Joe Lieberman went and did what we all knew that he would do: rejected the Medicare buy-in compromise offered this week. So where does that leave us? Sam Stein at HuffPo lays out the options:
The first is to convince the senator to support Democrats in breaking a Republican filibuster before casting a vote against the bill. This would allow for the legislation to pass with Lieberman still registering his opposition. Lieberman, however, has said he considers the procedural vote to cut off debate to be of the same significance as a vote on the bill itself.
The second path is to try and pick up a Republican moderate. But this too seems unlikely, as Sen. Olympia Snowe (R-Maine), Reid's best bet, has also expressed opposition to the Medicare buy-in provision.
The third path would be to appease Lieberman and wipe the provisions that he deems controversial from the bill. This, however, would likely lose Reid several progressive votes -- advancing the cause no further.
The final path would be to try reconciliation, the parliamentary procedure that would allow Democrats to pass chunks of health care reform by a simple up or down vote. There are a host of hurdles that come with going down this route, including questions over what, exactly, could be passed. And both the White House and Reid's office seem hesitant to use the procedural tool, even after Lieberman's latest round of opposition.
I would only add that a fifth option is to try and strong-arm Lieberman by threatening to strip him of his committee chairmanships if he filibusters. But so far, there's been zero indication by Reid that he or the caucus would even consider such a thing.
I think Sam Stein lays out good reasons why the first three options are non-starters and shouldn't be considered. However, in dismissing the fourth possibility, he seems to be assuming that a public option sent through budget reconciliation would never see the light of day. And he's mostly right: budget reconciliation is for budget matters only, and any new non-budget items, such as a public option, would have to be split apart in a separate bill which is subject to the 60-vote filibuster. So this leaves you with the same problem as before.
However, the Medicare buy-in compromise is directly related to the budget. All it does is allow people to buy into an existing government program, not create a new program. Since this is the case, the bill would not need to be split, and could be packaged entirely into reconciliation. So we can pass this with 51 votes and tell Lieberman, Nelson, and friends to kiss our asses.
The only question is whether we should leave it as something we should offer only 55-64 year olds, or something we should extend to everyone. I can see arguments both ways: making this a true Medicare for All program would be much stronger than any of the public options offered in the last few months, even stronger than the Medicare +5 option Pelosi tried to pass in the House and failed. But that risks losing enough Democrats to put getting 51 Dem votes in jeopardy, and then we'll run into the same kingmaker problems where one of the borderline Dems will hold everything up to extract compromises out of the bill. Either way, subsidy levels will have to be adjusted, and the 800-pound gorilla in the room that hasn't been addressed is still cost control.