As mcjoan's piece indicates, not only are the 50 House members in support of full and robust reform, they are willing to block passage of a bill without it--and they would have the numbers to do so, unless Republicans in sufficient numbers joined centrist Democrats to form a majority. And what specifically are their lines in the sand? The Congressional Progressive Caucus calls for a robust public option that must: - Enact concurrently with other significant expansions of coverage and must not be conditioned on private industry actions.
- Consist of one entity, operated by the federal government, which sets policies and bears the risk for paying medical claims to keep administrative costs low and provide a higher standard of care.
- Be available to all individuals and employers across the nation without limitation
- Allow patients to have access to their choice of doctors and other providers that meet defined participation standards, similar to the traditional Medicare model, promote the medical home model, and eliminate lifetime caps on benefits.
- Have the ability to structure the provider rates to promote quality care, primary care, prevention, chronic care management, and good public health.
- Utilize the existing infrastructure of successful public programs like Medicare in order to maintain transparency and consumer protections for administering processes including payment systems, claims and appeals.
- Establish or negotiate rates with pharmaceutical companies, durable medical equipment providers, and other providers to achieve the lowest prices for consumers.
- Receive a level of subsidy and support that is no less than that received by private plans.
- Ensure premiums must be priced at the lowest levels possible, not tied to the rates of private insurance plans.
In conclusion, the public plan, like all other qualified plans, must redress historical disparities in underrepresented communities. It must provide a standard package of comprehensive benefits including dental, vision, mental health and prescription drug coverage with no pre-existing condition exclusions. It must limit cost-sharing so that there are no barriers to care, and incorporate up-to-date best practice models to improve quality and lower costs. All plans, including the public plan, must include coverage for evidence-based preventive health services at minimal or no co-pay. All plans, including the public plan, should be at least as transparent as traditional Medicare.
Good stuff, and if it holds it gives progressives crucial leverage in conference between the House and Senate--a rarity, but perhaps testament to the overwhelming desire to make real change in health care, finally. The list of 50 does include an Oregonian--Peter DeFazio. Obviously Greg Walden is not a member of the CPC, and I don't think David Wu and Mike Schrader are either. But Earl Blumenauer is, he of the bluest of blue districts in Oregon. Why is he not committed enough to reform to draw the same line as DeFazio? I decided to ask, and here is his quotable reply: Drawing lines in the sand can be a helpful political tool, but when you are working on the committee that is writing the bill and trying to make it better, it is not particularly useful. Having said that, Rep Blumenauer has always supported - and worked to advance - a public option, including bringing Gov. Howard Dean out to explain and promote the public plan. His stance remains that we need a public option to compete with private plans to make them more effective and more affordable, and he’ll do all he can to make this a reality in the bill that comes before Congress. If it were someone else giving us the "there has to be comity" line I might be suspicious, and I note that other members of Earl's Ways and Means Committee, like John Lewis and Xavier Bacerra, don't seem to have a problem with drawing those lines--but there's no indication that Blumenauer is anything but an active force for serious reform. If he'd rather not state flat out his obstinance before it's necessary, I suppose I can accept that. It is GREAT to have a bloc saying what they won't stand for, but all I truly demand from our representatives is clarity on what they WILL support, and on that Blumenauer has been pretty clear. (As if to punctuate that, his committee has just passed out a pretty strong version on a 23-18 vote, paid for in part with a surtax on very high incomes.) And over in the Senate, it looks like the insurance industry and the GOP have found some help in their quest to kill reform by slowing it down as much as possible. Six "centrist" lawmakers are urging a delay in a letter to Senate leadership. The usual suspects against reform are represented--Nelson, Landrieu, Lieberman, Snowe, Collins...and Ron Wyden. Of course they're professing that they are really FOR true reform; they're just concerned that the bills hammered out over months of debate are just moving too quickly for them to process. Their timeline is suspicious, however: Jake Thompson, Nelson's spokesman, said the message of the letter is to show support for the reform effort, not oppose it. "Sen. Nelson is firmly committed to comprehensive health reform this year and wants to take the time to get this historic legislation right," Thompson said. The gang of senators say in their letter that the testimony of the Congressional Budget Office Director Douglas Elmendorf on Thursday persuaded them that delay is needed. At that time, Elmendorf said that the current health care plans under consideration would not considerably reduce costs and would add to the debt burden, an analysis that omits cost savings from prevention or negotiating lower prices. But the timeline doesn't add up. Reid told the Huffington Post on Thursday that he had spoken to Nelson Wednesday night and Nelson told him he would be sending him a letter. The conversation took place before the budget director's testimony. Elmendorf's remarks, however, may have persuaded uncertain senators to sign on to the letter. With each passing day, it becomes more and more clear that Senator Wyden is NOT a friend of health care reform. Not satisfied with continuing to push a stalking horse bill for the GOP, he's now moved on to join notable Senators against reform in the effort to kill it entirely by slowing it to death. (Added--don't believe that's their plan? It's what conservative leaders are telling their cronies, in a Politico article released just today...) If before it seemed like Wyden was more interested in "bipartisanship" than getting a good bill, his tactics signal a potential shift to a more active role in the group that would like to see legislation hobbled. Which is highly disturbing, and deserves some explanation from the senior Senator. |
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