They Should Be Thrilled

Anonymous wankers in the White House expressed surprise in the WaPo this morning about the intensity of feeling about the public option in the health care debate.

President Obama's advisers acknowledged Tuesday that they were unprepared for the intraparty rift that occurred over the fate of a proposed public health insurance program, a firestorm that has left the White House searching for a way to reclaim the initiative on the president's top legislative priority [...]

"I don't understand why the left of the left has decided that this is their Waterloo," said a senior White House adviser, who spoke on the condition of anonymity. "We've gotten to this point where health care on the left is determined by the breadth of the public option. I don't understand how that has become the measure of whether what we achieve is health-care reform."

"It's a mystifying thing," he added. "We're forgetting why we are in this."

If the public option gravitated to the center of the debate and the White House never wanted it there, it's their own damn fault for talking like CPAs about "cost curves" and "risk adjustment" and arguments that could be plotted on a graph for six months without being specific about the moral case of covering millions of people who have no choice and no hope, and beating back the unrivaled greed of the insurance industry. The only element of health care reform as set out by the White House with a beating pulse has been the public option, and humans being emotional creatures as well as rational ones, that's where progressives gathered.

But I want to focus in on this element of "surprise," which is silly, since the public option was the compromise down from the policy with the most intensity on the left in the health care debate, single payer. Beyond this anonymous staffer being clueless for his surprise, he's not even understanding that the revolt on the left is the only thing saving health care reform at this point.

When town hall crazies and conservative misinformation dominated the debate, health care was on a losing trajectory, if not dead in the water. Since Kathleen Sebelius' statement on Sunday on CNN, the nature of the debate has shifted so much away from that and toward actual policy you'd think it was intentional on the part of the White House. Noam Scheiber captures this at TNR.

Around the conference table at TNR, we’ve been saying for weeks that what Obama really needed was a group of equally vocal, equally zealous critics on the left, pulling the debate’s center of gravity in the other direction. And, wouldn’t you know, that’s exactly what’s happened over the last 48 hours. We’ve now got a pole on the left to match the intensity of the pole on the right. (Don’t get me wrong: I’m not suggesting a moral equivalence between the two. As far as I’m concerned, the critics on the left are basically right and the critics on the right are either insane or deeply cynical.) From a sheer tactical perspective, I think the White House and the Democratic leadership in Congress have dramatically improved their position.

You now have 64 House Dems who have raised over $100,000 and counting from over 1,600 Democrats in 24 hours since they took the pledge of not voting for any bill without a public option. You have House Democrats strongly behind the public option in their weekly caucus meeting, with everyone in support of it because their constituents had pressed them on it. You have labor warning Democrats that they'll sit out specific elections if any members oppose a public plan. There's a vital energy to the debate now that was simply missing when Obama was offering vague principles and playing an inside game trying to frame health care reform as entitlement reform. And it's actually doing more to get a health care bill passed than anything the White House has done all year.

Elites who reflexively kick the left will retreat to the familiar ground of the Washington Post editorial page to demand that liberals "give up on the public option". And they can make their case for that on the policy - the currently administered public option on offer, by firewalling those who get insurance through employers, will struggle to survive because it cannot capture enough of the market to force competition on price and quality of care (though historically, governments build on what gets enshrined into law gradually over time, so the policy of the moment matters less than what can be done with it eventually, and having nothing, or weak co-ops that experts have shown cannot work at all, would be disastrous). On the politics, liberal elites are dead wrong. They will lose health care completely if they alienate the base. And the base wants competition against for-profit insurance CEOs with a public option, at the very least. Because they understand that a properly administered version of this competition would save people and the government money, with more savings the more popular it is. That's only something to fear if you want to protect insurance company profits.

As Chris Bowers says:

However, the current fight over the public option is a perfect demonstration of why such left-wing criticism is absolutely essential to any attempts to pass progressive legislation by the Democratic leadership and the Obama administration. If there had been no left-wing revolt to Sebelius's statements on Sunday, it would be far more difficult for the Democratic Congressional leadership and the Obama administration to justify not giving into right-wing demands. Lacking any Progressive Block demanding more progressive legislation, the Democratic leadership and administration would be practically forced to offer up even less progressive legislation than even the compromises they were floating over the weekend [...]

It is understandable that some progressives who worked very hard to elect President Obama get irked by left-wing criticism. Not all Democrats are on the left, not everyone buys into the same strategies as me, and criticism toward someone you personally identify with is irritating [...]

No matter these objections, in order to pass progressive legislation, both prominent left-wing criticism and powerful, Congressional Progressive opposition to a Democratic trifecta is absolutely necessary. In the current health care fight, the lack of such criticism and the lack of such a block would mean that the public option was dead in the water right now. Not everyone is going to like it, and some party higher ups like Rahm Emanuel may call it "f*ckng stupid," but any progressive ecosystem lacking such criticism and left-wing organizing is only a short time away from suffering a mass extinction.

I would go further, and say that without progressive organizing around the public option, there wouldn't be any health care reform legislation. Period. The band of hippies is saving the Democrats from themselves.

Please thank those who have stood up for their efforts. Let's get to $200,000 today.

A Chip They Should Not Bargain

Everyone's freaking out about Kathleen Sebelius' statements about the public option on CNN over the weekend. I'm actually quite pleased that the conversation is moving back toward this, rather than the media obsessing over old conservatives shouting or people holding signs that confirm their ignorance. At least we're back to the policy. And talking about a health care reform with or without a public option in some way presumes a health care reform law. So maybe the teabagger protests have outlived their theatrical usefulness and everyone's ready to move on.

As to the specifics: Sebelius said that the public option was "not the essential element" in any reform. Which is of course true, based on the legislation they crafted. A bill where the public option would be an essential element would be a single payer bill. The bill that the White House and Congress put together relies far more on mandates and regulation, with a weak, walled-off public option that can only attract customers from the individual market and select small businesses thrown in to allow for "choice and competition," in their parlance. It's MassCare, which, depending on who you talk to, doesn't constrain costs enough or works pretty well. And MassCare does not have a public option. That part of reform was pretty much always designed as a bargaining chip, in the context of this legislation. And the White House has been bargaining with it consistently over a number of months.

As far as I can tell, there's been no change in the administration's position. It has always supported a public plan option. It has never claimed it essential, or the only path to competition in the insurance market. The one deviation came in July, when Obama said the words "must include" in a sentence that also had the words "public option." But it's not clear whether he was talking about the health insurance exchange or the public option. And that only happened, to my knowledge, once. That statement, not this one, was the deviation.

Try as we might to pin them down, the White House will never, ever, ever view a public insurance option as essential to passing a bill. Or anything else, for that matter, other than abstractions about "controlling costs" and "providing affordability." They want something to pass. Something they can call health care reform and tout as a victory after 40 years of defeats. If they think the best path to getting that through Congress is dropping the public option, they'll enthusiastically endorse such an approach. If they think it's not dispensable because 64 liberals in the House won't pass a bill without it, they'll have to keep it. The space in between, where the House doesn't compromise any further below a public option and the Senate doesn't allow anything beyond co-ops, is what Matt Yglesias describes as the legislative dead zone. This is basically the question House progressives must ask themselves:

If it comes right down to it and the senate is prepared to pass a bill that:

(a) subjects insurance companies to tough new restrictions,
(b) taxes employers who don’t provide decent health insurance to their employees,
(c) creates a new regulated marketplace in which individuals and small business employees can buy quality health insurance,
(d) expands Medicaid eligibility, and
(e) offers subsidies to ensure the affordability of insurance for middle class families

I have a hard time believing that House liberals will really kill the bill. But maybe they will.

This is where Mr. Krugman comes in today, comparing the plan on offer to what is occurring in Switzerland, where everyone must buy insurance, lower-income residents get subsidies, and the insurance companies have very strict regulations by which they must abide.

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

(One thing nobody who endorses this type of plan talks about is the fact that we have no national regulatory framework for health insurance companies, and the regulatory vigor in the states, where they are now regulated, varies widely from one to the other, so the plan on offer would either have to create a large new bureaucracy to accompany that regulation of insurers, or rely on the balkanized state approach. Neither is ideal.)

The public option could be an element of a Swiss-style system, but not the essential one. In essence, there's very little daylight between what Krugman says and what Sebelius said yesterday. So, what is one to think?

Those trying to minimize the importance of a public option are only looking at the one currently up for discussion, which is not available to anyone who gets coverage through an employer. That's not really a big enough market to change insurance company behavior anyway, which is why I favor the kind of plan offered by Ron Wyden, where employees can opt out of their coverage and buy into the insurance exchange. In fact, we have historically seen a government program like the public option refined and tweaked once it came into existence, from Social Security to Medicare. So we should not view it as static.

Which is why it's important to include it now. Sure, the public option could be added in future years as a deficit reduction element, much as MassCare is considering going to fee-for-service medicine after getting their universal system in place. But we're having the conversation now, and including a government-managed element in isolation down the road would allow everyone to train their guns very directly. This will not be the last health care reform bill in the history of America, but it's certainly the one with the most potential to codify something like a public option into law. And all the action for doing that is in the Senate - the White House will go along with whatever can pass.

...also, too: this is bigger than health care reform, it's about the progressive wing of the party being credible on standing their ground. That has implications on a host of issues.

Health Care: Progressive Movement Must Push Back On This Week's Lapses

It's early, and given the clear attention the President is paying to health care reform I ultimately believe something will get done. But without question, this has been a bad week for those who want to see a legitimate reform of the system. This article in The Hill captures some of the movement:

Despite having a popular president in the White House and comfortable majorities in Congress, the Democratic rollout on healthcare reform has encountered significant bumps in the road.

A cost estimate hanging a $1 trillion price tag on an incomplete bill, salvos from powerful interest groups and great uncertainty among key Democrats on what will actually be in the legislation that moves through Congress have emboldened Republican critics.

The Senate Health, Education, Labor and Pensions (HELP) Committee postponed the markup of its healthcare reform bill by one day, to Wednesday. On the eve of that markup, the powerful U.S. Chamber of Commerce publicly ripped the bill.

Senate Finance Committee Chairman Max Baucus (D-Mont.) initially planned to release his bill Wednesday, but he has pushed back his timetable because of cost estimate concerns.

“Will we have something out tomorrow? Not sure,” Baucus said Tuesday. “Thursday or probably Friday,” he added.

Perhaps more importantly, the unity that Democrats touted earlier this year has cracked. As conservatives lambaste Democrats, liberal healthcare groups are not rushing to their defense because so many questions about the legislation have not been answered.

Since then, the Senate Finance Committee postponed their markup until after the July 4 recess. And all kinds of compromise plans and half-measures are swimming around Washington. Apparently, centrists in the House from both sides of the aisle are meeting in secret to hash out one of them. Kay Hagan and Jeff Bingaman are refusing to sign on to the public plan in the Senate HELP Committee, delaying its inclusion in the bill, which is worrying advocacy groups. I'm assuming they prefer a compromise like Kent Conrad's out-of-left-field "health co-ops" plan introduced into the debate and sending a thrill up the leg of centrists last week. And today, old warhorses Tom Daschle and Bob Dole unveiled yet ANOTHER compromise plan:

Daschle, Dole and Republican Howard Baker released a bipartisan plan today that would tax some employer-provided health-insurance premiums, require individuals and large employers to buy health insurance, and create public insurance pools run by states instead of the federal government.

The proposals were put together over 15 months by the Washington-based Bipartisan Policy Center, which was started by Daschle, Dole, Baker and former Democratic Senate leader George Mitchell. Congress is drafting a bill to revamp health care, which President Barack Obama calls “the single most important thing we can do for America’s long-term fiscal health.”

Dole said the U.S. has a rare opportunity this year to enact a comprehensive health-care bill. “Let’s do it now,” he urged, saying it may be five years before lawmakers have a similar political opening.

The state-run insurance pools may run into some trouble due to economies of scale. A state simply cannot bargain the way a single payer federal government can.

There are basically two issues that have bedeviled reformers this week. One is the CBO scoring, based on an incomplete document that should have never been given to them, but causing moderate Dems to simply run for cover. This failure came about largely by the HELP committee offering an incomplete bill to try and get some bipartisan cover.

You might ask what the HELP Committee was thinking, sending Swiss cheese legislation to CBO. Well, the HELP Committee's expectation was that the CBO, in crafting its preliminary score, would assume something similar to the outline it had seen months before. The CBO didn't. In fact, it did the opposite. CBO ran its estimates with no employer mandate and an individual mandate with a laughably small penalty.

Members of HELP were thus shocked by yesterday's score. The specific provisions of the bill that the CBO examined did not look like the bill HELP intends to write. Which means that the numbers aren't correct. If HELP is writing a bill with a strong employer and individual mandate, and CBO scores a bill with no employer mandate and a weak individual mandate, that's not a useful estimate.

By Monday night, members of the HELP Committee were scrambling to give the CBO something closer to the final legislation to examine -- this time including rough details of the employer mandate and the individual mandate. They're hoping to have a new set of estimates by Friday, though that's probably ambitious. Either way, I wouldn't put too much stock in these numbers.

Doesn't matter. The numbers are out there, and the Democrats are running away from them as fast as they can. OF COURSE the Republicans would use the CBO score as a permanent talking point no matter what was changed on the bill. Forevermore, it will be seen as costing a trillion dollars a year and not covering anyone - just check out this piece. Max Baucus essentially pulled his bill so he can cover costs and cut government subsidies.

The other problem has been this continued wrangling over the public plan, which I think a healthy bit of Democrats are simply desperate to torpedo. Hagan and Bingaman won't sign on to it in the HELP Committee, and now Kathleen Sebelius has, perhaps unwittingly, given a bad compromise oxygen:

"I think there is a lot of understanding that the private market has really failed to provide affordable coverage to Americans," Sebelius said. The industry has had "a lot of opportunities" to get rid of coverage restrictions and other unpopular policies, Sebelius said, and really "hasn't served Americans very well."

However, Sebelius stressed that Obama is open to compromise on the shape of the public plan, which doesn't have to be run by the government. She spoke positively of a compromise idea that envisions consumer-owned nonprofit cooperatives, like rural electricity or agriculture co-ops. They would get started with seed money from taxpayers but then compete without government control. The plan by Sen. Kent Conrad, D-N.D., may end up in a health overhaul bill to be unveiled by the Senate Finance Committee this week.

Obama did offer a pretty forceful defense of the public option to the AMA this week. And if he wants to throw his weight around, he could probably muscle something through. But will the desire to create a bipartisan solution, which is supposedly more "durable" than a successful solution, trump the public plan? Bill Clinton hopes not:

If he can’t get a good bill, I wouldn’t give away the store on that. If he can’t get a bill that’s genuine universal coverage, that genuinely is going to cut costs and make health insurers give up some of these unbelievable administrative burdens that they’ve put on people, and that really gets to the guts of the delivery system and does more primary preventive care and actually measures things that work, then I would go for the 51. But I would spend a little time trying to get to 60.

Nyceve has more on this meeting.

So we've had a bad couple weeks, with Democrats scurrying in fear from the cost and the public option clearly being used as a bargaining chip. Enough. Chris Bowers has a proposal:

For years, candidates for, and members of, Congress told us that we needed to elect and re-elect them in order to lower health care costs and provide universal coverage. And so, for years, we dutifully worked our collective asses off, delivering wide majorities for Democrats--who said they would lower health care costs and provide universal coverage--in both branches of Congress.
Now, when it comes time for them to deliver on health care by providing a public option--the care minimum required to reduce costs and provide universal coverage--what we are getting instead are backroom deals, flip-flops, and cop-outs.
Enough.

Today, along with Health Care for America Now, Democracy for America and numerous blogs, a campaign is being launched to put an end to the backroom deals on health care. We made and delivered on a commitment to bring about wide Democratic majorities in Congress. Now, instead of negotiating in secret, this Congress needs to make a public commitment to us on where it stands on health care.
No more dodges. No more vague, open-ended responses. We need every member of the Senate--main obstacle to reform--to answer four questions on the public option:

Do you support a public healthcare option as part of healthcare reform?
If so, do you support a public healthcare option that is available on day one?
Do you support a public healthcare option that is national, available everywhere, and accountable to Congress?
Do you support a public healthcare option that can bargain for rates from providers and big drug companies?

As activists and as constituents, answering these questions are the minimum they owe us. We are entitled to specific, clear, written responses to all of these questions.

Email--don't call, but email--these four questions to your Senators now. Make it clear that you want a written response to all four questions. There needs to be as little room for interpretation as possible. The Senate is going to be the biggest hurdle on health care, as it has proven to the biggest hurdle on all legislation in 2009. That is where we must focus our pressure.

Here's the form to post where your Senator stands. We need a citizen whip count on the public option so we know where everyone stands. Only with this kind of clarity can we embolden, for example, the Progressive Caucus to demand a public option in any reform bill.

This is clearly the biggest domestic policy that will be tackled this year. We MUST not fail.

The Practical End Of The Two-Party System?

Kathleen Sebelius received confirmation from the Senate for the job of Health and Human Services Secretary, and among the 65 Senators in support was Sen. Arlen Specter (D-PA).

That's not a very hard call for him to make. And he still remains opposed to Dawn Johnsen, though I await seeing how he'll vote on cloture. But psychologically, there is an undeniable advantage to having 60 Senators who want to pass a bill rather than 60 concerned primarily with defeating it. While Newt Gingrich and his cadres are somehow yelling BWAHAHA! while they stay on the rat-free sinking ship, the truth is this represents a real loss for conservatives, who see their party marginalized and regionalized, without hope and without a meaningful constituency. Which is probably why some conservative activists are having second thoughts.

Self-reflection was hard to find from the Republican Party and from activists who had attacked Specter as an example of the GOP’s image problem — a man who prevented them from appealing to voters as the party of small government. Steele accused Specter of trying to “further his personal political interests because he knew that he was going to lose a Republican primary due to his left-wing voting record.” Eric Odom, the conservative web guru who launched TaxDayTeaParty.com — and who denied Steele’s request to speak at the Chicago anti-spending rally — responded to the news by tweeting “THANK GOD we don’t have to deal with an ugly GOP primary in Specter’s district.” According to Adam Brandon, a spokesman for the Tea Party-supporting FreedomWorks, the group’s chairman Dick Armey laughed at the news and asked: “Will anyone be able to tell the difference?” [...]

Among some other conservative activists, there was more regret, and more worry about how Specter’s switch would aid Obama and the Democrats. Gary Bauer, the longtime Republican evangelical activist who is now president of American Values, said Specter’s critics did not give him enough credit for his work in the Senate. “I don’t think that Clarence Thomas would be in the Supreme Court today if not for Arlen Specter,” said Bauer. “Having the support of what are derisively referred to as RINOS — Republicans in name only — can be important in the Senate.”

Bauer rejected the idea that the Republican brand would be strengthened now that Specter was no longer giving bipartisan cover to Democrats — and that Republicans were being shaped into the clear conservative choice that voters were missing in 2008. “I take a back seat to nobody in wanting the Republican Party to be Ronald Reagan’s party,” said Bauer. “But I would remind folks that Ronald Reagan picked George H.W. Bush to be his running mate. Ronald Reagan understood that there was another element of the party that needed to be brought along. We gain nothing if we replace RINOS with Democrats.”

Bay Buchanan, the president of the American Cause, acknowledged that Specter had been a “huge problem” for conservatives who opposed pathways to citizenship for undocumented immigrants, but worried that he would become even worse as a Democrat.

“Did he give us a few things?” asked Buchanan. “Did he owe President Bush something because he flew into the fray in 2004 and saved him in the primary with Toomey? Were we able to call in a few chits? Absolutely. And now the Democrats will call in their chits. This is not good for Republicans. I’m not going to tell you that we’re cleansing the party and that this is good for Republicans.”

The conservatives who have any inkling about how Washington works knows this is a problem for them. It's actually a problem for America. I know that "we need a vital two-party system" is a cliche, but that doesn't make it untrue. My hope is that the Conservadems and the liberals will split and we can have this debate from the center left where it belongs.

Now They Want Sebelius

Looks like we may have a Health and Human Services Secretary by tomorrow, just in time to get started in the middle of a flu outbreak and fears of a pandemic. Funny how the GOP finally agreed to end the obstruction right at this time, ay?

On the flip side of this, I agree with Brian Beutler that the continued obstruction of Dawn Johnsen is troubling.

In fact, Dawn Johnsen's nomination to head the Justice Department's Office of Legal Counsel seems to be, if anything, in more trouble than does Sebelius'. There have been rumors of a Johnsen filibuster for weeks now, and outside groups, both pro-confirmation and anti, have been lobbying Congress as the process has all-but-ground to a halt. (Just today, the groups People For the American Way, Alliance for Justice, National Women's Law Center, and NARAL Pro-Choice America hosted a conference call for reporters during which former OLC-chiefs Walter Dellinger (who served under Clinton) and Douglas Kmiec (who served under Reagan and George H.W. Bush), along with Johnsen's Indiana University colleague Aviva Orenstein, made the case for a quick confirmation.)

Now, keep in mind that Sebelius will be a cabinet-level official while Johnsen will not, and in that sense it's plausible that Democrats have prioritized a vote on Sebelius' nomination in order to make Obama's cabinet whole. But it's also plausible that Senate Majority Leader Harry Reid (R-NV) isn't as sure he can clear the cloture hurdle if the question on the floor is on the confirmation of Dawn Johnsen. More on the apparent disparity as I learn it.

Especially given the release of the OLC memos justifying torture and the display of how important that office is to upholding the rule of law, we need Johnsen in that seat now more than ever.

...Sebelius will still need 60 votes, by the way, though it appears safe that she can get them.

Playing Politics With People's Lives

Well that sure was smart.

Sen. Susan Collins (R-ME) was apparently unwilling to be seen as endorsing such "funny" sounding priorities as flu "preparedness" in an economic recovery package. Perhaps in an attempt to prove her fiscal conservative bona fides, Collins repeatedly insisted that (Rep. David) Obey's pandemic preparedness funding did not belong in the bill:

COLLINS: There's funding to help improve our preparedness for a pandemic flu. There is funding to help improve cyber security. What does that have to do with an economic stimulus package? [CNN, 1/31/09]

COLLINS: I think everybody in the room is concerned about a pandemic flu. But does it belong in this bill? Should we have $870 million in this bill? No. We should not. [MSNBC, 2/5/09]

After the funding was stripped, another moderate Republican attempting to appear tough on "unnecessary" spending in the recovery package, Sen. Arlen Specter (R-PA), endorsed Collins' crusade against the pandemic preparedness funding on Fox News:

MS. KELLY: Okay. $780 million for pandemic flu preparedness, in or out?

SEN. SPECTER: Out. Very important projects, I took the lead along with Tom Harkin on some massive funding for pandemic flu, but it belongs in our regular appropriations bill.

The argument for putting flu preparedness in the stimulus was that an outbreak at a time of economic downturn would be devastating, not to mention the fact that anything that spends money to buy anything is stimulus, and the money is gone for state and local public health for flu pandemics:

Hamburg said there is no more pandemic preparedness money in the pipeline for state and local public health. "The $600 million that was made available in December 2005, in the fiscal year 2006 emergency supplemental bill, the last of those dollars went out the door this past August," he said.

In addition to the cutoff of pandemic flu funding, public health agencies have seen their "all hazards" preparedness funding drop about 25% since 2005, Hamburg said.

TFAH and its partners are advocating for another $350 million specifically for pandemic readiness and additional money for other public health emergencies, he said.

There is likely, especially now, to be additional funding in the FY2010 budget, and maybe even an emergency appropriation. But right now, we have no money in the pipeline for flu pandemics, DURING a possible flu pandemic (I don't want to get too hyperbolic, because the severity remains to be seen).

This outbreak is also occurring at a time when we have no Health and Human Services Secretary, thanks to:

The Service Employees International Union has launched an online petition criticizing Republicans for delaying the confirmation of a Health and Human Services secretary in the face of a swine flu outbreak.

The union accuses Senate Republicans of delaying the confirmation of nominee Kathleen Sebelius to “curry favor with extremist outside groups” and depriving the department of leadership as the nation confronts a potential flu pandemic.

“This is simply unacceptable,” the union says on its website. “This disease is spreading as we speak, but right now, a Bush-appointed accountant is running the department. We need an HHS secretary NOW. Sign the petition telling the Senate to vote immediately to confirm Gov. Kathleen Sebelius. If we don't act, the swine flu might just turn into another Hurricane Katrina.”

To Republicans, governance comes last. Winning a cable news debate comes first. The country suffers.

Sign the petition.

This Week In Health Care

Ezra Klein is moving to the Washington Post. That's great - Ezra is one of my favorite bloggers, and I particularly appreciate his ability to drill down on health care policy. So in his honor, here's a great big health care post!

I would describe the prevailing mood from health care policy experts on the Hill as ebullient. The Senate committee chairs with jurisdiction are planning to mark up a bill by June, while working in close concert so the bills aren't all that different, and a final vote is expected by early fall. This appears to be happening.

The question, of course, is "what is happening?" What form will this legislation take? Some liberals are alarmed by the subtle shifts in the debate, and for good reason.

As Congress returns to begin an intense debate over reshaping the nation's $2.2 trillion health-care system, prominent left-leaning organizations and liberal House members are issuing a warning to their Democratic allies: Don't cave on us.

The early skirmishing -- essentially amounting to friendly fire -- is perhaps the clearest indication yet of the uphill battle President Obama faces in delivering on his promise to make affordable, high-quality care available to every American.

Disputes over whether to create a new government-sponsored insurance program to compete with private companies shine a light on the intraparty fissures that may prove more problematic than any partisan brawl.

More than 70 House Democrats recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan.

"It's way too early" to abandon what it considers a central plank in health reform, said Andy Stern, president of the Service Employees International Union. He said the organization pulled out of the bipartisan Health Reform Dialogue because it feared its friends in the coalition were sacrificing core principles too soon. "You don't make compromises with your allies."

Ultimately, I think the Administration supports a public plan, but they're willing to make it more of a public plan in name only (PPINO?), along the lines of Uwe Reinhardt's plan, which would operate like Medicare, but not paying the same bargain rates. That makes little sense to me and doesn't do much more than add a non-profit health care provider to the space. It won't necessarily force the private market to compete on price and quality, and given that a separate set of rules would do away with pre-existing condition and rate communities with a standard price, I don't see the benefit to a neutered public option. Reinhardt's plan isn't all bad, and it's actually better than other "level playing field" options I've heard. But I question its efficacy, and think that progressives still ought to push for a real public option.

The other big fight is over budget reconciliation, allowing Congress to pass the budget, with health care embedded therein, on a party-line vote instead of it being subject to filibuster.

Under the reconciliation process, the House and the Senate first agree on an overall budget blueprint and then pursue legislation — in this case, the health care overhaul — “reconciling” the blueprint with the needed policy changes. If enough Senate Democrats support the legislation, the White House would not need a single Republican vote.

The House adopted its version of the budget with the procedural shortcut. The Senate has been reluctant to authorize it, but may ultimately follow the House’s lead as the two chambers try to work out their differences.

A health care bill written mainly or entirely by Democrats would almost surely create a new public health insurance program, to compete with private insurers. It would require employers to provide insurance to employees or contribute to its cost. Employers who already offer insurance could be required to provide more or different benefits, and Congress could limit the tax breaks now available for such employer-provided insurance.

There's actually a budget vote today that would keep the option of reconciliation alive for health care, which Democrats in the Senate appear to be ready to allow, or at least not kill for now, since the leverage from threatening it can at least get Republicans to the bargaining table. This is an option, it must be said, that is a commonly used technique by both parties over the last three decades, and does not represent anything approaching a power grab. Nevertheless, obstructionist Republicans are vowing all-out war if Democrats go the route of reconciliation.

Although Senate Democrats are far from reaching a consensus on the reconciliation issue, party leaders confirmed Wednesday that they are reserving the right to use it to pass health care reform if Republicans fail to negotiate in good faith. Senate Republicans — saying they have every intention of being a full partner in the upcoming health care negotiations — said holding reconciliation in reserve could poison the discussions, and threatened retribution.

“If they go down that road, I think the fur is going to fly,” Senate Republican Conference Vice Chairman John Thune (S.D.) said. “I suspect that there is going to be an awful lot of resistance, and we will exercise our prerogatives so that the rules of the Senate are respected.” [...]

Sen. Lindsey Graham (R-S.C.), who was a member of the 2005 bipartisan “Gang of 14” that negotiated a deal on President George W. Bush’s stalled judicial nominees, said he would be willing to tap into the Senate’s parliamentary arsenal to block the majority from pursuing its agenda.

Similarly, National Republican Senatorial Committee John Cornyn (Texas) and Sen. Orrin Hatch (R-Utah) predicted that the GOP Conference would respond to Democrats’ use of reconciliation on health care with tough action.

What's comical about this is that Republicans are CURRENTLY using everything in their parliamentary arsenal to block the President and the Democratic Congress' agenda. Just today they blocked a vote on Kathleen Sebelius for Health and Human Services Secretary, despite the fact that she has enough votes on the floor to beat a filibuster (two Republicans voted her out of committee, plus 58 Democrats). And the head of the RNC has called on Obama to withdraw Sebelius from the position, all because she supports reproductive choice, as does the President, who was elected by the American people by a wide margin. I don't know how much more Republican obstructionists could possibly slow the chamber, given the circumstances.

Meanwhile, even their leadership is off message on this. Here's Paul Ryan on reconciliation.

“It's their right. They did win the election,” said Ryan, R-Wis. “That’s what I tell all my constituents who are worried about this. They won the election. They did run on these ideas. They did run on nationalizing health care. So, you're right about that. They have the votes with reconciliation. They nailed down the process so that they can make sure they have the votes and that they can get this thing through really fast. It is their right. It is what they can do.”

More proof that the GOP is stumbling around on this health care fight, without an alternative option and without a strategy other than "block that kick." They're giving the Administration and the Democratic Congress little choice but to blow right by them, and in that case, Democrats ought to get everything they can in the absence of Republican participation.

This Week In Health Care

The Progressive Caucus has a PR problem, but they also have an institutional muscle problem. The Blue Dogs frequently vote as a block, or at least threaten to do so if certain elements of legislation are not met. The Progressive Caucus rarely does that. But on health care reform, they are asserting themselves.

Dear Madam Speaker and Majority Leader,

Regarding the upcoming health care reform debate, we believe it is important for you to know that virtually the entire 77-Member Congressional Progressive Caucus (CPC) prefers a single-payer approach to healthcare reform. Therefore, it will come as no surprise as you work to craft comprehensive health care reform legislation, that we urge the inclusion of a public plan option, at a minimum, in the final legislation. We have polled CPC Members and a strong majority will not support legislation that does not include a public plan option that is supported on a level playing field with private health insurance plans.

We look forward to working with you to ensure inclusion of a public plan option and the successful passage of healthcare legislation that will provide a choice of quality healthcare for all Americans

Sincerely,

Lynn Woolsey, Co-Chair, Congressional Progressive Caucus
Raul Grijalva, Co-Chair, Congressional Progressive Caucus

Now, I mentioned a couple weeks ago what "a level playing field" actually means, and I don't think progressives are really going to like it.

The Level Playing Field Plan. Insurers, predictably, howled that a public insurer with access to Medicare's market power would put them out of business. (Generally speaking, liberals agreed with that.) The messaging they settled on was conceptually odd but has proven pretty effective. A public insurer, they argued, would not be competing on a "level playing field." This might have caused someone to wonder when, exactly, the market had ever cared about "fair." But instead, this frame has been widely adopted, with Obama telling Chuck Grassley, "I recognize that there's that concern. I think it's a serious one and a real one. And we'll make sure that it gets addressed." In answer to this, Len Nichols proposed a public insurance plan that doesn't have access to Medicare's bargaining power, and this is the policy that CAP's paper advocates. This is not single-payer lite. It's just an insurer without shareholders or highly-paid executives. (I should note that some, like Harold Pollack, believe you could begin with this plan and end with the single-payer lite plan. I'm not convinced, but its possible.)

As I said then, "such a public option would not achieve the kind of bargaining power to make it cost-effective."

Now, public option supporters got a boost with an endorsement from Kathleen Sebelius, who explained similar plans in the states:

In response to questions about a federal public-insurance option, Ms. Sebelius pointed to a government-run health plan for state employees in Kansas, as well as a public plan in California for Medicaid recipients. Such plans help create competition in insurance markets where there is little, Ms. Sebelius said.

"Often when you have 60% to 70% of market share, you have a monopoly, and it's really not a competitive environment," said Ms. Sebelius, who previously served as Kansas' insurance commissioner. "We have examples throughout the country of very competitive, very effective strategies."

But if those strategies are neutered and turned into something called a "public option" without the monopsony bargaining power that a public option could provide, it's not quite a revolution.

I do think that this new liberal pro-business group will be a major help in the health care debate. Already we're seeing Walgreens offering free health care for the unemployed and the uninsured at its in-store clinics. Businesses that are friendly to reform and have some resemblance of a heart can really move the debate.

Meanwhile, the leading voice on the opposite side of the debate has a past:

Richard L. Scott is unusual in these tough economic times: a rich, conservative investor willing to spend freely on a political cause.

He visited with lawmakers on Capitol Hill this week, and his new group, Conservatives for Patients’ Rights, has hired a leading conservative public relations firm, CRC, well known for its work with Swift Boat Veterans for Truth, the group that attacked Senator John Kerry, Democrat of Massachusetts, during his presidential campaign.

Mr. Scott’s emergence this spring as the most visible conservative opponent to Mr. Obama’s not-fully-defined health care effort has former friends and foes alike doing double takes, given Mr. Scott’s history.

Once lauded for building Columbia/HCA into the largest health care company in the world, Mr. Scott was ousted by his own board of directors in 1997 amid the nation’s biggest health care fraud scandal. The company’s guilty plea and payment of $1.7 billion to settle charges including the overbilling of state and federal health programs was taken as a repudiation of Mr. Scott’s relentless bottom-line approach.

“He hopes people don’t Google his name,” said John E. Hartwig, a former deputy inspector general at the Department of Health and Human Services, one of various state and federal agencies that investigated Columbia/HCA when Mr. Scott was its chief executive.

If this ends up being the best conservatives can do, we're going to be fine.

More Tax Trouble

The Obama revenue stimulus by having his cabinet nominees undergo rigorous tax scrutiny and pay back what is owed continues. I think the moral to this story is that 99% of all people get their taxes wrong, in particular at the higher income levels when the deductions are more complex. This would seem to be an argument for simplifying the tax code, which is what conservatives always say they want, but that isn't the lesson they're drawing.

Meanwhile, John McCain is a petulant child for what he put Kathleen Sebelius through yesterday.

"Would you agree," McCain asked, that executives of firms receive more lavish health benefits than their employees?

"Well Senator," replied Sebelius, "I certainly agree that in the marketplace that the self employed or small employers are often priced out. There's no question that employer based health insurance is the backbone --"

"My question," interrupted McCain, "is do you agree or disagree that employer based health insurance is much more generous to upper level management?"

"I'm not familiar with the differentials in the health insurance system," Sebelius relied. "In a state employees system or a manufacturing operation workers have good benefits and they don't differ from the benefits of the executives in those systems."

"Would you support removing the tax exclusion and substituting a removable tax credit of, say, $5,000 for families so they could go out and purchase their own health insurance in a policy of their choice?"

"Well, Senator, I support what the President has articulated an--"

"You know," McCain sharply interrupted, "we are asking for your views."

"I support what the President has proposed," Sebelius icily replied. "That if Americans have health insurance that they like they should be able to keep it. Dismantling the current employer based system to me is not the most effective strategy for reaching full coverage given how many Americans currently rely on it."

Shorter McCain: "Don't you agree I'm right? DON'T YOU!!!! I can haz White House now?"

Sebelius Is Go

Well, so much for that Senate seat in Kansas, although the next year and a half is going to be such a tough time to be a Governor that I think Obama is in some ways throwing Sebelius and Napolitano a lifeline. Anyone who is Health and Human Services Secretary when the system is reformed is going to get a massive amount of popularity. Sebelius herself might be looking to a higher office in 2016. And there's the Mel Martinez model of a cabinet secretary who moved into elected office after the first term. If Sebelius can manage the office, I think it's a good choice.

Looks Like Sebelius

In addition to California, another budget crisis has been simmering in Kansas, where the Governor signed a bill after getting resistance from Republicans to cover a budget deficit with reductions and moving money from other accounts. Tax refunds and state worker paychecks were at risk. The result is that services will go down, as they will across the country.

Therefore, it's no surprise that Kathleen Sebelius, the aforementioned Governor, may bail out and become the Health and Human Services Secretary.

Gov. Kathleen Sebelius of Kansas, an early Obama ally with a record of working across party lines, is emerging as the president’s top choice for secretary of health and human services, advisers said Wednesday.

Should she be nominated, Ms. Sebelius would bring eight years of experience as her state’s insurance commissioner as well as six years as a governor running a state Medicaid program.

But with President Obama about to begin a drive to expand health coverage, an issue on which the two parties have deep ideological divisions, her strongest asset in the view of the White House may be her record of navigating partisan politics as a Democrat in one of the country’s most Republican states.

I think Sebelius is one of the rising stars of the party, a popular Governor in a very red state. That she would not be running for US Senate in Sam Brownback's open seat at a time when we need all the Senate votes we can get is too bad, but if she stays in that Governor's mansion I don't know how popular she'll remain. It's a bad time to be running states.

I don't really know Sebelius' position on health care, but she's stepping into a difficult fight with a lot of competing interests. There are single-payer advocates and shared-responsibility advocates and those who want market-based solutions or absolutely nothing. I think Sebelius is going to have to harness the power of the American people to get anything major done, as well as navigate a lot of competing interests. There is momentum for reform but the devil is in the details and there are many pitfalls. Good luck to her.

Cannibalizing

The Obama Administration is floating Kansas Governor Kathleen Sebelius to replace Tom Daschle as the nominee for Secretary of Health and Human Services.

Kansas Gov. Kathleen Sebelius was very near the top of President Barack Obama's list of candidates to head the Health and Human Services Department, a senior administration official said Saturday.

The source, speaking on the condition of anonymity to discuss private administration deliberations, said no decision was imminent. But the official added the former Kansas insurance commissioner was rising as Obama considers prospective candidates [...]

Advocacy groups like the consumer watchdog role 60-year-old Sebelius played as insurance commissioner for eight years before she became governor.

This is all well and good (though being a watchdog to insurers isn't the same as promoting any kind of health care policy agenda, which I haven't seen), and Sebelius is certainly a better choice than Phil Bredesen, who would be a disaster. However, just this week a poll commissioned by Daily Kos showed Sebelius way ahead in the race for the open Senate seat in Kansas being vacated by Sam Brownback. A Democrat hasn't won this seat in Kansas since 1932, and there's nobody but Sebelius who would have a chance. We've seen just this week with the stimulus debate that having less Republican rubber stamps in the Senate would probably be a good idea, and based on her performance in Kansas, I think Sebelius would be slightly less wankerrific than her red-state Democratic counterparts. Similarly, before she was picked for Homeland Security Secretary, Janet Napolitano looked to be a threat to send John McCain into an unwanted retirement in Arizona.

We need capable cabinet secretaries, of course, but this week showed the importance of the Senate. Maybe the Administration shouldn't be cherry-picking the best candidates to win Republican seats.

...the flip side of this is that Governors aren't going to be popular the next couple years with the economic meltdown and all the budget cuts, so Obama may just be saving the reputations of some of these red-state governors.

The Exodus Of The Governors

With Bill Richardson and Janet Napolitano now ensconced in Barack Obama's cabinet, and with perhaps Kathleen Sebelius perhaps joining them as Secretary of Agriculture (I don't know if that will please the foodies who want a "sustainable choice"), the number of Democratic governors leaving in the middle of their second terms rises to three. That's 3 out of 28 Democratic governors, which seems to me to be a high number. From a party-building standpoint, this doesn't seem to be a great idea, particularly in Arizona, where a Republican Secretary of State will now replace Napolitano as Governor, and Kansas, where there's a conservative Republican legislature and Sebelius vetoed a lot of bad bills. However, as FMguru noted in the comments the other day, this is a bad time to be a governor. Revenues from state taxes and property taxes are way down, and budget gaps are growing. In fact, Arizona has the biggest budget deficit in the nation, at a whopping 24% of total spending. And balanced budget amendments demand that either taxes rise or services get cut. There's no way out of the mess (save for a more generous stimulus package to state and local governments than I expect) and the pain will be deeply felt. These governors are leaving at the right time for their credibility.

The question is whether the Republican governors, who are stuck at their posts, will make good choices or drown the government in the bathtub, which would have catastrophic consequences.

In the wake of a dreary election for Republicans, the quest to find their new leaders is on, and the party's governors think they can fill the void. The problem is their states are heading for budget difficulties that may compel the governors to swallow hard and either propose or accept tax increases.

And there is no better way to alienate the base of the Republican Party than to push for, or acquiesce to, tax increases.

"This is a tremendous opportunity to separate the sheep from the goats," said Grover Norquist, president of Americans for Tax Reform. "The guys who turn around and say 'I can't rein in spending, I must raise taxes'...are going to have a hard time."

It must be so easy to be a mewling child like Grover Norquist, playing to the selfish fears of his base, acting like a three year-old at the mall. This crisis will hopefully domesticate him, so that he might pee on the furniture a bit, but he won't be much of a problem anymore.

By the way, his Governors aren't listening to him anymore.

Among the states led by Republicans, Florida may have the biggest headache. Gov. Crist faces a $1.7 billion mid-fiscal-year shortfall, according to the Center on Budget and Policy Priorities. Meanwhile, tax revenue in the state, which doesn't have an income tax, plunged 8.2% in the quarter ended in September from a year earlier as sales took a hit, according to the Nelson A. Rockefeller Institute of Government. Seeking to balance the budget, Gov. Crist has said he would consider a cigarette-tax increase of 50 cents a pack.

A similar situation is playing out in Mississippi, where Gov. Haley Barbour, widely viewed as a star among Republicans, proposed a 24-cent-a-pack cigarette-tax increase and a host of other tobacco-related fees. The combined fees, if implemented, are projected to create $80 million in revenue for a state with a roughly $24 million midyear shortfall.

It's called reality, and it's hitting governors in the face. The real problem is all the balanced budget amendments, which paralyze states and force cuts at the worst possible time. But poor Grover probably was a cheerleader for them as well, so he's going to have to take the tax hikes like a good little boy.

Iraq: Solar Dynamo

It kind of makes me want to punch out every window in my house that we're now falling behind Iraq in the solar power chase.

In a city with constant electricity shortages but no lack of sunshine, the new buzz is solar energy.

Teams of engineers have appeared along major Baghdad roadways, bolting panels and bulbs to rows of towering steel poles to make solar-powered streetlights.

The workers who turned up recently in the upscale Karada district approached the task with near-religious fervor.

"We are lighting up the city with solar power," Sajad Hussein declared when queried by curious residents. "People say it is a gift from God."

Now, Iraq is doing this because they can't get their grid in working order, not out of concern for the environment. But here in the US of A, the President put a two-year moratorium on solar project development in public lands in the West until outcry forced him to reverse it It seems that there's less bureaucratic red tape for solar developers in frickin' BAGHDAD than here.

On a somewhat related and more hopeful note, here's a great interview between Grist and the woman who may become Vice President, Kathleen Sebelius, who has tirelessly fought against the construction of new coal-fired power plants as Governor of Kansas and increased their wind energy output. She found a way to sell that in conservative Kansas - by arguing (correctly) that future carbon pricing costs will be borne by the state with additional coal plants, and most of the benefit in energy would be going elsewhere anyway - and it's a good lesson for how we can move forward on renewables.

More Veepstakes

The Huffington Post profiles Kathleen Sebelius today. She's the Democratic governor of Kansas who has brought a host of former Republicans along to the party in the Sunflower State, adeptly working the conflict between the Mods and the Cons. She has ties to Ohio (her father used to be governor there) and is not afraid to challenge the Bush Administration, as she did when tornadoes destroyed Greensburg, KS, and she spoke out against the lack of National Guard equipment to deal with the catastrophe because of the war in Iraq. She's a uniter inside Kansas, and has earned high marks for the state's prison policy. She's squarely in the center of the Democratic Party and by no means on the left, but you could do worse. Her recent veto of two new coal-fired power plants in Kansas shows me that she's attuned to energy issues.

Still, with Obama's perceived lack of national security experience having a small-state governor on the ticket beside him would open up that debate further, as opposed to having Joe Biden on the ticket, who exudes confidence in national security discussions and would never shy away from a confrontation with Republicans on the issue. Of course, this confidence made him denounce his fellow Democrats, including Obama, on national security issues as well, and the Republicans would be sure to resurrect those quotes.

Ultimately, I don't think this matters a hell of a lot, but you know, it's an interesting parlor game. My dark horse: Anthony Zinni. Having someone with intimate knowledge of Bush's foreign policy fiascos would be excellent.

UPDATE: The attack dog qualities of one of the few Democrats to challenge McCain on FISA and illegal spying, as Biden has done, is not lost to me.

The Giant Pool of Money

This American Life did a great job explaining the mortgage crisis this week in an hourlong essay by Alex Bloomberg. The short version is that the "giant pool of money," all of the savings in the world, close to $70 trillion dollars in central banks and global pension funds and the like, needed to be invested in something that yielded a decent return. And investors and managers decided that US mortgages were that stable and lucrative investment. So financial institutions bundled them up into mortgage-backed securities and sold them. And sold them. And sold them some more. To the extent that more people had to be put into mortgages to satisfy the demand. And so more and more unusual mortgage products were created and sold, and people with no income were suddenly buying houses, and the system was all grand until the loans reset, and the pyramid came crashing down.

That's the short version. But it's well worth your time to listen to the full hour for some more details.

The thing is that once we fix the mortgage crisis and restrict mortgages to those who might be able to pay for them, and curb predatory lending and basically restore balance and order to the system, there's still going to be a giant pool of money that demands investment. Where will it go? Andy Stern (head of the SEIU) and Kathleen Sebelius (Governor of Kansas) have an idea for some of it - it can be spent on an investment in America's infrastructure. But not as a commodity to be bought and sold like a mortgage-backed security. No, this would be the opposite of a privatization scheme - public pension funds could be used to provide a long-term source of capital that would be repaid at a reasonable surplus.

Public pension funds, which are responsible for the retirement benefits of more than 18 million Americans, have more than $3 trillion in assets, and a long-term investment approach consistent with the stable returns that infrastructure assets generate.

Pension funds could buy and build infrastructure, putting the profits to work for the retirement of workers, not for the benefit of Wall Street CEOs.

This is how it works: Pension funds pool their assets and invest directly in projects to build new roads and bridges in multiple states, bypassing the Wall Street firms that want to siphon off profits. The steadyily increasing streams of revenue that come from tolls and other sources would deliver stable, long-term returns to working Americans, while creating well-paying construction and service jobs connected to each project.

These pooled pension direct investment vehicles would:

• Provide the much needed capital infusion sought by governors and state legislatures to improve their states' infrastructure;

• Ensure that billions of dollars stay in our communities instead of going to big financial firms;

• Create a multiplier effect, generating jobs, economic activity, and new tax revenue for states;

• Achieve strong investment returns and stable long-term cash flows that meet or exceed actuarially required levels; and

• Support "green" infrastructure projects that are environmentally sustainable.

It's a pretty creative solution, and wouldn't it be nice for a change if Wall Street wasn't seen as the automatic answer to fiscal crisis? There are issues with legacy payments and pensions for public employees and problems with our crumbling bridges and roads. Why not let them work together and combine forces to solve both problems? This is why Stern has been so successful with his union and why Sebelius may become the first female Vice President.

Blaming the Victims

In 2005, you saw the Bush Administration blaming Democratic Governor Kathleen Blanco of Louisiana for her performance during Hurricane Katrina, while at the same time they were criminally negligent in providing federal assistance. Now they're trying the same thing in Kansas.

The White House fought back Tuesday against criticism from Kansas’ governor that National Guard deployments to Iraq are slowing the response to last week’s devastating tornado.

White House press secretary Tony Snow said the fault was Kansas Gov. Kathleen Sebelius’.

In a spat reminiscent of White House finger-pointing at Louisiana Gov. Kathleen Blanco after the federal government’s botched response to Hurricane Katrina, Snow rapped Sebelius for not following procedure to find gaps and then asking the federal government to fill them.

“If you don’t request it, you’re not going to get it,” he said.

That's one of those, whaddyacallit, um... damn lies. And Sebelius has a lot of support in Kansas, so I don't think this one's going to work.

* Dec. 30, 2005: Sebelius writes to Rumsfeld requesting new equipment. “The Guard was critical to responding to recent blizzards and floods in Kansas, yet its ability to respond to similar situations is being diminished by a lack of equipment,” wrote Sebelius. Included with her letter was a list of equipment Kansas had lost to the Iraq war. [Kansas City Star, 1/21/06; Topeka Capital-Journal, 6/29/06]

* Jan. 23, 2006: Sebelius personally urges Bush to increase National Guard funding. In an one-hour motorcade ride in Kansas with Bush, Sebelius expressed concern about “a reduction of National Guard troop strength in its next budget.” Bush assured her he was “dealing” with the shortages. [Topeka Capital-Journal, 1/24/06; Kansas City Star, 3/11/06]

* June 28, 2006: Sebelius sends Army Secretary list of equipment lost in war. In a meeting with Army Secretary Francis J. Harvey, Sebelius told Harvey that the state had lost about $140 million in National Guard equipment to the Iraq war. Her office then sent him a list of the lost equipment. [Topeka Capital-Journal, 6/29/06]

* Sept. 5, 2006: Sebelius lobbies for replacement of National Guard equipment sent to Iraq. “Kansas’ congressional delegation, Sebelius and governors from around the country have been lobbying the Pentagon for increased funding to replace National Guard equipment that has been left in Iraq or damaged beyond repair after repeated use in war.” [AP, 9/5/06]

* Feb. 27, 2007: Sebelius pushes White House and Congress for more funding. “Now the Guard needs Washington’s help,” Sebelius said in press conference on Capitol Hill. “The President and Congress need to step up to the plate and give our Guard members the support they deserve.” [Press Release, 2/27/07]

Apparently this wasn't filed in triplicate on the proper T&S report, that's Snow's excuse for blatantly stretching the truth.

This is extremely simple. National Guard equipment belongs in the states, and doesn't need to be asked for. When disaster strikes, and it strikes unpredictably because it's a disaster, that equipment is needed immediately. It's not a situation that you can remedy with a formal request. The states need their own disaster preparedness program immediately. It's thuddingly stupid to suggest that a Governor didn't ask for anything so it's her fault for not being able to clean up after a natural disaster.

Mahablog has more.