There was a recent report in the New York Times that talked about the involvement of the White House on health insurance reform, and about their latest bipartisan outreach to Republican Senators like Senator Collins through the White House Budget Director, Peter Orszag, who has promoted co-ops and triggers as acceptable alternatives in spite of evidence from the CBO showing otherwise, and the catch-22 that is the Snowe trigger amendment:
Orszag signaled the administration doesn’t consider a government-run insurance program essential to the legislation. He suggested it would be sufficient to either create nonprofit insurance-purchasing cooperatives or set “triggers” to activate a public option if needed to cut costs...“The goal here is just to introduce more competition where competition is inadequate,” Orszag said. “Either one could work.”
And here's more from The New York Times article:
As the Finance Committee wrestles with the bill, which could form the backbone of an eventual Obama plan, the lobbying effort is already bearing fruit. One Democrat who consults frequently with the White House said that a main goal of the administration has been to prevent any Democrat from publicly declaring opposition to the measure. So far, the only one who has, Senator John D. Rockefeller IV of West Virginia, has scaled back his criticism after a private Oval Office session with the president.
Rahm Emanuel, the chief of staff, runs the campaign out of his West Wing office. A former congressman, he knows how to count votes. (It was Mr. Emanuel, for instance, who suggested Mr. Orszag reach out to Ms. Collins.) Aides say he does not host a regular health care meeting, but rather summons his team several times a day, typically with e-mail messages ordering colleagues to drop everything and show up right that minute.
Mr. Emanuel oversees two working groups: a policy group, run by Nancy-Ann DeParle, the head of the White House Office of Health Reform, and a political group, run by Jim Messina, the deputy chief of staff. They are deeply engaged in what Chris Jennings, who advised President Bill Clinton on health policy, calls “intelligence seeking” — trying to learn who has problems with the legislation, what those problems are and what it will take to win each member’s vote.
The trigger on the public option is still very much in play in the Senate Finance Committee where in order to get Senator Snowe's vote in passing the bill out of the committee, the Democratic Senators will vote for the trigger, thus making it a part of the bill that will have to be reconciled with the Senate HELP bill.
A bipartisan bill is the goal of the White House, given that President Obama has expressed that he prefers a bipartisan bill, which is why Snowe's vote is very important to them, and the attention they've given to her trigger amendment on the public option is telling.
When you have Democrats like President Bill Clinton and Majority Leader Harry Reid, that are allies of the White House saying that they think that the Snowe trigger is a good thing, that's when you know that the goal of bipartisanship is more important than a good bill.
President Bill Clinton on Meet The Press, September 27th:
"Now, the one Republican who's come up with a good idea is Senator Snowe. She deserves a lot of credit for saying when we did this Medicare prescription drug bill, instead of giving the government the power to negotiate for lower prices we gave the drug companies a chance to offer them, but we held the power in reserve. And if there was any state in America where there was no competition, you could do it. So let's do that for health care. That's a good idea. That's, that's the kind of debate the country needs, and I hope that the Republicans will come forward with it. "
That's the Snowe trigger amendment that President Clinton supports as an alternative to the public option, as does Peter Orszag, Majority Leader Harry Reid, and White House Chief Rahm Emanuel. It's a trigger that's designed to never be pulled, as Jason Rosenbaum at HCAN has pointed out:
In Snowe's trigger amendment, if affordable coverage is not available for 95% of a state's residents, then you get a public option in that state. While there are issues with state-based public health insurance options, the catch-22 comes with Snowe's definition of affordability.
Affordable is defined as 13% of income. So, if there is no plan in the exchange that costs less than 13% of a person's income, we'd get a public health insurance option. But that calculation of what a plan costs is made after the government pays out subsidies or employers pay their share. And therein lies the catch-22.
Max Baucus's bill caps out-of-pocket costs for people buying insurance in the exchange at 12% of their income. Therefore, after you add in government subsidies, costs will legally always have to be below 12%. The insurance industry can raise their rates as much as they want and government will make up the difference. The trigger, if passed, will never trigger. Not ever.
Many Democrats in the base know that the trigger is a cop-out, and that it's not a real alternative to the public option, and neither are co-ops. If the Senate Finance Bill passes with no immediate public option, but with the Snowe trigger on the public option, then you're getting an individual mandate to buy private insurance, which is what a majority of Americans in swing House districts and in the state of Maine oppose as a recent poll has shown:
"Nationally, voters oppose a mandate to purchase private insurance by 64% to 34% but support a mandate with a choice of private or public insurance by 60% to 37%... Each [survey] found that likely 2010 voters oppose ‘requiring everyone to buy and be covered by a private health insurance plan’ but support ‘requiring everyone to buy and be covered by a health insurance plan with a choice between a public option and private insurance plans.’"
It's political suicide for the Democratic Party to pass a bill that forces Americans to buy private insurance at 13% of their income, with subsidies directly going to these private insurance companies, and with no access to a public option. Not to mention that if you're self-insured, the regulations on pre-existing conditions, recissions, and denials of claims, won't even apply to you under the Baucus Senate Finance Committee bill.
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