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I imagine I am going to get a lot of grief on this diary.  As one of those who originally proposed the idea of a public option as part of the choice offered to all Americans under a reformed system (CHOICE proposal) and as a very strong supporter of women's reproductive rights (Halpin on Women's Reproductive Rights), I am prepared to hear it from all sides that I have somehow "sold out", given up, jumped the fence, etc.

But they will be wrong.  What I have done is to become a political pragmatist.  I think that we simply cannot let the present opportunity for health care reform slip away.  It is too important.  There are too many people who are depending on it.  And what they want is affordable, comprehensive health insurance coverage for themselves and their families.

The Democrats all are simply going to have to close their eyes and hold their noses and vote "YES". if we are to pass health care reform this year.

As this community knows all too well, health reform legislation is in quite a bind.  It is a veritable mess.  The House bill includes a pretty weak excuse for a public option and it places new restrictions on abortion coverage that exceed those of the Hyde Amendment, which restricts the use of any Federal funds for abortions (this is known as the Stupak -- or as some here call it, the stupid - amendment).  

What is even worse is that the Senate does not seem to have the 60 votes it needs for passing ANY bill -- it is unlikely to support a public option (maybe, one with a “trigger”) and many in the Senate are calling for the inclusion of the dreaded Stupak abortion amendment.

The likely bill that comes out of Conference Committee (assuming we get that far and the Senate can pass a bill), the final bill is likely to contain one too many “poison pills” for far too many legislatures.

Let’s look at the present dilemma:

  1. Most Republicans are unlikely to vote for ANY bill.
  1. Pro-choice Democrats will have a very hard time voting for a bill that includes the Stupak amendment.
  1. Pro-life Democrats do not want to vote for a bill without the Stupak amendment.
  1. Pro-public option Democrats will have a hard time voting for a bill without a public option or even one with a “trigger” (this is Olympia Snowe’s proposal – if certain health insurance coverage targets are not met by a certain date, it would trigger the development of a public option).
  1. Democrats opposed to a public option don’t want to vote for bill that includes one.

Yes, it has come down to the public option (no surprise there) and abortion coverage (score one for conservatives).  And the Democrats seem mortally split.  And unless the Democrats can come together and present a united front, we may not get a health reform bill at all.  I beleive that now is not the time for ideology or idealism.  Now is the time for political pragmatism.  Period.

Because, as we all know, if Congress does not pass a health reform bill in 2009, the Republicans are likely to make significant gains in the Congresssional midterm elections in 2010, with Democrats at risk of losing their majorities, and it may be a VERY long time (10-20 years) until Congress is likely to revisit this issue – at which point health care costs are likely not only to have bankrupted us individually, but the nation as a whole.

As Bill Clinton told Democratic Senators at a closed-door meeting yesterday on the Hill, doing nothing is the worst option.  According to reporters, he also whispered that he supports Senator Snowe’s trigger option.  And it appears the White House prefers a trigger to a proposed alternative that would let states opt-out of a public option.

Clinton's remarks

This is a vertable disaster.

Here is what needs to happen.  All Democrats need to close their eyes and hold their noses and vote “YES” on health care reform – even if they have to swallow what they consider to be a “poison pill” (no public option and greater abortion restrictions).  

As flawed as the bill is likely to be, and as abhorrent as it will seem to many, these are the reasons we have to pass a health reform bill now:
• it will extend health insurance coverage to millions of Americans
         o Medicaid alone will cover 15 million new people, and
         o all uninsured and small business employees will have subsidized coverage in the new insurance
               exchange;
• it will regulate the despicable practices of the private health insurance industry; and
• it will provide much needed reform to Medicare and the Medicare drug benefit.

A health care reform bill that includes the above minimum provisions will be a huge step forward, despite its flaws.  

Doing nothing is simply not an option.

Originally posted to Helenann on Thu Nov 12, 2009 at 09:25 AM PST.

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