The not-a-public-option public option compromise being floated by the Senate, in which the Office of Personnel Management would oversee a network of non-profit insurance agencies among which people in the exchange could choose from--an exchange within the exchange--is not going over well with HCAN, an influential health policy coalition.
The influential reform campaign Health Care for America Now says thanks but no thanks to the idea of trading away the public option for a system modeled on the one that covers members of Congress.
The statement declares that "a public option must be publicly established and accountable and operating nationally when the Exchanges start. Using nonprofits to replace a public option won't work."
It's not flying with House progressives, either. Here's co-chair of the Progress Caucus, Raul Grijalva:
Senate and White House leaders, he said, "have already compromised far too much. At some point in this process, the question became not what was the best policy for the American people, but what could be done to appease a recalcitrant handful who have negotiated in bad faith. We need strong leadership so close to the finish line, not efforts to water down a bill to the breaking point in a misguided attempt to win votes that were never there."
Grijalva said reports that the Senate is now moving toward the creation of a non-profit board to provide insurance, instead of an authentic public option, should "worry the millions of Americans who are counting on this bill to create affordable insurance and help them enjoy a fair marketplace." He emphasized that the House has already rejected such an approach, which essentially mirrors the health co-ops dismissed by most analysts as ineffective.
"A non-public option without government support will not bring down prices, expand coverage or provide competition for private companies," Grijalva said. "Voters will instantly recognize it as a whitewash of the problem we have spent the better part of this year trying to fix. They would be right to criticize any plan that fails to address their concerns, and they will be doubly right to reject this one."
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Grijalva added that modeling a plan on the Federal Employees Health Benefits Program that exclusively offers private insurance plans, as the Senate is reportedly considering, is not equivalent to a public option. Similarly, lowering the age of Medicare eligibility by five or 10 years "does not create enough private sector competition, which we desperately need to benefit working families," he said.
"We need a public option, period," Grijalva said. "I cannot support a system that forces Americans to buy private insurance and then allows those companies to collect government subsidies without competition. Our final health care bill should be based on policy outcomes and the needs of consumers, and the direction the Senate is taking does not give me confidence."
Grijalva is getting back up from some key fellow progressives in interviews with Greg Sargent:
In interviews with me just now, two well respected House liberals — Jan Schakowsky and Jerrold Nadler — expressed skepticism about the current public option compromises emerging from the Senate, and vowed that House Dems would not be railroaded into swallowing the Senate bill.
"It would be a mistake to think that the House leadership will go into any kind of conference committee with expectation that we’re just gonna sign on to the Senate bill," Schakowsky told me. "The House intends to negotiate with the Senate. We expect those deliberations to be vigorous. The House is not simply going to sign on the dotted line."
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Both Dems expressed skepticism about the current public option compromise emerging in the Senate, which would create a national plan along the lines of the Federal Employee Health Benefits Plan and would be administered by the Office of Personnel Management.
"It’s important to understand that [the proposal] would be a completely private plan," Schakowsky said. "Right now, I don’t see it as a good deal."
Nadler was more blunt: "I don’t know that I would support it."
The OPM idea is just not the equivalent of a public option, which must be occurring to the Senate progressives who are negotiating in the "Gang of 10." There's going to have to be a great deal more than just this expansion of Conrad's co-ops idea and an iffy Medicare expansion (Conrad will likely work his ass off to negotiate that away) in order to make any deal killing the public option worth considering.