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A Breakthrough on Health Care -- Drop the Public Option, Open Up Medicare

December 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.

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  • driskells 12/09/2009 9:07am

    I can’t get excited without properly reviewing the proposed changes.

  • zbeckerd 12/09/2009 2:09pm

    I agree it is hard to get excited. Sorry to those that are among the 180,000 people who are likely to die by 2014 only because they have no health insurance. Lieberman could not be more annoying could he?

  • Comm_reply
    Philomont 12/16/2009 11:09am

    I think the whole of that bunch in DC should be impeached. There should be another American revolution. Let’s stop fighting wars all over the world and start taking care of our own people. I for one will be dead by the time they get their acts together.

  • dbeltramo 12/09/2009 4:33pm

    THIS IS PATHETIC!!!!!!!!!!!!!! I couldn’t be more disgusted and angry if I tried! What are these morons in DC doing? As a single Mom, if I weren’t held hostage by the dictatorship known as the US Family Court system (another horrific joke on the American people), which gives my ex the right to prevent me from moving more than 50 miles, even though he’s had nothing to do with his child for 8 years, I would leave this country gladly! I ashamed to be an American if this is what we call “reform.” No wonder militia and militaristic groups are on the rise.

  • RetiredPublicSafetydotCom 12/09/2009 7:44pm
    Link Reply
    + -1

    I thought the use of the term “new deal” in the article was rather fitting.

    From Wikipedia-
    “The New Deal was the name that United States President Franklin D. Roosevelt gave to his complex package of economic programs 1933-36 with the goals of what historians call the 3 Rs, of giving Relief to the unemployed and badly hurt farmers, Reform of business and financial practices, and promoting Recovery of the economy during the Great Depression.”

    “A ‘Second New Deal’ in 1934-35 included the Wagner Act to promote labor unions, the Works Progress Administration (WPA) relief program, the Social Security Act, and new programs to aid tenant farmers and migrant workers. The Supreme Court ruled several programs unconstitutional; however, most were soon replaced, with the exception of the NRA.”

    Sen. Landrieu is probably going to hold out for another $300 million. At least there’s no need to worry about that Constitutional stuff now. Should be a walk in the park.

  • deborahg6 12/10/2009 4:42am

    Number 3: “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.”

    Good grief. Do these Dems think we are morons? They tell us that they’ve dropped the public option, but then leave the door wide open. What a joke. Except that it is not funny. Cannot wait until 2010 when we can start voting these so called “representatives of the people” OUT! It will be hard, but we can overturn this tyrannical legislation.

  • Comm_reply
    patriot12345 12/14/2009 6:36am

    The debate on health care reform is only the boiling point of a long simmering pot of American greed, deceit and apathy. I’m sickened by right-winged politicians and their supporters cloak themselves in the robe of Christianity. They decry socialism, while ignoring the fact that our Lord and Savior was the greatest socialist the world has ever known and His teachings literally defined the essence of true socialism. They preach strong opposition to abortion, yet return to the halls of congress to cast their votes against help for the children that are born into hopeless poverty. They cry for justice through the bloodshed of capital punishment, while ignoring the fact that our Savior was the first recorded incident of the state-sanctioned execution of an undeniably innocent man.
    Now, these same phony Christians are wielding their power and money to prevent affordable health care to less-wealthy Americans! It’s sickening !

  • spender 12/10/2009 5:05am

    Is this “national public option plan” similar to one of the versions the House had been kicking around over the summer? I seem to remember a few versions of the public option that would have been run by the Feds, rather than by each state, that had the bargaining power to keep costs down. If that’s the case, this plan doesn’t sound too bad…provided that the “trigger” isn’t designed to never be tripped.

    Why can’t everyone buy into Medicare? That would make this whole thing so much easier.

  • arlenbrack 12/10/2009 5:49am

    Start with something that can be achieved: ie.. Allow policies to be sold across state lines, get the ambulance chasers out, go after medicare “waste, fraud and abuse.” Then we can afford to subsidize the 5% of the population that can’t truly afford health insurance. The pro big government administration and it’s progressive base only want control and lifetime government jobs. They don’t want reform, the enlightened ones just want to “boss”, because the rest of us are just too stupid to know better. If congress really wanted to fix health care problems, the other half plus of the country, and it’s ideas would be included.

  • catfarmman 12/10/2009 11:23am

    What happens to those Americans who are under the age of 55? This is an outrage and my elected officials are going to hear from me.

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