Raul Grijalva has an op-ed in The Nation today, responding to all of the guesswork and confusion about the process and whether the public option will survive.
The House of Representatives is about to bring its final healthcare reform bill to the floor. The vast majority of the Democratic Caucus supports the inclusion of a "robust" public option that would pay providers Medicare rates plus 5 percent, but resistance from a small portion of the caucus is threatening to derail the effort. These members want a bill with either no public option or a diluted public option based on expensive negotiated rates and phony triggers. It is crucial that a robust public option is included in the bill, and that no triggers are involved.
I, and more than 200 other House Democrats, believe that a public option should start out by paying Medicare rates plus 5 percent for the first three years because the Medicare formula is already public and well understood, and this will maintain transparency. After that, the legislation currently being considered in the House would allow the government to begin negotiating rates with providers in a manner consistent with the initial rate.
Some members prefer that a public option plan start out by negotiating payment rates with providers right away. However, Congressional Budget Office estimates show that a public option that negotiates rates with providers would only save the government an estimated $25 billion over the next ten years, versus $110 billion with Medicare-plus-five. Negotiating rates immediately would drive the public plan down a dangerous path by linking it to skyrocketing medical inflation, and would not foster the competition necessary for real cost reductions to consumers and up-front savings for the government. Just as importantly, under the negotiated rate plan, the government will have to make up any loss of coverage by putting more people into Medicaid. This will further burden states as well as greatly limit individuals' access to providers....
Any public option structured around a trigger would not create such competition, and would be problematic for several reasons. Passing a bill that forces Americans to buy insurance they may or may not be able to afford is not only terribly unfair as policy, it would provoke a huge political backlash and threaten any future efforts to improve the system further. At the same time, nothing would to stop Congress from continuously pushing back the trigger deadlines, just as we do now with Medicare Part D. A law that puts additional burdens on consumers while doing nothing to change the landscape of the insurance market is doomed to fail.
That's what the Congressional Progressive Caucus, under Grijalva's leadership, has been fighting for all these months, and they now have more than 200 House Democrats with them. Help them get the rest of the way there by making a few calls this weekend, and leaving voicemails for the following members who are likely to say yes to a robust public option.
- Gabrielle Giffords (AZ-8): 202-225-2542, 520-459-3115, 520-881-3588
- Dennis Cardoza (CA-18): 202-225-6131; 209-383-4455, 209-527-1914
- Joe Donnelly (IN-2): 202-225-3915, 574-288-2780
- Kurt Schraeder (OR-05): 202-225-5711, 503-588-9100
- Lincoln Davis (TN-04): 202-225-6831, 931-490-8699, 931-473-7251
- Glenn Nye (VA-2): 202-225-4215 757-326-6201
- Jim Costa (CA-20): 202-225-3341, 661-869-1620, 559-495-1620
- Rick Boucher (VA-9): 202-225-3861, 276-628-1145
The House needs to pass the strongest bill possible going into negotiations with the Senate. All of the things that House members have fought to have included in this bill, not just the public option, will be best preserved with the strongest possible bill being passed by the House.