multi-branch system of government with its checks and balances. The mock title “President Snowe” simply does not do justice to the amount Max Baucus, Harry Reid, Rahm Emanuel, and Barack Obama have invested in her. Her sway on the issue of health care reform is closer to that of absolute monarch than of any American president in history. I think Empress Snowe more properly summarizes how completely some in the Democratic leadership are prepared to defer to her.

Good Day For Baucus, Bad Day For Real Reform

I'm sure Chairman Baucus, Senate Majority Leader Reid, and President Obama are all pleased that Republican senator Olympia Snowe voted for the Baucus bill in committee. Their goals have long been to pass anything they could slap the label “health care reform” on and declare victory. Sadly, Snowe's support could signal a bad day for real reform.

Snowe has long been opposed to some of the most important elements of reform. I'm not just referring to her opposition to a real public option and her support for a worthless trigger proposal.

Snowe opposes a real employer mandate, and instead favors a disastrously stupid “free rider” provision. It could have serious consequences for low-income workers.

She is against giving the exchanges the power to negotiate with private insurance companies. This is a provision that should help keep down the cost of health care. It would save individuals money and the government money. Snowe fears it is too much government involvement. John Kingsdale, who runs Massachusetts's exchange, called Snowe's insistence that the exchanges not have the power to negotiate price with insurance companies a recipe for disaster.

Just today, during the committee hearing, she reaffirmed her support for “national plans.” This would allow health insurance companies to sell national plans in any states. Individuals state would lose the power to regulate these insurance plans sold in their states. The national plans would be exempt from all minimum benefit requirements mandated by the state legislature. This has been for a long time one of the top goals of the for-profit health insurance industry.

These are only the few changes that I know Snowe requested. Other good ideas, like a minimum medical loss ratio for insurance sold on the exchange, a stronger regulator, and a better defined minimum benefits package, could also have been excluded at the request of Snowe. For Example, Cantwell's “basic health plan” amendment did not get Snowe's vote in committee. It may be left out of the merged bill because Snowe opposes it.

I fear all of these terrible ideas from Sen. Snowe will make their way into the final bill. Obama has signaled his desperation to win the support of Snowe, and seems willing to accept any idea she has regardless how bad. Snowe's vote may make it easier for the Democratic leadership to declare a political victory, but the cost of winning Snowe's support could be that health care reform is a policy failure. In which case, it is the American people who are the real losers.

So Fades The Co-ops

The CBO's brutal analysis of Conrad's proposal for small, state-based co-ops may have been the final fatal blow for the idea. The Hill reports that prospects for the co-ops are fading fast; it is an idea with few defenders and many detractors:

“It doesn’t have much of a constituency beyond Conrad because it doesn’t please any critics of public plan on the right and doesn’t satisfy any of the ardent public plan advocates on the left,” said a Senate aide. “You don’t gain anything by putting it in the bill.”

Just because the co-ops idea is on its deathbed, it does not mean the prospect for a real public option has increase. Snowe's worthless trigger--that is designed to never be pulled--is seen by many in the Senate as a way to make the claim that they included a public option.

The aide said that most Democratic lawmakers would vote for a public option with a trigger before embracing co-ops. Sen. Olympia Snowe (R-Maine) supports the trigger plan, which would set up a government insurance program only if private insurance companies failed to meet certain standards.

The good news is that progressive grassroots pressure has made it almost impossible for Democrats to pass health care reform without a “public option.” That bad news is that Democrats in the Senate are looking for anything, regardless of how worthless, on which they can slap the label “public option":

At this point, Senate Democrats are signaling they could get behind just about anything they could plausibly call the public option — from a “trigger” that could kick in a public insurance plan later, to Delaware Sen. Tom Carper’s proposal to give states an option to create a government program.

The battle is now over the shape and viability of the public option. Will it be a real public option or a worthless fig leaf with a pretty label?

Finance Committee Vote On Tuesday

The vote on the Senate Finance Committee health care bill is scheduled for Tuesday. The committee has 13 Democarts and 10 Republicans. The big vote to watch for is Republican senator Olympia Snowe. She is seen by many as the only possible Republicans vote for any health care reform legislation. If Snowe does vote for the bill in committee it could be used as an excuse for including her worthless trigger idea in the bill which is brought to the full senate floor.

“The public option with a trigger would be a compelling thing to put in the merged bill if the Finance bill has the endorsement of Snowe,” said the aide. “When progressives howl, you can point to Snowe’s support.”

The other votes to watch are that of Democratic senators Ron Wyden and Jay Rockefeller. Both Wyden and Rockefeller have been treated poorly by Baucus throughout the process of writing the committee's bill. One or both (as long as Snowe is a yes) could cast a protest vote against the bill. Regardless, the bill is expected to pass out of committee.

I Agree With Sen. Kyl: One Republican Vote Does Not Equal Bipartisanship

Republican Sen. John Kyl (R-AZ) said something on Fox News, which, surprisingly, I completely agree with (not a sentence I expected to write this morning):

"I don't think very many people believe that if you have one Republican out of 100, that therefore, it's a bipartisan bill," Kyl told Fox News. "I don't know what Sen. Snowe will do, but I know right now that she's very concerned about the cost of the bill and the fact that the Congressional Budget Office is not able to provide us with an accurate cost of what the bill is."

I'm with Sen. Kyl--having the vote of one Republican does not make a bill bipartisan. No regular Americans thinks, “Well, I will probably like this bill because it did get the vote of one whole Republican. It must be a super awesome bipartisan bill.” The idea that there are millions of Americans who want a health care bill, but only if it has the vote of at least one Republican senator, is absurd.

Why is the administration pursuing Snowe so strongly, even at the price of ruining health care reform? Roll Call seems to have the answer:

Snowe also gives Reid some cover with his liberals, in that he can push the blame for all of the controversial changes he will have to make onto the perils of bipartisanship.

It sounds like the plan is to push through a bad bill and act like the mean old Olympia Snowe made them all adopt the unpopular and destructive policies. This is the height of cowardice. The Democrats have a super majority (60 votes) in the Senate, and also the option to use reconciliation to pass a bill with only a simple majority. Snowe doesn't actually have the power to force the Democrats do anything.

If some group of Democratic senators are against extending quality affprdable health care to more Americans, if they support letting the insurance companies continue ripping off the American people, let them publicly stand up against reform. If this round of health care reform sucks, it will be 100% the fault of the Democratic Party. Snowe has no real power and no one outside the beltway really cares how she votes.

The High Price Of Snowe

The public option has gotten most of the attention as of late, but sacrificing it is only the tip of the iceberg for Sen. Olympia Snowe (R-ME). Snowe is not just on the wrong side of the issue on the public option, she is demanding several incredibly bad provisions ans policies be part of a health care bill in order for it to garner her support.

Sen. John Kerry wanted the Senate Finance Committee bill to give the new exchanges some power to bargain with insurers. This would likely help reduce the price of insurance on the exchange. It is something that is part of all the bills that passed the four other committees. Why did Kerry's amendment fail?

The reason, several sources on Capitol Hill say, was opposition from Olympia Snowe, the Maine Republican who also sits on Senate Finance. Snowe seems to be concerned that a more aggressive exchange would amount to more government--which, in fact, it would be. But, as Massachusetts has shown, sometimes more government is exactly what health care needs.

Snowe almost singlehandedly made the exchange worthless.

Jon Kingsdale, who runs the Massachusetts exchange, calls that a recipe for "policy disaster," as consumers faced a dizzying array of more expensive, less regulated choices. "It would be like telling your grocery store they have to offer every single kind of bread baked by every single bakery. . . . The exchanges would be nothing more than an automated Yellow Pages."

This is not the only time that Snowe has demanded an awful policy change. Unlike the other bills, the Senate Finance Committee bill does not have an employer mandate. Instead, it has a form of “free rider” provision, which makes companies who don't provide insurance pay a fine for each employee who gets tax credits to buy health insurance. Besides being a bureaucratic nightmare to enforce, it could have serious negative consequences for low income job seekers. For some reason, Snowe wants this bad free rider provision instead of an employer mandate.

A worthless trigger instead of a public option, weak, poorly regulated exchanges, the terrible “free rider” provisions--these bad policies might all be part of reform legislation in order to win Olympia Snowe. (I think we will be finding out for months what other bad ideas Snowe demanded be part of the bill.) In an effort to win Snowe health care reform is being crippled. Winning her could cost the government hundreds of billions of dollars and regular American families a few thousand a year in higher premiums. Is one Republican vote really worth the high price of Snowe?

Senate Finance Committee Ends Amendment Process, Next Stop Reid's Office

The Senate Finance Committee late last night finished amending the chairman's mark. The amended bill will be sent to the CBO for analysis. It is assumed that by Tuesday the CBO will have a preliminary score of the bill. If bill scores as not adding to the deficit, the committee should vote on the piece of legislation.

The bill is expected to pass despite the fact that several Democratic members of the committee are unhappy with the shape of the legislation. Committee members have been lobbied by administration officials to keep the process moving forward.

The big question is whether Republican Sen. Olympia Snowe will vote for the bill. Snowe appears to be the only Republican senator who might possibly vote for health care reform. She could vote against the bill in committee, but eventually vote for the bill after it is amended on the floor. If she voted for the bill in committee it might give her greater sway in deciding on how the two Senate bills (FinCom and HELP) are merged. HELP Committee Chairman Tom Harkin does not see room at the table for Republicans when the bills are merged.

Once out of committee, the bill must be merged with the Senate HELP Committee bill. The HELP bill contains a public option, tougher regulations, and more generous subsidies. Majority Leader Harry Reid will be responsible for merging the two bills. It is up to Reid as to whether or not the bill that is brought to the floor contains a public option.