As I've said before, the trigger proposal by Senator Snowe is still very much on the table as is the so-called state-based plans by Senator Carper. Both proposals are favored by the Senate moderates, and the White House still very much would like Senator Snowe to vote in support of the legislation coming out of the Senate Finance Committee.
One aide said that a no vote from Snowe would make it more difficult for Senate Majority Leader Harry Reid (D-Nev.) to include provisions she favors in the bill he puts on the floor. One such provision would set up a government insurance program that would only go into effect if private insurance companies failed to meet certain benchmarks for providing affordable, quality care.
"The public option with a trigger would be a compelling thing to put in the merged bill if the Finance bill has the endorsement of Snowe," said the aide. "When progressives howl, you can point to Snowe’s support."
If she votes no on the bill, then it'd be harder for Senator Reid to include a triggered public option in the merging of the two bills. Even though she may vote no in committee, Senator Snowe said that her vote is still up for grabs on the Senate floor.
The reason for her vote still being up for grabs if she votes no in the Senate Finance Committee is that there's another chance for her to offer her trigger proposal on the public option in the Senate floor on the merged two Senate bills. If she votes yes in the Senate Finance Committee, then it's a lot more likely her trigger proposal will be in the merged Senate Finance and Senate HELP bill before the floor vote.
It's not just the Snowe trigger proposal that's being seriously considered for inclusion in the merged bill, it's also the Carper state-based plans proposal, which is a scam they're trying to pull on us because these state-based plans will be useless and it's a "public-option-in-name-only" to try to placate us in the base. It's getting support fromSenate moderates such as Conrad and Nelson, who have been known for their opposition to an actual public option.
For more on why the Carper state-based plans won't work, please read this below:
The Carper amendment wouldn't permit anything which is not currently allowed; so it appears that Carper's amendment would then be worthless. . . but take a closer look, and you will see that it is worse than worthless. Carper's plan would, in fact, restrict what states currently could do.
The amendment says:
This would allow a state to offer a state public option; however, both the executive and state legislature would have to agree.
Most states (I believe every state) allows a law to be passed over the veto of the governor if it can get a super majority in the state legislature. By requiring both the executive and state legislature to agree, the amendment is placing an even higher standard than what is current law in order to create a state public option.
The amendment would place restrictions how the public plan could be run.
Regardless of the mechanism chosen, the state would be bound by the same insurance regulations and benefit requirements as private plans in the exchange. The mechanism would have to be completely self financed, aside from initial seed funding, and would be required to have a reserve fund in the same manner that private plans have. The mechanism could not explicitly require doctors to participate, nor use provider participation in Medicare or other public programs to force participation. Additionally, the state could not use Medicare or Medicaid style price controls or rates - they would have to negotiate rates.
If a state started a public plan today, they would not be required to follow all of these restrictions.
Finally, Carper's amendment would strongly limit who could uses this new state public plans or co-op:
The state mechanism would only be open to individuals who were eligible to acquire coverage through the exchange.
Once again, states can already help create insurance co-ops. They don't need to restrict who can sign up for insurance co-ops. There are currently non-profit health insurance co-ops in this country which are able to sign up everyone, not just people on the individual or small group market.
Neither the Snowe trigger, the Carper proposal, or the Cantwell amendment is an adequate substitute for a national public option. They're all fake-outs, and we shouldn't fall for such fake-outs that are designed to placate us in the base.
Also, here's something of an interesting note on Senator Rockefeller's possible no vote on the Senate Finance Bill from Senator Whitehouse, who seems to support both Wyden and Rockefeller:
Sen. Sheldon Whitehouse (D-R.I.) said a no vote from Rockefeller would send a strong signal that Democratic leaders cannot take liberal support for granted.
Baucus has gained leverage with Reid by arguing that certain policy proposals favored by liberals, such as the public option, would not have enough votes to pass the Senate. Rockefeller’s opposition could balance that argument by allowing liberal advocates to claim that a healthcare package closely resembling the Baucus bill could face significant opposition from Democratic liberals.
"It would send a signal to pay attention to the left," said Whitehouse.
Now, imagine that. I don't know if Rockefeller or Wyden will end up being both no votes, or if they'll vote in support of the bill to get it out of committee so they can get the promises of having their amendments come up for a vote on the Senate floor. I think that the latter possibility is rather more likely than the former. However, what Senator Whitehouse is suggesting is rather intriguing to think about.
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