Health reform two-step still possible

I don't live in the Washington "village," and I'm just a stupid hippie blogger, but I have stayed at a Holiday Inn Express and I just don't think the President is going to surrender his Administration to the insurance lobby easily.

Conservatives are cheering word that Joe Lieberman has stopped health care reform in its tracks.

But has he?

Lieberman did get any financial changes out of the bill the Senate is now considering.

In exchange for Lieberman's 60th vote to break a Republican filibuster, the present bill seems to require that people buy health insurance, but does very little to make health insurers price it affordably.

Liberals, as noted yesterday, are spitting mad.

What's left are the mandate, the insurance exchanges, new rules on insurers and some of the cost-cutting measures. Supporters of a public option like Howard Dean have gone all quiet.

The question is why. Are they beaten or are they being coy?

Tom Harkin, a public option advocate, continues to call for compromise in order to reach 60 votes. As he noted last month, a bill considered under reconciliation may need only 50 votes to pass, but it must come out of the Budget Committee and contain only financial provisions.

So why is majority leader Harry Reid caving?

Harkin notes the provisions in the current bill are important. They are better than nothing. He also notes reconciliation can only involve financial matters.

A public option is a financial matter. Increasing access to Medicare is a financial matter.

So here is how it can go down.

  1. The Congressional Budget Office scores the Medicare and public option proposals put forward last week, and shows them reducing the budget deficit.
  2. The current bill gets its 60 votes, and the House agrees to pass it as-is. It's law by Christmas.
  3. In January Reid goes to the Budget Committee, and they put through a cost-cutting bill using the CBO score as an argument for a public option and/or Medicare buy-in.
  4. That bill goes to the floor under reconciliation, meaning it needs just 50 votes to pass. Lieberman can oppose it, Nelson can oppose it, Landrieu and Lincoln can oppose it, and so can Conrad. With Joe Biden presiding it can pass with just 50 Democratic Senators voting aye.
  5. It could even have an effective date of 2010.
  6. Then the House passes the reconciliation measure, perhaps called the "Health Care Cost Cutting Act of 2010," and Democrats get what they want.

I'm not saying that's what is going to happen. But legislatively it can work. And the smiles on the faces of the President and the Majority Leader have to be there for a reason. The President, after all, spent four years in the Senate. He knows how the rules work.

I don't live in the Washington "village," and I'm just a stupid hippie leftist (socialist, communist, etc.) blogger, but I have stayed at a Holiday Inn Express, I read tea leaves as a hobby, I took political science courses in college, and I just don't think the President is going to surrender his Administration to the insurance lobby easily.

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