ObamaCare: Whither the “Public Option”?
posted at 8:50 am on September 30, 2009 by Karl
The Washington Post claims that the Senate Finance Committee’s rejection two amendments to create a government-run health insurance plan — on votes of 15-8 and 13-10 — dealt a “crippling blow” to the hopes of liberals seeking to expand the federal role in health coverage as a cornerstone of reform.
The reality is a bit murkier than that, and likely connected to to overall fate of ObamaCare.
Keith Hennessey, who used to work for then-Senate Majority Leader Trent Lott, thinks there is a roughly 70% chance the Democrats will pass a partisan comprehensive bill through the Senate, most likely through the reconciliation process — and that we may know as soon as a test vote on a tax law scheduled for October 5th. However, his analysis is (on its face anyway) a little touchy-feely:
[T]he President’s speech, and more importantly the behind-the-scenes work he, his White House staff, and Congressional Democratic leaders have been doing, are working. I sense a much greater degree of partisan unity among Democrats, creating flexibility on policy and therefore legislative bargaining room as the leaders try to craft a bill. Congressional Democrats appear to agree that they need to agree. They are, however, still not sure about what they’re going to agree. But at least in public, they are taking much more constructive tones toward their inter-party disputes. This increases their chances of success.
However, Hennessey later writes that he is “guessing there is much greater Democratic disunity than we have seen this week at the Senate Finance Committee markup.” Presumably, he means disunity on specifics.
Lefty blogger Chris Bowers, who has worked for SEIU and Media Matters, explains what he sees as the procedural dead-ends on health care reform:
1. No public option from the Finance Committee. True, but there is now a caveat to that, as we will see below.
2. Nothing will pass the Senate with 51 votes. On Monday, Bowers did a count showing a maximum of 51 Senators for the “public option.” However, Bowers notes that Bill Nelson (not to be confused with Ben Nelson) and Tom Carper voted for the Schumer amendment for a “level playing field” public option in committee on Tuesday. Thus, Bowers now thinks there are enough votes to pass a “public option” if it is included in the merged bill sent to the floor by the Budget Committee, and if it isn’t filibustered. Those are two decent-sized “ifs.”
After all, Bowers anticipates that the GOP will block extreme measures to pass ObamaCare:
Senate Democrats are not going to use reconciliation. If they attempt to do so, either in the Budget committee that is merging the HELP and Finance committee bills or by splitting the bill in conference, Senate Republicans will propose points of order requiring 60 votes to pass reconciliation. Since Senate Democrats have already ceded this procedural territory through their unwillingness to use the nuclear option, they will need 60 votes to pass anything. As such, they might as well just target 60 votes for cloture.
Moreover, the Lefty whip count assumes that everyone who has claimed to support it actually would at crunch time. A 51-vote majority makes everyone who backs it a potential target as the “decisive” vote in their next campaign. Politicians generally do not want to be in that position on a polarizing vote (ask anyone who voted for the Clinton budget), Senators even moreso. I could see a “public option” passing with 55 votes as more likely than with 51 votes. I could just as easily see Senators voting for some form of the “public option” in committee to cover their left flanks because the fix is already in to drop it. If I was Bowers, I would be a little more paranoid about the latter.
3. No good strengthening amendments will pass on the Senate floor — from the lefty perspective. In regular order, the Dems would need 60 votes.
4. Don’t expect much strengthening from the conference committee — again, from the lefty perspective. Bowers argues that the “narrow Senate vote margin, combined with the Obama administration’s rabid desire for a health care bill, will provide the Senate version of the bill with more leverage in the conference committee.” He leaves out that the Blue Dogs in the House also do not want to go any further than the Senate (as evidenced by the fact that the full House has not passed a version of ObamaCare yet).
Bowers argues that this all comes down to whether Harry Reid wants to include a “public option” in the final merged bill. Budget Committee Chairman Kent Conrad is against a public option, but Reid could pursue a backroom deal if reconciliation is not in play. Certainly, including the government-run plan in the bill would put the onus on the GOP to seek its removal, and up the psychological pressure on the Dems to keep it. However, if Bowers is correct that the Democrats will not try to ram ObamaCare through via budget reconciliation, thus requiring 60 votes, including the “public option” would risk endangering the passage of any healthcare bill, leading Bowers to argue that it depends on whether the White House demands the “public option.”
Thus, it seemed less than coincidental that a New York Times piece on Reid’s role in the debate quoted “senior Democratic Senate aides” as saying the Budget Committee bill would not include a proposal for a government-run insurance plan. The left freaked out, but the supposed “shoot-down” of that story by Reid spokesman Rodell Mollineau really only said it was speculative. Moreover, the left generally overlooked that the NYT story framed Reid as the man in charge of finding 60 votes — which may be journalistic laziness, or another hint.
Looking at the evidence to date — including the Obama administration’s persistent refusal to publicly demand the “public option” — my guess would be that Senate Democrats currently would prefer to proceed on ObamaCare in the regular order and that there is already a tacit agreement that the “public option” will not be in the bill that comes to the floor. Democratic Senators will have a lot more CYA leeway if the “public option” is axed in some backroom deal and no version of it gains critical mass on the floor.
The analyses from Hennessey and Bowers start from dissimilar premises, but are not that far apart in the end. Hennessey leans toward predicting reconciliation, which suggests his (likely GOP) sources think it more likely that the Dems do not have 60 votes for a comprehensive bill. Bowers is not thinking reconciliation, but acknowledges that the “public option” fits into that scenario only if Reid and the White House push it, risking a filibuster.
Hennessey may be right that we will have a much better idea of Democratic intent next week. But the “public option” is just one of a number of issues vexing the Dems at the moment, along with the overall cost, subsidies to support forced insurance coverage, how much to stick it to the states on Medicaid, regional disparities in Medicare reimbursement rates, abotion, illegal immigrants, and so on. The “public option” is an invitation to a filibuster that would require absolute party unity, with no margin for error. If the Senate Democrats had absolute unity, one would think it would be far more apparent than it is today. The primary argument against dumping the “public option” is the House progressives’ threatened revolt. But that same bunch has been telling the Blue Dogs for months that some bill must pass to avert a Democratic apocalypse — an argument that the Senate could throw back in their faces.
Update (of sorts): Reflecting again on the above, I want to underscore that on Tuesday aftenoon, Bowers wrote that it all comes down to Reid, but by Tuesday evening wrote — after talking to a source on the Hill — that it was all up to the White House. That is another likely indicator of where Reid is. As for the White House, the administration has consistently tepid on the “public option” and generally unwilling to dictate terms to either chamber of Congress. That all seems like bad news for the “public option” at the moment, though it leaves plenty of room for a government takeover of healthcare through mandates and regulation.
Update x2: The test vote on the unrelated tax bill Hennessey mentions is probably H.R. 1586, a bill to impose a tax on bonuses received by certain TARP recipients. Bloggers for the Heritage Foundation think it could be a shell vehicle to immediately substitute and vote on ObamaCare next week. Again, this would require 60 votes to overcome a filibuster, which seems unlikely for a measure as extreme as this on a bill as complex as this (Senators like Ben Nelson seem unlikely to go along). Of course, the GOP will need to be vigilant about it. Moreover, if the GOP blocks such an attempt, it does not automatically follow that Senate Democrats will move to reconciliation, though that seems to be the basis of Hennessey’s calculations.
Update x3: Tom Carper, whom the left is counting in favor of the “public option,” is now floating an alternative for the merged bill. Lefty blogger-activist Jane Hamsher believes the unions are caving on the “public option” at the behest of the White House.
Update x4: Reid has cancelled the Columbus Day recess so that lawmakers can focus on passing healthcare reform legislation during the week of Oct. 12 — which points against the Heritage scenario of ramming it through next week. It also points against Reid choosing reconciliation, as he cannot do that before Oct. 15.