ObamaCare: Reid’s public option gamble

posted at 9:00 am on October 27, 2009 by Karl

On Monday, Sen. Maj. Ldr. Harry Reid submitted a draft healthcare bill including a “public option” with an opt-out provision for states to the CBO. Allahpundit summarized most of the main points, but they are worth further exploration.

Reid apparently does not have 60 votes lined up for the public option, though Reid thinks he will have them after the CBO scores it. This move was supposedly forced by the hardcore liberals in the Senate, though this could still be the kabuki by which Reid sheds responsibility for a later failure to include the public option. Either way, the ball is now in the moderates’ court.

Allahpundit correctly notes that this proposal loses Sen. Olympia Snowe. Howard Fineman may not think that’s a big deal. Jay Cost, looking at ideological scores, suggests the White House wanted Snowe on board to woo Sen. Susan Collins and keep Sen. Ben Nelson on board. I think it is more the latter, and that the same applies to the next two Senator’s to Nelson’s left — Evan Bayh and Blanche Lincoln. Although Chris Bowers hears that Bayh is a solid vote for cloture, Bayh has suggested he might filibuster, though maybe not now. Ben Nelson supposedly opposes the idea of a national public option with an opt-out for the states. Both Bayh and Nelson have each received more than $470,000 from the health insurance industry since 2006. And Lincoln has not committed to vote to bring Reid’s proposal to the floor. Any one of these Senators could scotch Reid’s proposal after the CBO scores it — and may cite reasons other than the public option for doing so, at least for public consumption (though I doubt a lone Senator would do this; it’s more likely if two or three of them choose this course of action). It would be like Sen. Joe Lieberman saying his concern about the Senate bill is based on the deficit — not the insurers that dominate his state.

Bob Laszewski still thinks that there ultimately will not be 60 votes for a robust public option with an opt-out, because of the barriers to opting out. At least two of the analysts solicited by National Journal also see the opt-out as a ruse, while Paul G. Ginsburg notes that a robust public option with an opt-out could cause “an extensive pattern of distortions.” While some, like R.J. Eskow (a lefty not thrilled with the opt-out proposal) believe that the most conservative states are the most likely to opt out, Ginsburg notes that states with the highest rates relative to Medicare are likely to opt out in response to pressure from providers, which would likely affect the CBO scoring (and it will be interesting to see what sorts of assumptions CBO makes along these lines). Michael G. Franc notes that the 41 states with mixed or total Democratic control are unlikely to opt out today, but wonders whether Reid’s proposal — if it became law — would not turn state legislative and gubernatorial elections between now and 2014 into referendums on ObamaCare. State officials — already chafing at the way prior drafts of ObamaCare would burden their Medicaid programs — might be wondering the same.

In sum, a Senate bill with the public option is not quite a done deal. However, for the sake of argument, let’s assume that Reid can get such a bill to the floor. He can only do so by getting moderates to burn political capital — voting for cloture before voting against the public option or the bill in total. Voting for things before voting against them tends to hurt people on Election Day, as the moderates undoubtedly know. And the remainder of the bill may be difficult to pass, regardless of the public option. Including the public option (an idea so good that House Speaker Nancy Pelosi wants to rename it) may please liberals today, but it increases the risk that the bill collapses of its own weight on the Senate floor.

—
Update: Joe Lieberman: I’ll filibuster Harry Reid’s plan. Heckuva job, Harry! Lieberman also says he wouldn’t filibuster a motion to proceed to the bill. But that’s Joe twisting the knife. In all probability, the bill would proceed under an agreement allowing for the filibuster of amendments, which would require 60 votes to remove the public option. So Reid will be under bigtime pressure to yank it from the bill now. Alternatively, Reid could take another run at Snowe by switching to a “public option with trigger” plan.

Update x2: Reid says Lieberman is the least of his problems, which Dems better hope is a bad bluff. Bayh can imagine the Reid bill failing before it gets to the Senate floor. Lincoln says she’s still opposed to public option. Neither Bayh nor Lincoln is talking about a filibuster — pols always want maximum flexibility — but making such comments at this particular moment is not an accident, either.

Blowback