Blog - Progressives Getting Tough on Health Care

Believe it or not, the Progressive Caucus is the most powerful single non-party caucus in Congress. It might not seem that way, since all we ever hear about is the power of the conservative Blue Dogs and how the Democratic leadership was forced to weaken legislation because the Blue Dogs threatened to block it otherwise. The progressives tend to fold, not wanting their desire for progressive legislation to get in the way of passing legislation that is better than nothing. But the Progressive Caucus outnumbers the Blue Dogs, 83-52.

The progressives are preparing to use their power to block legislation on health care. Yesterday, after President Obama, Health and Human Services Secretary Kathleen Sebelius and Sen. Kent Conrad [D, ND] said over the weekend that a public health insurance provider was not an essential part of reform and that it would be dropped in the Senate, House progressives came back and vowed to block any bill that does not contain a public option. Here’s a letter they sent to Sebelius:

Dear Secretary Sebelius,

We write to you concerning your recent comments about the public option in health insurance reform.

We stand in strong opposition to your statement that the public option is “not the essential element” of comprehensive reform. The opportunity to improve access to healthcare is a onetime opportunity. Americans deserve reform that is real-not smoke and mirrors. We cannot rely solely on the insurance companies’ good faith efforts to provide for our constituents. A robust public option is essential, if we are to ensure that all Americans can receive healthcare that is accessible, guaranteed and of high-quality.

To take the public option off the table would be a grave error; passage in the House of Representatives depends upon inclusion of it.

We have attached, for your review, a letter from 60 Members of Congress who are firm in their Position that any legislation that moves forward through both chambers, and into a final proposal for the President’s signature, MUST contain a public option.

We’ve been hearing from conservative Democrats in the Senate that the votes aren’t there to pass a public option. So, if the House can’t pass a bill without a public option, and the Senate can’t pass one with it, where does that leave us? Here are a couple interesting takes…

Nate Silver of FiveThirtyEight thinks there is a possibility of getting a public option through the Senate with only 50 votes. The key, he explains, is that the public option must be included in the underlying bill that comes to the Senate floor. It can’t be added as an amendment because it would be filibustered, and public option supporters don’t have the votes to break a filibuster. If it’s included in the bill, there will be a Republican amendment to take it out, but with 50 votes (and a tie-breaking vote from Joe Biden), the amendment could be warded off without filibustering. After that, it’s a matter of muscling the bill through a Republican-led filibuster to get to a final vote on passage that would require only 50 votes, again with a tie-breaker from Biden.

The trouble, of course, is getting the public option out of the committee process. The Senate HELP Committee has approved it, but the Senate Finance Committee is leaning strongly in the direction of an alternative health insurance co-op. It would probably take liberal members of the Finance Committee (Rockefeller, Bingaman, Kerry, Schumer, Stabenow, Cantwell, Menendez) to come out strongly against a bill without a public option, like the 60 House progressives did, to bring some version of the public option back to life in the committee process. With Republicans now coming out against the co-op plan, it’s possible to shut down the co-op plan with a liberal-conservative alliance in the committee.

Mike Lux of OpenLeft sees possibilities for passing a public option plan to President Obama for his signature even if the Senate doesn’t pass a public option when they take up the bill initially. Lux, who says he’s “been through a ton of these kinds of issue fights, both from inside the Clinton White House and from the outside,” says that legislative logjams like this can and do get solved. It’s just a matter of persistence. Specifically, he sees two options for getting the public option back in the conference committee and passing it through both chambers:

A. The first is that conservative Senators are given a fig leaf compromise on the public option, so that they can say to people they forced a compromise, and then are brought over with all kinds of other incentives that make them more comfortable with the bigger bill.

B. The second is that the conference committee simply breaks the bill in half, one half being the less controversial part that everyone agrees upon, the other being the public option and the financing, both of which can go through the reconciliation process. Then Obama and Reid muscle the 50 votes they need for support.