As featured on p. 218 of "Bloggers on the Bus," under the name "a MyDD blogger."
Wednesday, September 23, 2009
Kent Conrad's Sneak Attack
Kent Conrad wants things his way. He's turning out to be as devious as anyone in the Senate. Brian Beutler reports on his effort to get the health care bill outside the window for reconciliation, which is the clear intent of this stalling tactic:
Sen. Kent Conrad (D-ND) indicated today that there may be major delays in the health care process going forward. During today's health care hearing, he told CBO chief Doug Elmendorf today that the Senate Finance Committee must be provided with a complete CBO score of the final package before the panel can hold a vote on it.
"With respect to the issue of when scoring might be available, because...it is critically important that we have scoring before a final vote is cast in the committee," Conrad said, "it is important for us to know, once there is a package, after the amendment process here, can you give us some rough estimate, in days to have a CBO score."
How long will that scoring take?
Elmendorf estimated that the full reporting could take two weeks:
"I think we can update our preliminary analysis...within a few days of the package actually being set. A formal cost estimate would require...two weeks of work by us, once the package is settled."
Conrad ultimately suggested that the committee could hold its vote on the basis of the preliminary analysis, but that two week window would presumably still apply to progress beyond the committee's vote. It would, after all, take a similar amount of time to complete a final cost estimate of the package that ultimately comes to the Senate floor.
Kate Pickert has more on this, though she curiously removes Conrad's name from it. He does appear to be the prime mover. He never agreed with the option of reconciliation, and if he can push the bill past October 15, a sort of deadline for that process, he can assure that all the legislation would have to move through a 60-vote process. Since nobody is suggesting that a public option has 60 votes in the Senate, it would essentially doom that measure, and boost Conrad's preferred co-op option, which would give millions in seed money to Blue Cross of North Dakota, which has 90% of the state market, because they could conceivably as a non-profit pass for a co-op.
It's not that Conrad really cares about the score of every item in the health care bill - after all, when the CBO produces a score he doesn't like, he's happy to ignore it.
When the Star Tribune asked Conrad if he agreed with CBO director Doug Elmendorf's conclusion that, "They seem unlikely to establish a significant market presence in many areas of the country," Conrad answered:
I do not agree with the Mr. Elmendorf's assessment on co-ops. Based on the advice of leading actuaries, we are providing enough federal seed money for these co-ops to insure 12 million Americans.
If Conrad doesn't care what the CBO assigns to his own preferred policies, why should it matter to get a complete score before voting the bill out of committee?
Conrad laid it on thick yesterday, trying to use the experience of countries like France, Germany and Japan - which do things like guarantee a baseline level of coverage for all citizens and ban insurance companies from making a profit - as proof that no government-run program is needed. But of course, Conrad's conception of health care reform bears no resemblance to those systems at all, and a public option offering baseline care at an affordable price actually does.
Harry Reid's still out there talking about reconciliation if 60 votes cannot be attained. Is it worse if he doesn't know that Conrad is pulling out the rug from him, or if he knows?
...Olympia Snowe supports this delay as well. Amazing that the two Senators with lots at stake in their own non-public option alternatives would want to delay the bill past the reconciliation window! Ezra notes that this kind of delay would be unprecedented in the history of the Finance Committee.
...This amendment was defeated. Blanche Lincoln voted with the minority, but Conrad didn't.
At Least Education Reform Seems To Be Moving Swimmingly
There actually is one area of President Obama's agenda which could be plausibly described as a government takeover. That would be his plan to streamline the student loan market, eliminate the middlemen who provide no service, and allow students to borrow from the government directly, with the massive savings from that plowed into Pell Grants to help more kids go to college. If Obama were this swift with the middlemen in the insurance industry he'd be praised on the left as another FDR. As such, Sallie Mae and the others in the private student lending market, who get subsidies to do what the government can do on their own for much cheaper, don't have the power and influence to stop their own destruction.
Educational institutions currently have two ways to offer federal loans to students. In the Federal Family Education Loan (FFEL, pronounced "fell") program, the government pays subsidies to banks and lenders to dole out money to borrowers and reimburses companies up to 97% of the cost of any loan that is not paid back. The second way is the direct-loan program, created in 1993 as an alternate option, in which the government cuts out the middle man, lends money directly and gets all the profits. If the Student Aid and Fiscal Responsibility Act (SAFRA) passes both houses of Congress, the approximately 4,500 colleges and universities that are currently signed up for FFEL will have to abandon the program and start using the direct-loan option by July 1, 2010.
The House will likely pass the bill this week, and if it runs into trouble in the Senate, it could easily move through reconciliation since the whole point of it is to end wasteful subsidies to the private lending market, which expand the deficit. I think there will be 50 votes for this, as Pell Grants are popular, the private loan market serves no purpose whatsoever, and another part of the bill offers challenge grants for early childhood education, another broadly popular priority. We're going to see change - we can actually believe in! - in higher education. And the students who supported Barack Obama in record numbers will recognize this almost immediately. Savvy play.
Jay Rockefeller is actually the chair of the health subcommittee in the Senate Finance Committee. Any "Gang of Six," or really any legislation on the Committee, should at least have his input, if not his controlling hand. Yet Max Baucus froze him out of the legislation in favor of Republicans who will never sign on to the final version and worthless schemes like the Conrad co-op proposal (which is just a thin ploy to get Blue Cross of North Dakota, which controls 90% of the market in Conrad's state, the "co-op" label so it can access federal start-up funds). Rockefeller may have the last laugh when the bill moves into the full committee.
U.S. Senator John Rockefeller, a Finance Committee member and a strong backer of a government-run insurance option, said on Tuesday he will not support the panel's healthcare bill in its present form.
Rockefeller told reporters he was unhappy with the lack of a government-run "public" insurance option in the bill, which is scheduled to be made public on Wednesday, and had problems with some of its changes in children's health insurance and Medicaid, or healthcare for the poor.
In particular, Rockefeller wants a public insurance option instead of the weak co-ops, better affordability provisions so working people can actually use the bill, and changes to the way that Baucuscare deals with the Children's Health Insurance Program and Medicaid.
Rockefeller specifically said "There is no way in its present form that I will vote for it... unless it changes during the amendment process by vast amounts." Now, getting amendments through may not be an easy task. Each Rockefeller amendment in that committee would have to get the votes of all the Democrats plus at least a couple Republicans, if Baucus and Conrad hold firm on them. Considering that 10 of the 13 Democrats on the panel were completely shut out of the process during the Gang of Six talks, I'd expect a lot of support for what Rockefeller wants to do, but Baucus and Conrad can basically nullify anything meaningful on their own, should they want to.
Still, Rockefeller's advocacy is important because it sets the tone for Democrats with the full Senate, where votes like his will be needed. Jon Cohn explains.
A little over a month ago, right before the August recess, I spoke with Rockefeller at some length. And he was clearly wrestling with how to position himself.
No living senator has done as much to promote health reform as he has. It's the cause of his life and, for the first time, the goal is within reach. He admitted that voting against a package, even a flawed one, was difficult to imagine.
But Rockefeller also made clear his frustration with the compromises Baucus was making, whether it was replacing the public plan with a co-op or gradually reducing the subsidies to help people pay for insurance. He was particularly incensed about the changes to Medicaid and CHIP, programs to which he's devoted much of his time--and on which many West Virginians rely.
At the time, it seemed like Rockefeller was still on board, if only to help get a bill out of the Finance Committee and onto the Senate floor. But you got the feeling--well, I got the feeling--that he was near the breaking point.
Sometime since that interview, clearly, he's hit it.
Every vote is precious in the Senate, given that votes on the Republican side other than Olympia Snowe and maybe Susan Collins will not be forthcoming. Harry Reid has laid down the marker that anything less than 60 votes will lead him to go through the reconciliation process (and I don't think Reid's low poll numbers in Nevada will be much of a factor - the consequences of doing nothing on health care would be far graver for him). Therefore everyone in the Democratic caucus, essentially, represents an interest group to be satisfied. Rockefeller is standing up and saying that he's perfectly willing to vote against something that doesn't fulfill the promise of health care reform as he sees it. Bernie Sanders probably feels the same way. Maybe Barbara Boxer does. Or others. Max Baucus and his cronies will have to wrestle with that.
The President will apparently support and endorse the public option in his speech tonight but fall short of demanding it. More on that in a later post. Really, if the members of Congress supporting a public option don't show their mettle in this debate, it won't totally matter what the President supports.
Over the past 48 hours, the blogosphere has blown all kinds of holes in Max Baucus' bill, but on Capitol Hill people are being a bit more circumspect, probably because they just want him to pass the sucker out of his committee so we can get on with the work of health care reform. And yet even media types are slagging Baucus for delaying the same bill he could have had in June for three months for no particular reason. So clearly, his centrality to the debate has lost traction.
The center of gravity has really shifted toward Olympia Snowe. And therefore, it's good to see Robert Reich knock her trigger proposal back to kingdom come. Reich rightly notes that this idea we can devise a formula to know definitively if insureres are living up to their responsibilities is ludicrous. Therefore, corporate interests and Republicans (redundant) will just argue the numbers on the trigger and delay the public option forever. And adding a five-year delay just snuffs out all of the political energy for change.
Even better than this is Chuck Schumer arguing enthusiastically for using reconciliation for at least part of the bill - and a public option would fit that mold.
Q: I’m curious, the leadership was trying to use reconciliation as way to force Republicans to the bargaining table. Do you think that failed and do you think reconciliation is still part of the plan?
A: I think we still have to look seriously at reconciliation because even with 60 Democrats, you know, if we’re able to get somebody here from Massachusetts, it’s not easy to do.
Q: Are you planning on having an interim appointment from Massachusetts?
A: No, I don’t know. That would be up to the Massachusetts state legislature but I know they’re considering it. Ah, so, so the bottom line is that even with 60 or even if Olympia Snowe comes to some kind of agreement, it’s going to be hard, and I’ve always favored using reconciliation for good parts of the bill. I think that will get you the best bill, the strongest bill and the bill that will have the greatest positive effect on the American people. Ultimately, we’ll be judged not by whether we pass the bill, but ultimately we’ll be judged by weather it works. Leaving the bill as something that doesn’t work, even if we pass it, leads to hurting both the country and the party.
Now if THAT could only become the center of gravity opinion in the health care debate...
In addition to the slagging of Baucus-care and Snowe-care and the talking up of reconciliation, you have the insistence from House progressives to only vote for a bill with the public option. And as Anthony Weiner notes, there's a strategic component to this as well:
Dem Rep. Anthony Weiner, who’s taken on a counterintuitive and increasingly high profile role defending the public plan, just said for the first time in an interview with me that he doesn’t see “any way” he can vote for a bill without the public option in it.
“I dont see how I could,” said Weiner, when I asked whether he’d vote for a bill without a robust public plan. “I dont see any way I could.” His throwing down of the gauntlet is more striking when you consider that he’s known at home in New York as a moderate who’s not known for bucking leadership [...]
“All of the protest letters in the world don’t add up to much if you don’t finally stand up and vote No on something the President and Nancy want,” Weiner said. “There is clearly a sense that progressives in Congress are easily rolled.”
“If the Congressional left can’t pass even something as modest as a watered down public option, then frankly I don’t think anyone is going to take the left very seriously later on in this Congress,” Weiner continued. “When Blue Dogs talk, there are fewer of them but they have more influence than when progressives talk.”
Yes, this is a proxy for future fights and a means to change the dynamic in the Congress, getting respect for progressives pushing the agenda that got most Democrats in Congress elected. The combination of all of these things is adding up to a decent enough strategy, but the President is also no bystander here. More on that in a moment.
Obama, though, has shown some willingness to budge on the inclusion of a government-run insurance plan. But Republicans like Alexander are expressing concern that Democrats will ultimately throw up their hands in the effort to seek a bipartisan compromise and tap their majorities.
"Thumbing their nose at the American people by ramming through a partisan bill would be the same thing as going to war without asking Congress' permission," he said. "You might technically be able to do it, but you'd pay a terrible price in the next election."
Trying to establish a program of quality and affordable health insurance for everyone is like starting a war.
Furthermore, getting 51 votes in the Senate and 218 in the House for a bill establishing quality and affordable health insurance for everyone is like ignoring Congress and starting a war.
I want to know when in American history has the process by which a bill passed been the basis for any voter backlash. Seems to me that the Republicans gained seats after pushing through a war authorization for Iraq in 2002. Not to mention their tax cuts, using budget reconciliation. And they won seats in 2004 despite using reconciliation for the 2003 tax cuts. There is not a voter alive who wouldn't have already voted against a member of Congress willing to vote against him or her simply because of process. James Surowiecki gives another example:
Set aside the philosophical point that requiring bills to get sixty votes in the Senate before they become law contradicts the logic of majority rule. Even in straight political terms, where is the evidence that ordinary voters remember how laws were passed and reward or punish politicians based on that? On the contrary, voters judge politicians (to the extent that they make rational decisions) based on whether the laws they passed worked or not. In my recent interview with Barney Frank, he made this point with reference to the 2003 expansion of Medicare to include prescription drugs. That bill passed the House of Representatives by one vote, and only passed because the Republican leadership kept the vote open for hours so that they could strong-arm members into supporting it. But, as Frank said, voters today aren’t asking for its repeal or complaining about the way the benefit was enacted, because—for all of its flaws, like the infamous “doughnut hole”—on the whole they’re reasonably happy with the way the plan has worked. The reality is that if the Administration passes significant health-care reform that works—that is, it regulates bad behavior by the insurance companies, makes insurance portable, makes it possible for individuals to buy insurance at reasonable rates, and reduces (as a result) the number of the uninsured—American voters will not care that it passed via reconciliation. Political victory on this issue isn’t going to be determined by how the law gets enacted. It’ll be determined by what happens once it is enacted.
The problem, of course, is that the reform plan out of Max Baucus' Senate Finance Committee doesn't look very effective. And if that's the final plan, the public will be a harsh judge.
And yet, somehow, we keep being told by Democratic members of the Senate that there is no way a public option will pass through the Senate [...]
It is strange how only one Senate Democrat has stated categorical opposition to the public option, and how the Senate leadership has state reconciliation is still on the table, but that we keep hearing from multiple Senate Democrats that a public option won't pass the Senate. Unless we are dealing with number three, then there is an almost conspiratorial code of silence among the Democratic Senate leadership right now. Have they decided they are not going to pass a public option under any circumstances, but they just haven't informed the American people about this yet?
Opposition is always framed as "the public option cannot pass the Senate", as if every Senator has done the whip count by themselves, and removing the agency of that particular Senator to vote for or against a bill. It just "can't pass." Except, I've heard lots of Democratic Senators on the record supporting a public option, but nobody on the record, save Lieberman opposing it. In fact, there are 51 members of the Senate who have said, at one point or another, that they are amenable to a non co-op public option. That's enough to pass through reconciliation, and while I find the idea that a public option through reconciliation would have to be stronger than it is now to be intriguing, in reality, smart legislative staff could figure out a way to pass a ham sandwich if they wanted.
That's not the issue. The issue is that the Democratic Party is conflicted over whether standing for some kind of values and principles or getting enormous donations from corporate interests. In a nutshell.
As Senate leaders begin work on a Democrat-only health care bill, they're finding themselves confronted with an unexpected irony: Though the caucus has reached an uneasy consensus around a public option that's modeled in many ways after a private insurer, it may be necessary to make the public option more liberal, and thus, more politically radioactive, if it's to overcome a number of unique procedural hurdles [...]
"A very robust public option that scores significant savings would presumably be easy to justify doing through reconciliation," says a Senate Democratic aide. "But it is still being studied whether other, more moderate versions of a public option could pass parliamentary muster."
According to Martin Paone, a legislative expert who's helping Democrats map out legislative strategy, a more robust public option--one that sets low prices, and provides cheap, subsidized insurance to low- and middle-class consumers--would have an easier time surviving the procedural demands of the so-called reconciliation process. However, he cautions that the cost of subsidies "will have to be offset and if [the health care plan] loses money beyond 2014...it will have to be sunsetted."
And there the irony continues: Some experts, including on Capitol Hill, believe that a more robust public option will generate crucial savings needed to keep health care reform in the black--and thus prevent it from expiring. But though that may solve the procedural problems, conservative Democrats have balked at the idea creating such a momentous government program, and if they defected in great numbers, they could imperil the entire reform package.
Now this is just funny. The Democratic leadership wanted a bill called the "public option" that would essentially be a non-profit unable to reach those who get insurance from an employer. But in order to pass it through reconciliation, they'd have to pump it up significantly. In addition, this signals that a "co-op" idea wouldn't score at all and couldn't pass through reconciliation either; it would cost seed money for start-up, but wouldn't add or subtract from the budget afterwards, and so would have to be sunsetted or excised. So Senate Democrats probably figure that they'd lose too much support in the Senate on a robust public option and they should lose it altogether. But if they do that, they'll lose the support of the House, who say that they really will hold firm and not pass a bill that gives insurance companies a bailout through a forced market. So that's the space in between right now.
Sen. Judd Gregg has hundreds of procedural objections ready for a healthcare plan Democrats want to speed through the Senate.
Gregg (N.H.), the senior Republican on the Budget Committee, told The Hill in a recent interview that Republicans will wage a vicious fight if Democrats try to circumvent Senate rules and use a budget maneuver to pass a trillion-dollar healthcare plan with a simple majority [...]
Gregg said the only way for the so-called public option to have the necessary budgetary impact to warrant procedural protection would be if the program were “very aggressive in setting rates, price controls and rationing,” an option that might cause conservative Blue Dog Democrats in the House to bolt.
Absolutely hilarious. Democrats are backed into a corner now, needing to support a real public option or none at all. And it's all up to them, since they only need 50 votes in the Senate. We'll now see pretty plainly whether Congressional Dems and the White House want to be a kept party for corporate interests or not.
I actually see the bigger problem, that insurance regulations wouldn't be able to get through in reconciliation, and would need a "sidecar" bill requiring 60 votes, and anyone bullied into passing something they didn't like in reconciliation may not be so happy about supporting the sidecar. So you'd have a public option but no exchange. Essentially, you'd have a bill made of Swiss cheese. Nevertheless, it's still worth doing to push the limits of the process obstacles in the Senate, with the overall goal of breaking them and their resistance to the change people desire.
Reconciliation began as a limited way to expedite passage of the budget bill that came at the end of each year. It did this by limiting debate and short-circuiting the filibuster. But year by year, administration by administration, it's becoming more significant. It was used to pass much of Reagan's economic agenda. Clinton expanded it to balance the budget, reform welfare and change the tax code. George W. Bush used it for tax cuts, trade authority and drilling in ANWR. Now Barack Obama might use it for health-care reform -- and if that works, for much else.
The reconciliation process's modern role has almost nothing to do with its original purpose. It doesn't reconcile budgets. It evades the filibuster. And maybe its increasing centrality is a good thing. One scenario is that reconciliation becomes a fairly common, albeit still constrained, process to pass legislation without risking the filibuster, which makes the Senate work a bit better. Another is that the need to sidestep the filibuster makes reconciliation common, but its limits begin to annoy members of both parties, and so they either unshackle reconciliation or repeal the filibuster, either of which would make the Senate work much better.
Either way, the elevation of reconciliation -- by both parties -- amounts to an admission of the problems with the filibuster, and a step towards a 51-vote Senate. The further that process advances, the better the Senate will work. In the long run, that's a good thing.
Absolutely. I support reconciliation even if it means a wacky bill, simply to highlight the inequities in the process, and hopefully, provide impetus to changing them.
Yesterday the White House basically shut down the Gang of Six talks, when Robert Gibbs said that Mike Enzi's comments over the weekend showed that he had "walked away from the table." In truth, they probably knew this for weeks, and were just looking for an excuse to end things. Now Max Baucus is largely saying the same thing, that this months-long process has been something of a charade, and that reform will happen with or without the GOP.
U.S. Sen. Max Baucus of Montana says a health care overhaul will happen this year even if Republicans back out of bipartisan talks under growing public pressure and that the death of Sen. Edward Kennedy could help hold together a compromise deal [...]
"I think the chances are still good," Baucus told The Associated Press in an interview Monday. "I talked to them, and they all want to do health care reform. But the sad part is a lot politics have crept in. They are being told by the Republican Party not to participate."
If it falls apart, Democrats will have to turn to the "nuclear option" — forcing through an inferior bill through a process that only requires 51 votes instead of 60, Baucus said.
Using budget reconciliation is not a "nuclear option," it's been used dozens of times in the past, including to achieve Republican tax cuts and other goals. That's just the AP accepting Republican frames.
But overall, the content here is a good sign. While Baucus still believes that a bipartisan bill would be superior to something pushed with a majority - I don't know why he thinks that, though I have some theories - he acknowledges that something must pass and he cannot wait forever. Indeed, as the Republicans have basically vowed to derail any reform bill, there is no such thing as the "superior" bipartisan option. So we're looking to reconciliation.
Meanwhile, Mark Begich kinda sorta supported the public option yesterday, meaning we're that much closer to the necessary votes in the Senate. There are issues with using the reconciliation process, which I'll get into in a later post.
The bipartisan circle jerk is falling apart. More lawmakers are signing on to the public option. Health care events are ramping up throughout the country.
I wouldn't say the tide is turning, but there are slightly better signs.
Strong words from Harry Reid on the public option.
Reid opened a private meeting of health care providers in Las Vegas on Tuesday by saying, according to one attendee who took notes: “We have a problem in America and it’s called the private insurance industry.”
Reid went on to express support for a public option, the proposed government-run insurance plan that he compared to Medicare, saying any meaningful reform legislation would have to include a public component.
Nevada’s main progressive group said the majority leader’s comments during Tuesday’s meeting of about 20 hospital CEOs, doctors and other health care providers was among the most significant statements they have heard on his thinking.
“We’re energized and we’re also confident that Sen. Reid is on the right side on this issue,” said Michael Ginsburg, a community organizer at the Progressive Leadership Alliance of Nevada, who attended the meeting. “That’s something we can take to our supporters and reassure them.”
Couple things here. First of all, Reid is up for re-election and it's going to be a dogfight, with Reid already behind in the polls. Because of his leadership position, he is caricatured by the right as a liberal ideologue, and members of his own party find him not able to compete procedurally in the Senate and get the Democratic agenda passed. But Reid has always been solid on fighting the insurance industry, which he once called the enemy of most everything we do today. And that principle has held up, despite his re-election battle. Surely Reid knows that Democrats must pass a bill if they have any hope of a decent showing in the 2010 midterms.
Second thing is that this offers good evidence that Reid may split the bill, getting the public option and other budget-related measures through on reconciliation, with the non-budget items coming in a second bill under regular rules with 60 votes. The second bill could wait until a successor is elected for Sen. Kennedy, by January 26 at the latest, if not earlier if the law is changed. Anthony Wright has a good piece about bill-splitting examples in the states when it comes to health care reform. Policy should trump process in this case.
Third thing is that Reid should threaten to repeal the McCarran-Ferguson Act that gave the insurance industry an anti-trust exemption. This has allowed the insurance industry to highly concentrate in almost every state market and has offered precious little choice. Just the buzz of repealing McCarran-Ferguson will send the insurance industry into battle mode, and the public option would be seen as practically benign by comparison.
During a tele-townhall with constituents today, Senate Majority Leader Harry Reid said he supports a public option...but then he added an extremely important caveat. Reid said he doesn't think the public option ought to be a government run program like Medicare, but instead favors a "private entity that has direction from the federal government so people that don't fall within the parameters of being able to get insurance from their employers, they would have a place to go."
That sounds suspiciously like Reid would prefer a so-called co-op system, which almost all reformers regard with suspicion, and many regard as a non-starter.
A recent AARP poll shows 79% support for a public option competing with private insurance companies, although the poll question is kind of odd and doesn't reflect what's on offer. Nevertheless, other polls that accurately depict the public option show support in that range. However, that is not equally spread throughout the country. For instance, in a conservative state like Nebraska, more people don't support a public option (by a plurality) in health care reform, for whatever reason, and Democrat Ben Nelson gets 56% support for his handling of health care thus far. We don't have hard data on Louisiana, but Mary Landrieu, who has actually more strongly opposed a public insurance option than Nelson, may also be more in line with the interests of her state than some realize.
Speaking before what was described as a friendly crowd at the Monroe Chamber of Commerce yesterday, Sen. Mary Landrieu said she was opposed to much of the Democrats' legislative agenda.
Asked under what circumstances she would support a public option, Landrieu responded, "[v]ery few, if any. I'd prefer a private market-based approach to any health care reform that would extend coverage," according to the Monroe News Star.
"I'd like to cover everyone -- that would be the moral thing to do -- but it would be immoral to bankrupt the country while doing so," Landrieu said. The public option as currently conceived is expected to be a deficit reducer.
Dishonest? Absolutely. But out of step? Perhaps not.
What can we realistically expect from Democrats like this in red states? Obviously, under a "split the bill" scenario, they could signal support for the more broadly popular elements of reform, like insurance regulations, while opting out of the more controversial elements that only require a 60-vote standard. Or, they could simply opt to allow cloture, the wish of the majority of their caucus, while voting against the final bill. Markos polled this in the case of Nelson:
If Ben Nelson joined Republican Senators in filibustering and killing a final health care bill because it had a public health insurance option would that make you more or less likely to vote for him or would it have no real effect on your vote?
More
Less
All
21
15
Dem
7
24
GOP
31
9
Ind
19
15
We can assume Nelson will vote against any bill with a robust public option. The big question is whether he will join Republicans in filibustering such a bill. Nebraska Republicans would sure love that, but at the end of the day, they'll vote for a real Republican in a contested election. Nelson would gain a small sliver from Independents, per this poll, but his real danger is among Democrats -- where he would lose a full 17 points of support [...]
If Nelson was to play this properly, he'd vote against any robust public option (and be justified doing so, given his constituency), but allow an up-or-down vote on the bill. Given the political realities of his state, that's the best we could hope for.
How can we position this so that Nelson comes around to this reality? I would look at how Republicans are pressuring Chuck Grassley. Grassley has something only the caucus can give him - the ranking membership of the Senate Judiciary Committee or the Budget Committee. And so he feels the pull from his members to not join in any bipartisan deal. Nelson and Landrieu both have pretty low seniority at the moment, although there's been a near-historic amount of turnover in the Senate recently. But if they have any designs on better committee assignments, or eventual chairmanships, the caucus should inform them of how they would do best to stay in their good graces. This pressure, by the way, should theoretically be much stronger on a Max Baucus or Kent Conrad, who already have that seniority. In addition, Landrieu and Nelson should be asked, pointedly, if they want to go down in history as having stopped access to health care for all Americans for a generation.
Maybe it's crass to talk about this, but Ted Kennedy's death leaves a hole in the US Senate. A figurative one, of course, one that won't likely be filled. But there's also a literal hole, one that brings the number of Senators down to 99, with 59 on the Democratic side. Because of the rules of the state of Massachusetts, there will be no replacement for the Senate seat until January 2010.
Politico reported this morning, "[I]t appears for now that Massachusetts will be without a second senator until a special election can be held early next year.... Under the 2004 law, the governor must set a special election to fill a vacant Senate seat between 145 and 160 days after the vacancy occurs - meaning, in this case, that a special election would be held in the second half of January 2010."
All of this is of the utmost importance, of course, because of a possible vote this year on health care reform, a fight Kennedy described as "the cause of my life." The prospects of overcoming Republican obstructionism were difficult enough, but with 59 votes in the Democratic caucus, defeating a GOP filibuster may prove impossible, which in turn makes the reconciliation option more appealing.
Of course, there are certain elements that cannot be achieved through reconciliation, namely the insurance regulatory reforms, among other things. And I simply don't see any Republican watching so much of the bill passed through a 50-vote process and then invoking cloture. Unless Olympia Snowe gets religion, all Senators in the GOP will obstruct and obstruct.
I know that Kennedy's death is seen by some as a rallying cry to pass health care reform. I fear it's as doomed as ever, at least until we get a replacement in Massachusetts.
(And who will that replacement be? I'd expect the entire Massachusetts delegation in the House to run for the seat.)
"In his honor and as a tribute to his commitment to his ideals, let us stop the shouting and name calling and have a civilized debate on health care reform which I hope, when legislation has been signed into law, will bear his name for his commitment to insuring the health of every American."
...Talk of Massachusetts potentially changing the law to allow a caretaker Senator to hold office for five months, and even to give that position to former Governor Michael Dukakis. I'm actually pessimistic that this will happen. Deval Patrick is unpopular, and this will look very partisan, regardless of the outpouring of sympathy for Kennedy's death. Patrick will have a tough re-election fight coming up and may not want to deal with an appointment controversy.
Gang Of Six Member Recognizes That Bipartisanship Is Dead
Jeff Bingaman, the least vocal member of the Gang of Six, is resigning himself to the reality that his bipartisan funfest is nothing more than a charade, and anyone who actually wants to pass health care reform is on the Democratic side of the aisle.
Sen. Jeff Binagaman (D-NM)--one of the six members of the Senate Finance Committee who have been hashing out a health care reform bill for months--says that if bipartisan negotiations go nowhere, he'd support an effort to circumvent a filibuster and pass legislation without any Republicans.
"If we are unable to do it any other way, that is an option. It is a very difficult option," Bingaman told a crowd of about 200 at a town hall event in Albuquerque yesterday. He was referring to the possibility that Democrats will pass health care reform through the so-called budget reconciliation process.
The acknowledgment signals that even those members of Congress most invested in passing bipartisan health care reform are well aware that those efforts might not bear fruit.
"I don't think that that effort [at bipartisanship] is what is stymying progress," Bingaman said.
"It may well not succeed, but it has been worth the effort, and we are continuing with it."
I obviously don't agree that it's been worth the effort, but if you're a Democrat who really doesn't want to pass health care reform without bipartisan cover, it has. But the moderates made a tactical error. They now risk passing no bill at all because Republicans won't budget one inch to help them. They've allowed the town hall meeting craziness narrative to take hold, to the extent that even liberals like Russ Feingold are proclaiming that there will be no bill until Christmas. The legislative fight has become a test of mettle, and if Democrats lose their most vulnerable members will simply be wiped out next year. So now they really have to do this on their own. You wouldn't see Democrats openly talk about waiving the Byrd rule if that wasn't the case.
Should Democrats use the procedure known as reconciliation, the assumption has been that certain elements would have to be stripped out of the bill and passed separately, because a Senate rule known as the Byrd Rule only allows reconciliation for legislation that costs or raises substantial amounts of money. That would include the expansion of Medicare or Medicaid, revenue-raising tax provisions, and even the creation of a public health insurance option, depending on how it's written. But non-budget-related items -- most of the new insurance industry regulations, for instance -- would presumably be put in a separate bill that would go through regular order -- and would therefore need 60 votes to overcome a filibuster.
Passing two separate bills, however, is seen by some Democrats as too much of a lift for the slow-moving Senate.
But there's another alternative, according to Martin Paone. Paone, who served as a Democratic Senate floor staffer for 29 years, has been advising Democrats as they craft their legislative strategy. He proposes that Democrats try to get 60 votes to waive the Byrd Rule -- which would then allow the inclusion of those non-budget-related provision in one bill that would require only 51 votes for final passage [...]
Conservative senators such as Mary Landrieu (D-La.), Ben Nelson (D-Neb.) or Olympia Snowe (R-Maine) could, in voting for a Byrd Rule waiver, put themselves on the record as being in support of popular insurance industry reforms, while still opposing final passage of the bill -- a political strategy that may be appealing to them.
This happened in both 1990 and 1997, under Democrats and Republicans. The world didn't end.
Mike Lux has a primer on the best practices to get a good bill through the sausage-making process. Let's check off where we're at on them:
• Hold the progressives in the House to only vote for a public option. So far, so good. They've signed multiple letters, taken multiple pledges, sent a very clear message about their determination. They need to stay strong.
• Get the Democrats in the Senate to accept that this will have to be a Democrats-only bill. This seems to be moving in the right direction. Schumer sent exactly the right message over the weekend, and it's clear things are beginning to head that way.
• Split the bill into two parts in the Senate, with the public option and the financing going through the reconciliation process. Democats are sending signals that they are moving in that direction as well.
• Get enough Senators on board for the public option. The whip count DFA and we at OpenLeft have been running shows us at 45. We need five more, and there are several Democrats I think are prime possibilities to come along if this is the path we go down.
• Above all, don't panic. There will be some rough days ahead. Certain Senators will keep saying we can't get this done, and pundits will continue to shed the worst possible light on each day's events. But we just need to hang tough, hold strong, and keep working.
Everything's moving in the right direction, actually, and on #3 we're seeing the Senate take a look at an even bolder line. But panic is always in the air when you're dealing with Democrats.
The last thing I'm worried about is that Republicans will be able to stop the budget reconciliation process. Nobody really cares about Senate procedure and you can't build a movement out of it. They're trying to scare Democrats into not using it, and that may work, but everybody knows that the GOP is full of crap on this one. Even Shep Smith.
I mentioned earlier the rumblings from Democrats about passing a public option plan through the reconciliation process rather than through something subject to filibuster. Clearly the public option either saves or spends budget money - I don't think one member of Congress would disagree with that - and typically those types of things are available to reconciliation. COBRA, the program allowing people to retain their employer-based insurance if they are laid off, was achieved through reconciliation - in fact, COBRA stands for the "Consolidated Omnibus Budget Reconciliation Act". So the history is there to do this, and of course, Republicans have used this history over and over.
In a memo that was drafted and circulated on background in April, Senate Democrats made the case that using a budget reconciliation bill to pass health care reforms is perfectly within their rights, given the Republicans' promiscuous use of the same tactic when they were in power. Excerpts of the memo were published by various news outlets back in the spring, but the memo doesn't appear to have been previously published in its entirety until now. And now, with Democrats ramping up the threat that they'll invoke the process in the fall, they're rehashing those same arguments.
"[S]hould Republicans choose not to cooperate [on health care reform], the inclusion of reconciliation instructions [in the budget] provides a backup option which could be used to prevent a filibuster and approve legislation by a majority vote," the memo reads. "[T]here is nothing unprecedented or unusual about the use of reconciliation." The memo goes on note that Congress has invoked the reconciliation 19 times since 1980, including in 2001 and 2003 when ", the Republican Congress used reconciliation to pass enormous tax cuts"
"Republicans not only used reconciliation rules to push tax breaks for the wealthy, they also made no meaningful effort to assist the growing number of uninsured Americans," it reads.
This will be a very important document to use once the Republicans ramp up their whine about how very "unconstitutional" it is to mandate a majority vote on the public option.
The question is whether we can reach 50 votes in the Senate. Chris Bowers has either full commitments or fairly strong leaning in that direction from 49 members.
I will say this - it's going to be a lot easier to get from 49 to 50 in the Senate than it will be to peel back 30 or 40 of the House members who signed a letter saying they would support no bill without a public option. I actually attended this town hall meeting in Maxine Waters' district, and the bottom line is this: she will not be able to win re-election if she, after this performance, votes for a bill without a public option. Maybe on a smaller issue, she could get away with it, but not on an issue where 500 people in her district come to a standing-room-only town hall meeting and she says she will draw a "line in the sand." And I expect that other House members, in very blue districts, have made the same claims.
"President Obama has been trying to reach across the aisle" to win a compromise with Republicans, Waters said. "It is not going to happen."
Then Waters made a public appeal to Obama.
"The people of this country elected you and gave you a Democratic majority in the House and the Senate. . . . Yes, we know that you are a nice man, that you want to work with the opposite side of the aisle. But there comes a time when you need to drop that and move forward," Waters said. "We're saying to you, Mr. President, 'Be tough. Use everything that you've got. Do what you have to do. And we have your back.' "
Maybe I'm wrong, and progressives in the House will find some wiggle room by voting for a public option in the initial bill and accepting whatever comes out of conference. But I simply do not see them being able to get away with that. People are engaged and ready to go to war over this element of the reform, and won't accept a too-clever-by-half series of votes from their representatives.
Former Democratic National Committee Chair Terry McAuliffe is demanding his party take a stand on health care legislation that the president and many others aren't willing to take: Pass a bill with a public option for insurance coverage or don't pass anything at all.
The long-time adviser to the Clintons, striking an atypically progressive tone, urged the White House to get more assertive in its handling of health care reform and described a bill without a public plan as a "failure."
"If we don't have the public option, we are wasting our time," McAuliffe told the Huffington Post. "To chalk something up and get something that is not the right thing to do is morally wrong... To pass something just so you can go home and go into election saying we passed something is not why lawmakers are sent to Washington."
After a bit of silence following his loss in the Virginia Democratic gubernatorial primary, the former DNC chair has come out swinging on the year's most important legislative issue. On Thursday, McAuliffe agreed to host a fundraiser with the first Virginia pol who insisted that a public option be in the bill. The offer, he said, extends to Sens. Jim Webb and Mark Warner -- both of whom have been sour on the idea of a government-administered option for insurance coverage. He's also involved in whipping support in Congress for the public option.
McAuliffe is the first business-friendly Democrat making the business case for competition in health care, saying that the status quo is bankrupting individuals and companies. But more important, he's a figure with ties to the donor class and the Third Way wing of the party. That he's arguing so strongly for a public option suggests that he's placed a bet that the party would benefit from going that route, and more important, would suffer from failing to do so.
Now it's basically up to the leadership to decide which way to go. Nancy Pelosi has said that her chamber cannot pass a bill without a public option. Steny Hoyer cut her off at the knees yesterday, saying "I'm for a public option but I'm also for passing a bill." Of course, in the House, those two statements are not mutually exclusive, but Hoyer clearly counts on progressives caving. $361,614 says they won't.
As for the Senate, Harry Reid has a choice to make. He can include the public option in the elements of the bill to pass through the reconciliation process, or turn the screws on ConservaDems to invoke cloture on the bill, or he can continue to allow the Baucus caucus to hijack the process. Reid has the ability to bypass the Finance Committee completely, if he chooses, and bring a bill to the floor. And he can use reconciliation for the elements about which Baucus and his cronies feel squishy.
Reid can't do it alone, of course. The President would have to get involved behind the scenes. But Democrats who are losing their base had better think of something to get this through.
The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes [...]
Most legislation in the Senate requires 60 votes to overcome a filibuster, but certain budget-related measures can pass with 51 votes through a piece of parliamentary sleight-of-hand called reconciliation.
In recent days, Democratic leaders have concluded they can pack more of their health overhaul plans under this procedure, congressional aides said. They might even be able to include a public insurance plan to compete with private insurers, a key demand of the party's liberal wing, but that remains uncertain.
Other parts of the Democratic plan would be put to a separate vote in the Senate, including the requirement that Americans have health insurance. It also would set new rules for insurers, such as requiring they accept anyone, regardless of pre-existing medical conditions. This portion of the health-care overhaul has already drawn some Republican support and wouldn't involve new spending, leading Democratic leaders to believe they could clear the 60-vote hurdle.
I wouldn't call budget reconciliation, which is how the Bush tax cuts came into being, a "sleight-of-hand." It's been on the Senate rulebooks for decades. Furthermore, passing something by a majority vote should NEVER be seen as something foreign and exotic. It happens to be the prevailing law of the land. Only recently have we had this magic 60-vote requirement on all legislation. Only recently have Republican obstructionists used it in every single case they can. THAT would be the sleight-of-hand, getting the media to believe that a definitive 60-vote standard exists.
I don't think Republicans would sign on to the less controversial elements of reform knowing that the more controversial ones will go the reconciliation route, so you'll still need to convince all Democrats to support cloture on the insurance reform/individual mandate section of the bill. But if the leadership can get that done, I'd say go for it. Jim Manley, Harry Reid's spokesman, said in the article, "we are determined to get something done this year by any legislative means necessary."
This, by the way, is an absurd statement by Olympia Snowe:
The idea of using reconciliation angers even such moderate Republicans as Ms. Snowe. "At a time when we need to bolster the public's confidence in whatever we do with health care, I don't think the reconciliation process will serve the purpose of providing affordable health security for all Americans," she said.
Nobody in America cares about the process used. People aren't staying up at night angered that the Bush tax cuts used a particular Senate process to pass. They may be angry that George Bush cut taxes on the wealthiest Americans in a time of war. If the bill actually provides affordable health care for all Americans, the number of votes will not have any bearing whatsoever on public confidence. In fact, the public does get confused when they hear 58 Senators voted affirmatively for something and the bill failed. The byzantine, anti-Democratic process of the Senate is what saps the public confidence in government.
The NYT reports that "Democrats Seem Set to Go It Alone on a Health Bill". In plain English, this means that "Democrats want a health bill." There was never going to be Republican support for anything calling itself health reform that Democrats and the President would support. You could whittle and whittle and whittle the bill down to nothing and it wouldn't matter. Somebody in Washington finally figured this out:
Rahm Emanuel, the White House chief of staff, said the heated opposition was evidence that Republicans had made a political calculation to draw a line against any health care changes, the latest in a string of major administration proposals that Republicans have opposed.
“The Republican leadership,” Mr. Emanuel said, “has made a strategic decision that defeating President Obama’s health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day.”
Ya think? Jon Kyl said yesterday that “There is no way that Republicans are going to support a trillion-dollar-plus bill.” Chuck Grassley admitted that he wouldn't vote for his own compromise and legitimized the "death panels" smear despite having voted for it in the past. You're just figuring out that Republicans view their jobs as blocking any legislation at all costs?
We're starting to hear this meme from the right that liberals are interested in negotiation and compromise with Iran and North Korea, but not with Republicans. Well, we've done the negotiations. They led to nothing for months. And the meme itself is false.
In foreign policy, liberals often believe that disputes with foreign actors can and should be settled through negotiation and compromise. That's because international relations isn't a zero-sum affair. Conflict is costly to both parties, good relations bring benefits to both parties, so disagreement is generally amenable to compromise. Ideological disagreement isn't zero-sum either. Neither conservatives nor progressives are wedded to principles that require defense of wasteful Medicare spending. But partisan politics is zero-sum. A 'win' for the Democrats is a 'loss' for Republicans. And the predominant thinking in the Republican Party at the moment is that inflicting legislative defeats on Democrats will lead to electoral defeats for Democrats. That makes the GOP hard to bargain with.
I would say "impossible." They're convinced it's 1994, and they're not needed by virtue of the numbers.
So where to go from here? Well, Democrats in the Senate could demand that their members join no Republican filibuster of any health care measure supported by a majority of their ranks. They can choose to not support the final bill if they wish. They should not keep it from a final vote. That's the simple solution. If that process winds us up with a public option in the House and a weak co-op option in the Senate, the conference committee could actually produce a positive result, provided Harry Reid puts the people on the conference with jurisdiction over the bill, like health subcommittee chair in the Finance Committee Jay Rockefeller (strong public option supporter) and retirement and aging subcommittee chair in the HELP Committee Barbara Mikulski (supporter).
That bill would easily pass the House. The Senate is trickier. But the conference report can't be amended. It can't be changed, or held up in committee. It can be filibustered, and it can be voted against. Those are the options. If three Democrats opposed the legislation and wanted to kill it, they would literally have to filibuster it (this is assuming that Democrats have 60 votes, which is not certain given Kennedy's health). That would be a very hard thing to do at that stage in the game. It would isolate the obstructionists, ensuring funded primary challenges and the enduring enmity of the Senate leadership and the White House. Kent Conrad can say that there aren't enough votes for a public option and imply that he's just protecting the final bill from defeat. But is he willing to be one of those "no" votes? Is he willing to filibuster? That's a different game indeed.
At this point, no Democratic Senator has committed to joining a Republican filibuster, an important distinction. The conservaDems should be asked if they plan to do so.
If that fails and President Nelson (who likes to shout at public option supporters in the media off camera) or some other newly elected President tries to torpedo the bill, there's the option of splitting reform into two bills, with the filibuster-able stuff in one bill, and stuff relevant to the budget packed into a bill that can be achieved with 50 votes in budget reconciliation. That makes those provisions likely to be subject to a sunset, but once a public option, expanded Medicaid, increasing subsidies and other budget-relevant things get enacted, I submit it will be hard for any Congress to allow them to expire. Failing that, there's the straight reconciliation path, which contra Chris Matthews is not "blowing up Senate rules" but part of them (someone who's never talked a word about Senate rules in his whole career should probably not start now), but which could get messy if elements not relevant to the budget got excised.
Or, Democrats could behave like Republicans and rule by fear and questioning opponents' patriotism. But that's, er, unlikely.
The point being, there are options, and lots more open up when you recognize the large majorities in both houses of Congress cancel the need for bipartisanship inside Washington.
Like I said over at the Cerulean Cherub's place, getting a health care bill passed through reconciliation would be great fun even if it were a crap bill [...]
From a democratic (small d) perspective, the Senate has been asking for it for a long time now. The filibuster is not a constitutional tradition, and as we've seen, amply, is a safeguard of made-up Senatorial principles, not democratic principles, and the public good be damned.
Yes, we need sane healthcare, but we need lots of sane things that we're not getting because of the absurdities that the Senate enables -- Max Baucus directly represents fewer than a million people, and has extensive power over the healthcare of over 300 million Americans. Why? Because he's a fucking healthcare maven genius! Or not! It's all amazingly silly.
A case could be made that whatever the content of any specific bill, a punch to the solar plexus of the pudgy, complacent Senate would be good for the nation. The nation's health literally rests at the whim of a very small number of individuals who are only directly accountable to a very, very small percentage of the nation's voters. Whatever this is, it's not democracy.
The Senate has basically gotten completely out of control. It was conceived as a saucer to "cool the cup" of the passions of the House, but there's a fine line between that and freezing the cup and throwing it into a meat locker. If the Senate were instituted after passage of the 14th Amendment, the Supreme Court would likely have found it unconstitutionally in violation of the equal protection clause. California has 69 times as many citizens as Wyoming, and yet their citizens get the same amount of Senate representation. The Senate was a bad compromise put in by the Blue Dogs of the 18th century.
What's more, it's gotten worse, as runaway egos and peculiar Senate rules have completely paralyzed the legislative process. The filibuster has only recently been transformed from an occasionally used temper tantrum to a de facto 60-vote supermajority requirement. This recent development is a significant intrusion to the ability of the country to govern itself.
The filibuster, however, has undergone little-noticed changes. Even as successive generations have weakened it by creating the option of cloture, the filibuster itself has become more present in everyday legislative maneuvering. The political scientist David Mayhew argues that we've misremembered our own past on this matter. He's written that Senate has never faced “any anti-majoritarian barrier as concrete, as decisive, or as consequential as today’s rule of 60."
That seems strange, of course. After all, the filibuster was stronger back in the day. But it wasn't used to create a de facto 60-vote majority. It used to be more akin to a temper tantrum. Mayhew looked at FDR's court-packing scheme as one of his examples. The filibuster hardly figured into the discussion. “General opinion is that the [bill] will pass,” wrote the conservative Portland Herald Press, “and sooner than expected, since votes to pass it seem apparent, and the opposition cannot filibuster forever.”
Its elevation to the decisive rule in the U.S. Senate is a recent development, and one that has taken a countermajoritarian institution (both in its structure and representation) and saddled it with a supermajority requirement. The product is an almost impossibly obstructed legislative body. We tend to assume this will work out fine, as we've had the filibuster forever, and we're still around. But the evidence is that the filibuster did not really exist in this form before, and so it's very hard to say whether it will work out fine. And those who think that the political system will always respond to emergency, and that countermajoritarian rules don't matter, should really take a look at what's going on right now in California.
Reconciliation may or may not be able to produce a bill worth a darn; YMMV. But if the fallout from using it produces a demystification of "Senate process" as some kind of holy writ, the effects would be profound. Process changes have often preceded substantive policy changes. Unless you want health care reform and financial regulatory reform and climate change and energy and all the rest in the tender hands of President Ben Nelson in perpetuity, it may be worth breaking the dam that's holding back the country.
Max Baucus has been setting deadlines on his committee's work on the health care bill for years now, so until we get to September 15 I'm going to go ahead and call B.S. on this.
Senate Finance negotiators have agreed to try to reach a bipartisan accord on health care reform by Sept. 15, a senior Senate source said Friday.
Baucus has told his Senate colleagues that at that point he will move forward with a markup of a health care bill, whether he has a bipartisan agreement to work from.
That said, this has always been the plan. Give Republicans a choice - they can have input and be part of the process, or Democrats will have to go it alone, because failure is simply not an option.
What would a Democrats-only bill in the Senate look like? Well, it should be a simple task, with 60 Democratic Senators voting in solidarity to move the process forward, then voting their consciences on the final bill.
With the health care bill languishing in the Senate and under fire in the House, Democratic leaders are quietly preparing for Plan B.
Under the scenario now being discussed, bi-partisan talks would be aborted and parliamentary maneuvers used to force the bill through with a party-line vote.
Senate Finance Chairman Max Baucus, D-Mont., still has time to try to work out a deal with his Republican counterpart Chuck Grassley, but fellow Democrats are growing restless.
"There's rising disgruntlement with how Baucus has handled this," a senior Democratic aide tells ABC News. "We have to look at other options."
But of course, you have the Ben Nelsons and Mary Landrieus of the world, so it could call for more evasive tactics. And that would be reconciliation. That has a hard deadline of October 15, so this September 15 deadline for Finance Committee talks would give the bill one month to pass a Finance Committee markup, get merged with the HELP committee bill, and make it to the full Senate. Contrary to popular opinion reconciliation doesn't HAVE to turn any bill into Swiss cheese; the worst thing about it is the 5-year sunset provision, which would not be good at all (most of these new procedures wouldn't start for four years).
Interesting that Baucus came up with a way to get the bill out of his committee and put pressure on Republicans just a day after seeing his committee chairmanship threatened, isn't it?
We're going to get student loan reform this year. It's basically a done deal. And as such it's not getting a lot of credit. But it's a significant, smart reform.
Right now, middlemen get subsidies from the Feds to lend to students, taking their cut from both the Feds and students in the process. There is no reason the government cannot lend directly to students, the PURPOSE of the student loan program, making the system more efficient and cutting down significantly on costs. The only people against this have personal stakes with student loan middlemen in their communities. But we should create jobs that create things rather than suck off profits from processes they don't need to be involved in. Yesterday a bill cleared a House committee that would end the unnecessary payments in the student loan market.
A bill that cleared a House committee Tuesday would largely remove private lenders from the federal student loan industry, generating an estimated $87 billion savings over 10 years to fund more government grants and loans.
The Student Aid and Fiscal Responsibility Act of 2009 would eliminate an entire category of student loans issued by private lenders and subsidized by the federal government, vastly expanding direct lending by the government starting next July. Democrats would use the savings to fund a $40 billion increase in federal Pell Grant scholarships over 10 years, $10 billion in community college upgrades and $8 billion in pre-kindergarten changes, among other uses.
Republicans opposed to the legislation say it amounts to a federal takeover of student lending.
Yes, indeed it is a federal takeover. One that would save $87 billion dollars.
We have several problems with the conservative takeover of the rhetorical side of government. One is that taxes are verboten. Another is that private industry always works better and cheaper than the federal government. That's not true, especially in this case, where the government pays lenders to do the lending they could do directly just to maintain the illusion of the private market.
Why I say that this will pass is that there's a budget reconciliation option on it. And unlike with a complicated health care reform bill, this is completely straightforward and falls entirely under the deficit reduction standards of the budget. So we'll get this, and it will be a step forward for America.
I had a chance to participate in a conference call with President Barack Obama and some bloggers today about the health care debate. Clearly the very fact of this conference call's existence shows that the White House is leaving no stone unturned in searching for allies to help sell reform, and that the President is ready to step forward in this debate. That's a good thing. He still has enough political capital to manage the process where he wants it to go, and if he wants certain elements of the policy included in the final bill, provided that there is a final bill, I wouldn't bet against them getting in there. And the result of the conference call was interesting.
The President spoke for a few minutes, then took about 15 minutes of direct questions. In his opening remarks, he said that now was a critical time for the bill, and that we're closer to passage than we've been in the last 50 years. Those who are opposing have offered no credible alternative but the status quo, which he termed "unacceptable". He hoped that the blogs would help him in "debunking myths," for example the notion that this bill, which is entirely paid for as a package, would spread record deficits. He said that the default position in Washington is one of inertia, and that pressure must be kept on members of Congress - not Republicans, but members of Congress - to move the process forward. He made sure to highlight - as did David Axelrod in a short Q&A afterwards - the words of Sen. Jim DeMint, calling health care Obama's "Waterloo." Clearly that will be used by the White Hosue as a badge of honor and a rallying cry in the weeks ahead, because it evokes the same concept as the leader of the GOP Rush Limbaugh saying he hopes Obama fails.
With that, the President took questions, and it was truly unlike most press conferences you'd see by the heavily pancaked White House press corps. Bloggers wanted to know about two things - the tactics for getting a bill through, and the substance of that bill. For example, John Amato from C&L asked if the President would call on Congress to forego the August recess if they didn't reach a floor vote by the deadline, which the President pretty much dodged. He acknowledged that we cannot delay any further and that we've been debating this for 50 years, and that those who are calling for delay are doing so deliberately in order to kill any hope of passage, but he would only commit himself to working as hard as we can to see "serious forward motion" by the recess, and never fully answered what I think could be a good tactic Amato brought up, to ask the Congress to finish their work and keep reform on track. In a similar kind of question about reconciliation, Jonathan Singer from MyDD asked at what point we move to using budget reconciliation if a Senate bill stalls, and the President kept that stick of reconciliation in his back pocket, saying that they expect a bill by mid-October, but failing that, "we'd look at all options including reconciliation." He admitted that reconciliation wasn't the preferred option but that the status quo cannot continue. That speaks very well to the probability that something will pass this year.
What I wanted to ask about was something that Robert Reich wrote about today. The White House and Congress have made all these deals with key stakeholders, which do provide for hospitals, drug companies and doctors to give back some profits, but preserve additional costs that could be wrung from the system. And these "legacy costs" are making it very hard to provide the kind of controls that reformers seek and Blue Dogs pay lip service to.
Big Pharma, for example, is in line to get just what it wants. The Senate health panel’s bill protects biotech companies from generic competition for 12 years after their drugs go to market, which is guaranteed to keep prices sky high. Meanwhile, legislation expected from the Senate Finance committee won't allow cheaper drugs to be imported from Canada and won't give the federal government the right to negotiate Medicare drug prices directly with pharmaceutical companies. Last month Big Pharma agreed to what the White House touted as $80 billion in givebacks to help pay for expanded health insurance, but so far there's been no mechanism to force the industry to keep its promise. No wonder Big Pharma is now running "Harry and Louise" ads -- the same couple who fifteen years ago scared Americans into thinking the Clinton plan would take away their choice of doctor -- now supportive of Obamacare. Private insurers, for their part, have become convinced they'll make more money with a universal mandate accompanied by generous subsidies for families with earnings up to 400 percent of poverty (in excess of $80,000 of income) than they might stand to lose. Although still strongly opposed to a public option, the insurance industry is lining up behind much of the legislation. The biggest surprise is the AMA, which has also now come out in favor -- but only after being assurred that Medicare reimbursements won't be cut nearly as much as doctors first feared.
But all these industry giveaways are obviously causing the healthcare tab to grow. And as these long-term costs rise, the locus of opposition to universal health care is shifting away from industry and toward Blue Dog and moderate Democrats who are increasingly worried about future deficits.
I asked the President about this tension between these buyoffs to stakeholders and his goal to "bend the cost curve" and make health care cheaper and more effective in this country, and here's a paraphrased version of his answer.
I cannot expect the hospital association, for example, to sign up for something they don't think is right for hospitals and exepct them to back reform. So I understand what they're doing to protect their interests. I think we can negotiate and find a good way to go about this. In theory we could cram down additional savings, but to have the American Medical Association, the American Nurses Association, the drugmakers, the insurance companies, all of them on our team, that does help us move the process forward. Theoretically, there should be enormous savings inside the system. We all know that we pay more for health care than we should, and we shouldn't need additional revenue. But that's harder to do in practice, because all these powerful interests block the efforts. What I think is that we can get a framework where reform begins, one with an insurance exchange, and a robust public option, concrete reductions in cost, prevention, health IT, comparative effectiveness research, and it will be possible to achieve greater savings with a more efficient system down the road. And we can revisit the policy 10 years from now and possibly see even more savings than what was scored and anticipated.
I found that to be both a decent and a deeply unsatisfying answer. I understand that you don't want the stakeholders bringing in the Howitzers and seeding massive attacks against any reform, so keeping them on the same side is important. At the same time, with these groups bought off, and indeed knowing that they will get an ultimately good deal from Washington, the transition from the broken system we have to that theoretical one that Obama discussed gets delayed. I agree about getting a framework in place, something to tweak down the road. But we spend so much time in our politics bowing to powerful interests that it's very frustrating to concede that as a political reality. Especially when drugmakers and insurance companies are pretty reviled in the populace (though doctors really are not). Obama seems to know that there's an easy path for real reform, but it's complicated by a real control from special interests of the levers of the political debate. So we keep the dogs at bay, but in the process, we don't reform health care to the extent that we could. That animates the "if you like what you have, you can keep it" mantra (even if what you have is ultimately inefficient), and these deals with stakeholders. Then the fiscal scolds can talk about how the bill costs too much even while resisting those cost control methods because they would hurt these same stakeholders! It's maddening.
There is a bright spot, however. Obama went pretty far in support of a public option, a fairly tangible reform effort, on the call. He doubted the evidence that a co-op plan like that pushed by Kent Conrad would work, citing past experience that showed them having trouble getting off the ground. And he then said that the House and Senate bills would not be identical, that a conference committee would certainly be required. And at that point, the White House would engage in serious negotiations, with the President's fundamental principles and benchmarks in place. The House and Senate bills would not match up exactly, but that would not mean that the final bill wouldn't include certain elements, he essentially said. The President was basically saying: get it to conference, and we'll straighten it out. That probably doesn't mean that the President gets everything he wants, but it means that the big issues will be at his determination and discretion, almost certainly.
I think that's an important reminder. Past White Houses have used the conference committee very effectively to make sure bills matched preferences. Obama signaled his willingness to do that. Which means that, while we can have a role in getting this bill through each chamber, the White House will be able to make their presence felt to a degree at the finish line. In effect, he will take ownership of the policy and ensure it beats the status quo.
I am a film and video editor, stand-up comedian, and blogger. My editor resume is here. A sample of my stand-up is here. The blog is what you're reading right now. Wasn't that easy?
View blog reactions
