A Breakthrough on Health Care -- Drop the Public Option, Open Up MedicareDecember 9, 2009 - by Donny Shaw
Democrats in the Senate have negotiated a new deal to break the impasse on health care reform. It involves getting rid of the public option altogether, but, somehow, all the liberal Democrats seem to like it.
The deal appears to have three parts:
1) Medicare Buy-In — Starting in 2011, uninsured people between the ages of 55 and 64 would be allowed to “buy in” to Medicare. Until the Exchanges and affordability credits in the bill are set up in 2014, eligible people would have to pay for Medicare with entirely their own money at full price. It could be expensive. But in 2014, Medicare would become available to 55 to 64 year old on the Exchanges and people would be able to use their government-provided affordability credits. People in lower income brackets would get most of their Medicare coverage paid for by the government.
2) Non-Profit Health Care Network — Starting in 2014, the Office Personnel Management (OPM) would run a program modeled on the Federal Employees Health Benefits Plan, which provides health care to members of Congress, that allows private insurance companies to set up national non-profit plans that would be offered to consumers on the Exchanges. The plans would be privately run, but the OPM would essentially be the regulator determining if they meet certain quality standards and should be allowed to sell on the Exchanges.
3) Public Option Trigger — If the national non-profit network does not meet certain goals for making health care affordable to enough people, the creation of a national public option plan would automatically be created by the federal government and offered on the Exchanges.
More details, including a Congressional Budget Office score, should be coming along soon and we’ll post them to this blog as they are available. Jonathan Cohn at TNR has laid out ten key questions on the deal that need to be answered before we really know how (well) it all would work.
The White House likes it. Former DNC Chairman Howard Dean, who was previously opposed to a public option-less bill, likes it. Sen. Bernie Sanders [I-VT], who has said he would filibuster a bill without a public option, says it may be stronger than the public option plans in either the House or Senate bills. On the House side, progressive Democrat Rep. Anthony Weiner says he likes the deal “a lot,” adding, it “would perhaps get us on the path to a single payer model.”
So far, though, it’s unclear which moderates will support the deal. Sen. Joseph Lieberman [I, CT] opposes the trigger. “My opposition to a government-run insurance option, including any option with a trigger, has been clear for months and remains my position today,” Lieberman said today.
Now we wait and see what the other key swing-vote senators — Nelson [D-NE], Landrieu [D-LA], Lincoln [D-AR], Snowe [R-ME] and Collins [R-ME] — have to say about it…
UPDATE: Via TPM, Landrieu and Lincoln today both declined to endorse the deal. But they didn’t denounce it either. Both basically said they need to see a CBO score before deciding if they will support the deal.