The jig is up for House Blue Dogs and Senate Moderates.
Congressional budget analysts have given House leaders cost estimates for two competing versions of their plan to overhaul the health-care system, concluding that one comes within striking distance of the $900 billion limit set by President Obama and the other falls below it.
House leaders have been working to lower the cost of the $1.2 trillion health-care package they offered in July. The report from the Congressional Budget Office, a copy of which was obtained by The Washington Post, puts the cost of one plan at $859 billion over the next decade and the other at $905 billion.
....
Both packages are based on the original House framework, which proposes to extend coverage to more than 30 million Americans by expanding Medicaid eligibility and subsidizing private insurance for people who lack access to affordable coverage through an employer. Each would expand the ranks of the insured to more than 95 percent of Americans by 2019, and each would create a government-run insurance plan to compete with private insurance companies.
Well, well, well...
It has been interesting to see Republicans and Senate moderates pivot in their arguments against the public option recently. It seems like they knew the fiscal argument was no longer operative.
Under the $905 billion version favored by liberals, compensation rates for medical providers in the government-run insurance plan would be based on Medicare rates, which are significantly lower than private rates. That idea, which Senate liberals also support, would hold down costs for the government, according to the CBO, but it would create a problem for providers in rural areas where Medicare rates tend to run much lower than the national average.
Under the $859 billion version, administrators would negotiate rates directly with doctors and hospitals, the option preferred by moderate Democrats from rural areas.
The link to Medicare rates has been a very contentious issue and Sen. Conrad has been using this as a primary basis for his argument against the public option once his we don't have the votes charade ended.
The CPC has been holding extremely firm on their Medicare +5 requirement. However, the fact that both bills basically meet the President's financial requirements is huge. This gives them a lot of leverage.
The moderates like Sen. Mary Landrieu and Sen. Ben Nelson are now only left with the Republican argument that this is a "government take over" of health care (which the media dutifully reiterates using Frank Luntz's language. I notice the word "public option" is not used in the bolded quote above). There is simply no other argument against having a public option remaining. If they are truly fiscally conservative, they would change course stat.
My guess is that they will simply find new arguments, because there is big time insurance lobby money to be had. But we will see. There is now no doubt that a public option could easily be included in the final bill. Only the slippery slope conspiracy theory remains.
If the public option is not in the final bill, we will have no choice but to assume there are certain Democrats who quite simply have no interest in real, robust health care reform. Instead, it will be clear their constituency resides on K St., not their home states.
It is time for Progressives in the Senate and House to join forces and make it clear to the moderates and the WH that they now have a line in the sand. No trigger free public option for all = A No Vote on Health Care Reform. Blue Dogs and Senate Moderates have been coddled to long. If Progressives are ever going to take a stand, they now have all of the ammunition they need.
Let's give the support they need to maintain the firewall. We can do it folks, if we keep the pressure on.
We are the ones we have been waiting for.
Update [2009-10-16 10:10:12 by justmy2]: Thanks for the recs everyone...this is great news and provides an important arrow in the progressive quiver to bring to the negotiation table in conference, and hopefully gives Sen. Dodd a bit more power in the Senate merger negotiations. I hope Senate progressives can now make the same progress with their recalcitrant colleagues in the same way the Pelosi was able to pull Blue Dogs along.
We are getting there folks. But now is not the time to let up. Reform opponents have no cards. If Progressives are ever going to go all in, now is the time. This is the moment to make history.
Update [2009-10-16 10:10:12 by justmy2]: An important note provided by BennyToothpick in comments. The CBO did not provide an estimate of whether either of the bills will be deficit neutral according to the article. This doesn't mean that it is not deficit neutral, but it is outstanding, and I wanted to make sure that part was clear. However, it does meet the President's cost targets.
Update [2009-10-17 10:13:16 by justmy2]:While I was away from site access, It was pointed out in comments that the Baucus bill was actually scored at $829 billion. I mistakenly thought the President's $900b goal was the Baucus score. I think that $900 billion number has been hammered into my head. I have corrected the title to be more accurate. However the point of the diary remains that the fiscal argument against the public option has been removed.
I regret the error.