E.J. Dionne, the Washington Post columnist has been talking with administration staff, senate staff, congressmen and lobbyists for the various industries.
Dionne on Compromises
He comes out of it with news that several different types of compromises are afoot and most of them are pretty good.
The first involves the excise tax, which I believe is needed for the final bill, others may disagree, but labor is willing to compromise on it. The current amount is set for 23,000 and labor estimates that would impact 1 in 4 families. I'm not sure on those estimates. People have stated it was lower, but labor also estimates that if raised to 28,000, it would effect 1 in every 14 families, that number seems a bit high, but that's still substantially better.
Many opponents would settle for raising that ceiling to $28,000 for families, with a comparable increase for individuals. That would reduce the number of policyholders covered by the levy. But because of fierce resistance to the tax from a large group of House Democrats, this could prove to be one of the most vexing issues in the negotiations.
The second compromise has to do with the medicaid debacle that was started by Sen. Nelson. Right now, he gets his funding entirely paid for in the Senate health bill. Obviously, other states have balked at that. The compromise involves better medicaid funding for ALL states.
In the meantime, negotiators are looking to extend to all states a version of the special deal that saved Sen. Ben Nelson's home state of Nebraska from the bill's increased Medicaid costs. Nelson himself is pushing for this change, which would cost $25 billion to $30 billion over 10 years. One solution: somewhat more modest across-the-board Medicaid relief to all states.
The final compromise will deal with the insurance industries and the progressive organizations. The thinking is that because the public option was killed the sides will be more willing to compromise but with Nelson and Lieberman taking strong stances throughout the debate (to their detriment in the polling), it's unpredictable. But there's the possibility that the antitrust amendment would be included in the bill along with the national exchange and the healthcare companies would be legally binded to maintain their 1.5-2% savings that they agreed at the WH or 2 trillion dollars in savings.
The bargaining could open the way for unusual coalitions. For example, both the insurance companies and many progressive groups want to hold providers to the public promises they made at the White House last year to cut the increase in annual health-care costs by 1.5 percent a year over the next decade. This would amount to $2 trillion in savings.
One compromise might involve the insurance companies agreeing to a national insurance exchange and, possibly, antitrust changes if the final bill also includes a legal requirement that the providers live up to their cost-containment promises.
All in all, as I stated earlier. The Bill WILL TURN LEFT. The only question was in degree. If these changes hold up the bill would turn pretty significantly left.