Green Room

ObamaCare: Public option + trigger = exit strategy?

posted at 11:25 am on September 3, 2009 by

There is a rumor (most likely floated by White House chief of staff Rahm Emanuel) that Pres. Obama is secretly negotiating with Sen. Olympia Snowe for a healthcare reform that would phase in a government-funded health insurer if private insurance companies fail to meet quality and cost benchmarks over a certain period of the time. Allahpundit scores this as an “Uh-oh,” but the devil is in the details.

Sen. Snowe has pushing the notion of a “public option with trigger” for months, and it has been the Left expressing dismay over the idea. True believers like Robert Reich say Snowe is fronting for Big Pharma and health insurers, with conditions that would be easily met by other pieces of the emerging legislation. Rahm Emanuel has been floating the trigger idea since January, again to the dismay of lefty groups like MoveOn. The left notes that congressional Republicans crafted a similar trigger for the Medicare prescription-drug benefit in 2003 — and it has never been triggered. For the left, the “public option” deferred is the “public option” denied.

However, it is a proposal that serves the administration’s interests. Pres. Obama reportedly would like not only to pass a takeover of health insurance based on an individual mandate, but also to get back some of the post-partisan image he had as a candidate. Some administration officials welcome a showdown with the left wing of the party to achieve these goals. The maneuver would also lure Blue Dog Democrats to the bill — and many Blue Dogs still expect to pass some healthcare reform bill.

This tactic carries its own measure of risks for the administration. The first risk is that the progressives continue to balk and refuse to vote for a final bill with a trigger. This seems unlikely, but most of them are from safe seats and plan to hold those seats long after the Obama presidency, so there could be some rebellion at the margin.

The second (and larger) risk is that a proposal designed to grab the center holds only a handful of votes. That is what happened in the dying days of HillaryCare in 1994. Those proposals never made it to any sort of vote.

The third risk is that whatever momentum is left for ObamaCare rests on the notion that politically, failure is not an option on healthcare reform. The theory that Democrats in swing districts are better off voting for an unpopular takeover of one-sixth of the economy has always seemed counter-intuitve. Now, Sean Trende has done a regression analysis of the 1994 midterm election showing that holding all other things equal, had Democrats gone ahead and passed HillaryCare, their losses likely would have been even greater than they were. Trende notes:

Right now, almost all of the 60 or so Democrats in Republican PVI districts have cast a controversial (in Republican districts) vote on Obama’s stimulus plan. Many of them have voted for cap-and-trade. Unless public opinion changes substantially, many of them will be pressured to cast an extremely controversial vote on the health bill. These Democrats don’t need this vote.

In short, the “public option with trigger” might appeal to Pres. Obama and Sen. Snowe, but there is no reason for Democrats of any stripe to adopt it as their own. That may be why similar healthcare compromises failed last time around.

Recently in the Green Room:

HotAir — Politics, Culture, Media, 2017, Breaking News from a conservative viewpoint

Fixing crime in America is a complicated issue

Taylor Millard Jun 23, 2017 8:31 PM
Top Pick

Cops alone won’t solve it.

Top Pick

Victim’s father was President Maduro’s supervisor back when he was a bus driver.

Democrats forgot all about the “era of good feelings”

“Bernie and Jane Sanders have lawyered up.”

“the Judiciary Committee is examining the circumstances surrounding the removal of James Comey.”

Winning isn’t everything. It is the only thing

Trump signs VA reform bill into law

John Sexton Jun 23, 2017 2:41 PM

“What happened was a national disgrace, and yet some of the employees involved in these scandals remained on the payrolls.”

A new era of something.

“…died suddenly in less than a week just after his return to the U.S.”

The shortsightedness of “Denounce and Preserve”

Taylor Millard Jun 23, 2017 12:11 PM

Pragmatism for the sake of pragmatism doesn’t always work.

Perhaps if you threw in a new car?

Gay marriages still growing, but not as fast

Andrew Malcolm Jun 23, 2017 10:31 AM

More, but not as quickly.

Should’ve stuck with the pirate gig. It was working for him

The battle for the rubble of Raqqa is underway

Andrew Malcolm Jun 23, 2017 8:51 AM

Won’t be much left.

Your list of demands is a publicity stunt

“what happened that day was emblematic of a deeply troubling trend among progressives…”

“The jobs are still leaving. Nothing has stopped.”

Bad vendor. Bad! No cookie!

“The Corps is just starting to grapple with the issues the court has identified.”

“So you want me to sing my praises, is that what you’re saying?”

Why would we possibly want that?

“I mean he sold our country to The Russians.”

I could think of someone else you might want to ask about…

“You can ask a hundred people what hate speech is and you get a thousand different answers”

Trump: I never made any recordings of Comey

Allahpundit Jun 22, 2017 2:01 PM


Hackers stole private data from election databases

John Sexton Jun 22, 2017 1:21 PM

“90,000 records stolen by Russian state actors contained drivers license numbers”

Failure to protect the city

Big man on the Middle Eastern campus

Biased Americans see media as biased.

Tough times down on the liberal ranch

Will Nancy Pelosi survive this latest Dem disaster?

Andrew Malcolm Jun 22, 2017 8:41 AM

Eat quick, before it’s gone.

Slow your roll, boss

“I’m bothered by the lack of emerging evidence…”

FIrst look at the Senate health bill

John Sexton Jun 21, 2017 9:21 PM

“the Senate bill would go farther than the House version in its approach to cutting Medicaid spending.”

Divide and conquer?