Health-Care Bill with Public Option Still Possible
While there has been little public news about the health-care bill lately, behind the
scenes, much is going on. The two bills that passed Senate committees are now
laboriously being merged by majority leader Harry Reid. Although
a recent poll
shows that 57% of all Americans now back a public option, a handful of Democratic
senators are opposed to it, making it difficult for Reid to assemble the 60 votes needed
to invoke cloture to stop a promised Republican filibuster.
However, it now appears that the opposition of some of these senators is more
parochial than ideological. For example, Sen. Kent Conrad (D-ND) has
not because he fears a government takeover of health care, it is simply that the proposed
plan will pay hospitals the same as Medicare does, which is below the national average in
low-cost North Dakota.
Pay the North Dakota hospitals more and Conrad's vote is available.
Of course, paying hospitals (and doctors) more, raises the total cost of health
insurance and one of President Obama's goals is to reduce that cost.
Sen. Ben Nelson (D-NE) is "intrigued" by the possibility of a public option that
entire states could opt out of. Surely Nelson knows that any state that opted out
would end up paying higher premiums than states that didn't opt out and the
citizens thereof would undoubtedly notice this fairly quickly, but this idea gives him
cover to vote for the bill. So what Reid is doing is trying to thread the needle,
adding and deleting very specific provisions to get all 58 Democrats and 2 independents
on board. One of the independents, Sen. Joe Lieberman (D-CT), may be the hardest
of all to get to support the plan, again for parochial reasons. On domestic issues,
Lieberman is generally fairly liberal, but the insurance industry is largely
headquartered in Connecticut and he is trying to protect its profits. If the
industry abruptly picked up stakes and moved to New Jersey, he would suddenly
become he big supporter of health-care reform.
To some extent, the potential loss of Lieberman's vote is why Reid is courting
Sen. Olympia Snowe (R-ME) so frantically. If Snowe is in and Lieberman is out he could
still get to 60. If 60 votes are not available, Reid could use budget reconciliation,
which requires only 51 votes (or 50 and Joe Biden), but despite the fact that
reconciliation has been used 19 times since 1980, Reid is afraid to go this route
because it would enrage the Republicans and he is facing a very tough reelection
battle in Nevada in 2010.
Over in the House, Speaker Nancy Pelosi wants a public option based on
Medicare rates but she
the 218 votes she needs to pass the bill.
Again here, many of the Blue Dog (conservative) Democrats oppose the bill simply because
hospitals in their low-cost rural districts are paid less than hospitals in big cities.
However, given that only that about a quarter of the Blue Dogs are needed, Pelosi
could compromise with them and go for a bill that allowed the public plan to negotiate
rates with health-care providers. This strategy would raise the cost of the bill but might
get enough votes. Also, a Medicare+5 option, which would pay Medicare rates plus 5%
might have enough votes. So when push comes to shove, providing 5% more money to
hospitals could magically overcome deep-seated ideological objections from enough members
to pass the bill.
In the end, politics is all about money.
Well, not entirely. It is also about perception. Many people perceive a government-run
health-insurance system as a Bad Thing. But they perceive Medicare (which is a government-run
health-insurance system) as a Good Thing. So some House Democrats are now
to rebrand the public option as "Medicare Part E." The argument for this is that the
public does not understand what a "public option" is but the public knows what Medicare is
and likes it. It may seem crazy that just renaming the public option could matter, but it
could. In fact, many liberals have pushed for "Medicare for All" from the beginning, and now
it is starting to gain (a little bit of) traction.
DNC and RNC Fundraising Roughly in Balance
The Democratic National Committee has
$62 million this year compared to the
Republican National Committee's $69 million. For the third quarter, the DNC outraised the
RNC $24 million to $23 million. Historically, the RNC has generally outraised the DNC, but
controlling both the White House and Congress gives the Democrats an edge since they can
promise more to special interest groups and potentially deliver. All the Republicans can
do is promise.
McDonnell Takes Commanding Lead in Virginia but New Jersey Tied
A new SurveyUSA poll
shows Republican Bob McDonnell with a 59% to 40% lead over Democrat Creigh Deeds in the
Virginia gubernatorial election to be held two weeks from now. This is the biggest lead
McDonnell has held all year. Over in New Jersey, it is too close to call.
Monmouth University poll
just released shows Gov. Jon Corzine (D-NJ) and Chris Christie (R) tied at 39%
with independent Chris Daggett at 14%.
Democrat Owens Leads in NY-23
With the Republicans likely to win the Virginia governorship and the Democrats
having a decent shot at hanging onto the New Jersey governorship by their fingernails,
the tie breaker on Nov. 3 could be the special election in NY-23, the seat vacated
by John McHugh (R), who is now Secretary of the Army. The most recent
there shows Democrat Bill Owens at 33%, Republican Dede Scozzafava at 29% and Conservative
Doug Hoffman at 23%.
This race has split the Republican party badly, with the party establishment naturally
backing the official Republican candidate despite her moderate positions on many issues
but conservative activists backing the red-meat conservative Hoffman, who is running on the
Conservative Party line.
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