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Basis for a Compromise?

September 21, 2009 - by Donny Shaw

Majority Whip Sen. Dick Durbin [D, IL] said this morning that he thinks some kind of variation on the public option can get 60 votes to break a filibuster in the Senate. Baucus’ co-op idea doesn’t seem likely at this point to win over enough support, but Sen. Olympia Snowe’s [R, ME] “trigger” option might.

Basically, her idea is to add a mechanism, on top of Baucus’ co-op plan, that would trigger the creation of a public option in states where insurance coverage isn’t expanded enough once the bill’s other reforms take effect. She’s seeking to add it as an amendment to the Senate Finance Committee bill this week. Here’s the text as published in the committee’s “Amendments Relating to Expanding Health Care Coverage” pdf:


Short Title: Provision of Safety Net fallback plan to ensure access to affordable coverage

Description of Amendment: This amendment establishes a non-profit government corporation through which a safety net plan would be provided in any state in which affordable coverage was not available in the Exchange to at least 95% of state residents. An individual would be deemed to have affordable access if either of two conditions is met. First, two or more plans are offered with premiums – the cost of which does not exceed a specified percentage of the individual‘s adjusted gross income (AGI), after deducting any available tax credit or employer subsidy from the cost of such premium. The percentage contribution shall range from 3 percent of AGI at 133 percent of the Federal Poverty Level, to 13 percent at 300 percent and above. Assessment of affordability shall follow submission of plan premiums filed one year in advance of the first day of each policy year, and should a state be found to not meet the 95% threshold, plans would be permitted to submit of any revised premium filings, after which a second assessment of affordability shall be performed. If, after that second assessment, a state still be deemed as not meeting the affordability standard, the safety net plan shall be offered within that state, and shall be available at the pending open season enrollment.

Translation: If a state does not have at least two exchange-qualifying insurance plans that cost less than 13% of adjusted gross income for at least 95% of the population, the federal government would automatically establish a state-wide public plan.

This isn’t an instant compromise. Liberal Democrats are probably not going to support a plan like this unless the affordability level is reduced from Snowe’s proposed 13% to something lower. But that could cause the Snowe to back away from it – and she’s the only Republican who has shown any interest at all in supporting it. The fundamental problem here remains that there are two very distinct groups trying to negotiate – those that want a public option and those that don’t. Snowe falls in the latter, which is why she’s backing this plan. So as the Democrats tweak her trigger plan to make it more likely that public plans will be set up, it becomes more likely that she’ll drop out of the deal entirely.

Tricky grounds to negotiate for a compromise here, but it seems like this is where things are headed.

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