Massachusetts Attorney General Martha Coakley (D) won the Democratic nomination for Ted Kennedy's Senate seat yesterday, getting more votes (47%) than any of her three male rivals. Given how blue Massachusetts is, it is virtually certain she will be elected the state's first female senator over state senator Scott Brown (R) in the Jan. 19 special election. All the polls had predicted a Coakley landslide so few people were surprised by the results.
Sen. Ben Nelson's amendment to the health-insurance bill, which would have forbid insurance companies from covering abortions, failed to pass in the Senate yesterday. It went down to defeat 54-45. The amendment was essentially the same one as the Stupak amendment which is in the House bill. Nelson was unhappy with losing, but he didn't throw a hissy fit or promise to filibuster the final bill. Most likely, he didn't really expect it to pass and now can tell the people of Nebraska that he did his best but those Eastern Liberals beat him down. That's probably good enough for his next campaign. With many senators, it is the symbolism and sound bites that matter, not the actual legislation.
Majority leader Harry Reid has spent the week gently nudging his caucus towards a compromise bill that would reform the health-insurance system. One obstacle was removed yesterday when the anti-abortion amendment was put up for a straight up-or-down vote and it was defeated. The other main obstacle is the public option, which about 56 or 57 senators approve. In any other legislative chamber of any democracy in the world that would be enough, but since a Republican filibuster is assured, that is not enough to pass the Senate. Hence Reid has spent the week desperately trying to find a compromise that all 60 members of his caucus can sign onto. In now appears that he may have one, but the details are still secret. According to rumors, the most likely elements of of the compromise are:
Conservative senators like this because they know the trigger will never be pulled and there will be no public option. They can live with more regulation of the insurance companies because few voters understand that kind of stuff so it won't come back to bite them. Progressives don't really like the deal, but once people under 65 are allowed to buy into Medicare, they can envision a future Congress dropping the limit to 50, then 45, then 40, and eventually Medicare becomes the single-payer plan they want.
But as usual, the devil is in the details. For example, could everyone 55 and older buy into Medicare, or only uninsured or sick people? The insurance companies (and the senators who serve them) would absolutely love a way to get sick people 55-65 off private plans while keeping the healthy 55-65 year olds. This would be a great windfall to them. Another key issue is when would this provision kick in? If it starts before the 2010 elections, the Democrats would undoubtedly pick up many votes among older voters who signed up. If it kicks in in 2013 or 2014, there is plenty of time for a future Congress to kill it altogether.
Also up in the air is what exactly would the federal option mean. Currently, federal employees can get a health-insurance plan offered by private companies but negotiated by the Office of Personnel Management. Could every American buy this insurance? If so, the OPM would have immense clout in negotiating deals with private companies since it could deliver millions of customers. To the extent that anyone could choose between his or her employer's insurance, the federal plan, (and if older than 55, Medicare), there would be real competition among insurance companies. However, the senators who get large contributions from the insurance companies will do their best to minimize that competition. Thus until the details are revealed, it will be hard to tell what the proposal really means.
One huge (political) advantage of a triggered public option is that the two Republican senators from Maine, Olympia Snowe and Susan Collins, might vote for it. Their votes would mean that Reid could afford the loss of Sen. Joe Lieberman and one other member of his caucus
The idea has been floated to have the House just pass the Senate bill, thus avoiding conference altogether and getting the bill to the President's desk before Jan. 1. However, killing the public option may so anger House Democrats that such a plan is unworkable. If the Senate passes a bill with a triggered public option and it goes to conference, conferees from the House will be in a real bind. If they insist on a public option in the final bill, the entire bill may go down in flames in a Senate filibuster. If they don't, it might fail in the House. They might try to go for a compromise though, allowing anyone 50 or older to buy into Medicare. Such a bill might be able to pass both chambers but at this point no one really knows what could happen.
The Congressional Budget Office is now figuring out how much the secret plan will cost. Once that number is revealed, Reid will announce the plan and the real fight will start. If the bill will ultimately reduce the federal deficit (because the--unknown--taxes it contains exceed the projected government outlays), then it will be a much easier sell to people like Ben Nelson, who can then claim he helped reduce the federal deficit. Remember, maybe half of the battle is about the actual legislation and the other half is about grandstanding and positioning yourself as the champion of something popular back home.