The Wall Street Journal reports tonight that Harry Reid is going along with the opt-out:
WASHINGTON — Top Senate Democrats are close to finalizing their health bill and could unveil a measure as soon as early this week that would include stiffer penalties on employers who fail to provide health coverage.
Senate leaders plan to submit the bill to the Congressional Budget Office for a cost estimate as soon as Monday, and make the legislation public as soon as Tuesday, according to a person familiar with the negotiations.
Details of the legislation could change, but its broad outlines are becoming clear. Employers with more than 50 workers wouldn’t be required to provide health insurance, but they would face fines of up to $750 per employee if even part of their work force received a government subsidy to buy health insurance, this person said. A bill passed by the Senate Finance Committee had a lower fine of up to $400 per employee.
The bill to be brought to the Senate floor would create a new public health-insurance plan, but would give states the choice of opting out of participating in it, a proposal that Senate Majority Leader Harry Reid of Nevada backed last week.
CNN has the same story.
Now, the other provision highlighted in the WSJ’s reporting is the employer mandate. The AP expanded upon this with more detail tonight as well. I was told this week that the employer mandate question was being considered, and it would be among the most controversial in the entire legislation and would probably be saved until the end, so it rings true that we could see final legislation head to the CBO Monday or Tuesday.
As for the employer mandate, the HELP bill had a real one. The Senate Finance Committee excised it, and in its place put in a “free rider” provision that was immediately called the worst policy in the world. This penalizes companies who have uninsured workers on their payroll eligible for subsidies, not just for denying to offer coverage to workers. If a company pays their employees enough, no penalty. Similarly, if a company hires someone who has family income above the subsidy level, they’re fine. It would encourage hiring of those who already have a family income rather than a single mother or individual breadwinner – or it would encourage hiring undocumented workers ineligible for subsidies.
The bill reportedly increases the penalty for not offering coverage to those who would qualify for subsidies, but that only increases the likelihood for discrimination against low-income workers.
Other details in the AP story: the bill would maintain the SCHIP program rather than fold it into the insurance exchanges, something Jay Rockefeller has been fighting for and generally a good idea. Maria Cantwell’s proposal, which was approved as an amendment to the Finance Committee bill, which would allow states to negotiate for group coverage for residents below 200% of the federal poverty level, will be in the bill as well.
Of course, of great interest to everyone who has been watching this odyssey is the inclusion of the public option, left for dead just a few weeks ago, along with a state opt-out provision. Traditional media and DC elites have marveled at its resiliency in the debate, even after the President himself reportedly worked to kill it in favor of the trigger proposal last week. The White House took the unusual step of posting a denial on their blog about the matter, with communications aide Dan Pfeiffer saying:
In his September 9th address to Congress, President Obama made clear that he supports the public option because it has the potential to play an essential role in holding insurance companies accountable through choice and competition. That continues to be the President’s position.
Senator Reid and his leadership team are now working to get the most effective bill possible approved by the Senate. President Obama completely supports their efforts and has full confidence they will succeed and continue the unprecedented progress that is being made in both the House and Senate.
Progressive groups tore into the President over the weekend, with the Progressive Change Campaign Committee releasing an ad and MoveOn.org creating an unique photo petition of former Obama staffers demanding that Obama get behind a public option with no triggers. The PCCC remains unimpressed by Pfeiffer’s statement, asking of the President, “How long will he refuse to fight?”
It’s entirely possible that there’s some kabuki theater going on, with Reid bringing along a bill and then finding himself unable to break a filibuster with this version of the public option, at which point it gets downgraded to the trigger. Any loss of momentum on a bill like this could prove fatal, however, so my guess would be that a bill would be built to pass.
Monday should be interesting.




47 Comments

Support this site!
Subscribe to the newsletter
Advertise on Firedoglake
Send
us your tips
Make us your homepage
About FDL News Desk
This still sounds like weak tea. I sure hope that Obama doesn’t sell out HCR just to suck up to President Snowe.
I have just moved to a Southern State, so I understand that the opt out might hurt me personally. I was trying to tell my new friends in the state that this might become a hidden tax on the South. They have convinced me however that the democratic party has to learn from FDR. The democrats had a solid grip on the south and they have lost it mostly because of what is seen as “we know what is best for you backward little people”. Let the Southerners realize it by themselves and come to the same conclusion. And quite frankly, local conditions do vary. In South Dakota they are worried that not many doctors want to practice — so if they want to entice them, what is so wrong about it.
What I see is that there is an enormous influence of money that is very cleverly being used by all the lobbyists. I still do not believe — same as Krugman– that this is about to happen, even with an opt out.
The main point is that the opt out will create a war of attrition. Now, all that money has to be spread at the state level. This will make the competition with the public option in non opt out states even harder for the insurance companies.
We really need to make it clear to the doctors that we have no quarrel with them. Nor with the hospitals. The insurance industry is a middle man which is wasteful and the pharma industry is greedy as hell. If we can separate these four groups clearly the fight might be easier.
I wouldn’t worry about missing out on the crippled negotiated-rates public option that Obama is allowing. Chances are it will actually increase premiums in states that have it. The reasons are complex, but in general the individual and small group markets are not very lucrative, and having a public option as an inefficient tag-along will increase everyone’s costs.
It will be interesting to see what happens with the free-rider provision. There is a good discussion of the issue at CBPP (link below). Doubling down on bad policy for budget cosmesis has been a hallmark of this reform from the get-go. Probably that’s what’s going on here too.
The carve-outs for SCHIP and Cantwell’s low-income program means the exchanges will be too small to work properly. That’s okay with me because I don’t think they would work anyway. But there goes another of the original selling points of reform…
Given all the problems, what’s really starting to look promising are amendments that allow states to experiment with single-payer, Wyden-Bennett, and other ideas. Hopefully those amendments survive, because they are the only remaining reason to support this reform in my opinion.
http://www.cbpp.org/cms/index.cfm?fa=view&id=2921
bmull,
you could be right. I do like the idea of states getting the right, (how did they lose it in the first place?), to establish a single payer system. Let us hope it works. Let us also hope that we all get more and more aware of the havoc that corporate money is playing with our democracy.
This is a Deal Breaker if true. It should also drop the resale value of homes in states that choose to Opt Out.
How did they lose it? Because all the “states’ rights” people are only for “states’ rights” when it’s a code for screwing over black and brown people. If states’ rights are actually used to help people (and possibly hurt corporate donors to political campaigns), then they’re eeeeevil!
David – Thank you for your posts. While I always read them I sometimes fail to comment. I have been developing this twitch due to all of the conflicting reports. Opt in, Opt out, PO, no PO, Robust PO, watered down PO. Gawd there are a lot of horses in this race.
There certainly are a lot of horses. Makes my head spin a little.
Has anyone seen a list of states that would possibly or probably opt out? I don’t trust my state governor or legislature and with good reason. Wonder where my state stands, now that it’s looking more and more like we’ll get an opt out potential.
I don’t worry about California opting out.
The opt out provision is a real potential washout for a lot of those governors that are playing the recessionist game. Governors like Perry will do the usual irresponsible thing, and opt out. The time to get those third world types out is overdue, and if this happens the unintended consequences could well be the end of the right wing. A showy enough result, which I am so ready for. :-}
I don’t see that. I think we would be lucky to go into a house/senate merge process with a robust house public option and a senate opt-out version. Living in a red southern state, I think the eventual outcome would be increasing public pressure to overthrow Neanderthal holdouts in state government. I don’t think property values is realistically a factor. The conservatives would view it as a means of maintaining property values by encouraging only “desirable” immigration (Not my view, but it’s what they would think.).
Thanks, Loo. That’s good news. Fortunately, I am covered through the mister’s insurance, and it’s pretty good too. That said, there are so many folks with nuthin’. Like my son who only has a part time job. I spent a good deal of time talking with a homeless couple outside of a grocery store the other day. She’s diabetic and went to a county facility to get insulin. They wouldn’t help her. Poor kids…maybe in their 20′s. Asked them where they were hanging out and they told me specifically. In a shack behind the garage of an abandoned house. Will put together a box of goodies today and try to find them.
and states would vote to opt-out, why? i don’t get it. barack and the spineless democrats have decided, so as not to be another 1994 clinton era failure, to pass something. so the question now is, is doing nothing if it means no employer mandate, none or a weak public option and just another taxpayer handout to the health insurance monopolies aka the 2003 medicare modernization act better than doing nothing?
either barack is being disingenuous or rahm is ruling the day, and i didn’t vote for rahm.
How sweet of you.
about those horses . . .
my .02 on the whiplash some of us are experiencing – WH/Leadership still aren’t up to speed on the level of scrutiny now being provided by various mediums – it’s still their world and we just live in it. hence the clumsy, hamfisted tone of some of their responses – they are flat out not used to having to be this accountable for their bs
full disclosure – I enjoy watching them be the reactive ones for a change
Well, some states prefer to think of themselves as “pro-business”, which usually means “screw the worker”, not that I’m advocating that, but that is why they would.
I agree. I know a lot of “soccer moms” and “Nascar dads” who, when their twenty-something, unemployed kids can no longer be listed on their insurance, would see things in a new light.
I wish that Austin could opt out of Texas.
Any Opt Out PO option will open onto statehouse politics x 50 which then becomes subject to the worst of money politics,sweetheart deal politics and base state/regional politics and race to the bottom social/economic gaming.
Like this is not already the norm with corporations doing hop scotch with proposed new factory locations,job distributions to already built up locations.
It is certain the for profit health insurers are going to scrimmage each state with lots of money and sweetly baited offers which more than a few cash strapped statehouses will do a tumble for. See California For Sale.
Gosh– since Opt Out on Federal Governance is such a clever idea why not open the IRS,Social Security and EPA to state by state Opt Out as well?
This Opt Out idea sounds more like a weak spined dereliction on part of
the Congress and this Do the Wrong Thing Obama WH to do a political lateral pass off.
One can see without too much difficulty how Social Security or Federal IRS would have fared at time of creation if each state capitol could do the skip out based on state house politics.
Opt Out looks more like death by money politics as known and practiced at the state level for any viable national PO. WashingtonDC does the Pontius Pilate Hand Wash Dance and the for profit insurers sabotage PO state by state.
Barack Obama lets this slide he should be voted out in 2012. Charlatan.
Thanks for the early morning smile.
I’ll concede, it could be a double edge sword. Still, I think it would ultimately be the end of Republican domination in the south. I don’t think the insurance companies and right wing politicians are secretly supporting an opt-out plan. I don’t see many voters, told that they could be assured of health coverage for themselves and their families, except for Rick Perry, staying away from the ballot box.
That has been the good news…plus the glaring and undeniable role of money…pay to play, no doubt, with a bigger gimme coming from the Supreme Court on a McCain-Feingold issue….Bring in those corporate dollars. Never been more obvious.
Mr Perry has gotten himself seriously ridiculed for being a Neanderthal…rejecting the stimulus, restacking a Commission to delay factual findings in a death penalty case. Senile at a young age.
Actually, Kay Bailey Hutchison’s position on health care is the same as Perry’s. I wrote them both (saying that I knew their idiological position, but asking them at least to state the truth regarding death panels, etc.). I just think that, over time, if either of them stood in the way of affordable health care which was available in other states, they would be tossed.
There is another solution: US-290 West to I-10. I-10 west to I-25. I-25 north to I-40. I-40 west past Arizona…
For too long the red states have held this country back, refusing to lose the Civil War and refighting it ad nauseum in desecration of those Americans who lost their lives to teach them a lesson.
They opposed integration, they opposed civil rights, they opposed voting rights, they opposed Medicare and opposed SCHIP.
At some point, people living in the red states have to take responsibility for changing their reality, either by organizing their neighbors to change politics, or using the constitutional right to free travel and moving to a state more in sync with their political views.
It is not acceptable for red staters to deny potential government financed health care to those who would not otherwise qualify simply because their elected officials are stuck in the Pleistocene.
We can hope, and even the Republican leadership hss gone after her for muddying (“dithering”) up her plans for resigning from the Senate; don’t we wish the Dems would produce a strong candidate.
Why do doctors and hospitals get a free pass?
Average doctor salary is 3x the average health insurance agent.
I think the GOP in Texas is bluffing. They won’t opt out.
It will be like the stimulus. After a bunch of smoke and BS,
the southern Republican states will scrap like junk yard dogs
for every bit of what the feds have to offer. That is their
historic MO.
Bingo.
There is another solution
Unfortunately my parents live in San Antonio and are getting on in years. Will probably have to help take care of them at some point, so I can’t see leaving Tejas for the foreseeable future.
Can’t someone do an ad with excerpts form the Convention speech, “There are no red states, etc.?
In addition, is there video anywhere with members of Congress pledging allegiance to the flag- with all that “indivisible” stuff in it?
This is one country and all the citizens deserve a fair chance. What is so hard about this? This is real – not theoretical. A family member is now facing dire circumstances as husband and wife are both unemployed, not sure what will happen. How uncaring can these politicians be? It hurts.
When I need to be seen by a doctor, a health insurance agent just won’t do.
I don’t know about your comment. Maybe I’m reading it wrong.
And in Arizona, there’s already a movement by the whacko right to “opt out” of all “Government run health care programs”. I pointed out to the pollster who wanted to know what I thought that it would make Medicare illegal in Arizona, and they seemed so very confused. But they’re already gearing up.
Lets cut to the chase. The whole health care debate is a convoluted way to somehow get the American people to PAY for people who have no insurance. In the end it is about money. The truth is that the Republicans don’t want to spend any of THEIR money on the lazy, primarily minority, individuals that are too lazy to work and pull themselves up by their bootstraps. It is about transfer of wealth. Something that the Republicans hate unless it is a transfer to themselves. It is all about money. The insurance companies profits. The Congressman’s campaign donations,the rich guys taxes. It is about whether or not 45,000 deaths and 1 million bankruptcies trump new taxes or not. Maybe if we hit the truth head on instead of playing a shell game we could get somewhere. If we can focus on the economic and social benefits of universal health care, especially the economic, we can change the paradigm so that the people who are thinking they are going to get screwed are actually going to make out in the long run. Maybe the focus should be that the insurance companies are REALLY the bad guys and that it will be a good thing if they are corralled. We have to convince small business that this will help them not penalize them. We can do this.
Well, this totally sells out the south. I can’t see how you can expect the south to adhere to any sort of mandate with this situation.
And, will someone please tell me what all the money is for? I can understand taxes going to provide actual health care but not to buy insurance policies for people.
This is a total mess and I doubt it could be implemented anyway. Not without all states, it would be too piecemeal.
If Obama is so concerned about winning local elections then he should do the right thing rather than waste money and time doing the wrong thing and trying to talk his candidates up. Just do the right thing and perhaps you can save the Democrats.
This is the wrong thing.
New post up…
Part of the conversation on Matthews yesterday was about the internal Repub struggle between the centrist/serious conservatives & the “wingnuts”…just nice to watch. The latter have been losing their voice and members. Nice.
I think one of the seriously missing and important facets in this debate is the importance of having a healthy nation/population (even if that means some immigrants, as well.) Our population, including children, has become obese; preventable illness is a shame; emergency room care is costly and over-extended. Why do we fail to make and to see the self-interest part of this debate? Sort of like educating (or not) our young…why have we lost our values and our minds?
Oh yeah….the money thing
related fake news
SUB-ROSA NEWS
Some of the News
That may be True
OBAMA APPOINTS OLYMPIA SNOWE AS HEALTH CZAR
In recognition of Senator Snowe’s immense contribution to health care reform legislation,, President Obama has named her to the new office of National Health Care Director. In a written statement, the President noted the Senator’s long study and deep knowledge of health care issues facing the nation. In addition, her work in the Senate has made the reform bill truly bi-partisan.
White House press spokesman Robert Gibbs denied rumors that appointment to this office was the price demanded for her vote. He noted that it was clear that her strong efforts in support of real reform were made because history had called.
homer http://www.altara.blogspot.com
Seems pretty straight-forward: White House calls Obama discouraging public option claim ‘absolutely false’
Hope no devil is in the details.
http://rawstory.com/2009/10/white-house-calls-obama-discouraging-public-option-claim-absolutely-false/
This state opt-out is the best comprimise I have seen. When the people in these red states find out that they don’t get health insurance because their republican politicos don’t want them to have it, what do you think will happen?
They will vote the bums out.
Win Win situation.
David:
This is more than news or reporting. Your detailed analysis is much appreciated!
My only question about the opt-out: Will states that opt-out actually get higher subsidies for the private insurers, since those policies will be more expensive than the public option? I don’t like the government subsidizing private profits, and certainly don’t think that opt-in states should have to subsidize those that opt-out.
Actually, not so much. The R-tards here seem to think that this is somehow about the poor/brown/black folks getting the hard-working, morally superior folks who have money & insurance to give those same poor/brown/black folks healthcare. They can’t grasp that the poor folks already have Medicaid, and that the PO as it currently exists would be a self-paying solution that wouldn’t cost those who have insurance a single dime, so they are ALL IN for the Opt-Out “solution” (a solution to a problem that doesn’t really exist).
Take, for instance, Perry’s/Cornyn’s claim that the Public Option would cost Texan’s $23 billion to cover those who won’t buy it now or can’t get a job to get insurance. I agree that the PO would cost Texans SOME money, but it would be for health insurance for those folks like me (I’m a contractor, so I don’t get insurance from my employer).
Anyway, I don’t see where the people will vote these jokers out. If anything, opting out would get them votes from the even wing-nuttier folks than already vote for them.
That’s pretty much the conclusion I came to after studying the issue for awhile. Sounds good until you get in to the grubby details. I’ve made the point before that increasing complexity works in favor of the health cartel. Simplicity works (on this issue) in favor of the people. (Single payer)
What else can they opt out of? How about welfare? How about free school lunch for kids from low income families? I have heard one or two Republicans say how being hungry would be a great motivator for school kids.
SHHH! Don’t give some people any ideas. Anyway, I’m sure Governor Perry will be willing and able to take care of everyone without the evil federal government’s help.