Saturday, October 31, 2009
NEW JERSEY GOVERNOR: This is just a very dirty, unfortunate race. The incumbent Democrat Jon Corzine is deeply unpopular, but he has managed to succesfully drag down the popularity of the Republican challenger Chris Christie. As a result, the race is a true toss-up. There's also the wild card of independent candidate Chris Daggett. Corzine has embraced President Obama, which may help him with African American and young voters. Christie has yet to really form a cohesive message, and he's proven to be a bit of a lackluster campaigner. The bottom line is that Jon Corzine SHOULD lose this race. He has not done a particularly good job managing the state, and he is a former Goldman Sachs executive, and they haven't exactly been winning many popularity contests recently. But I'm not sure Corzine WILL lose this race. A small majority of polls has shown Corzine with a slight lead. Two weeks ago I said Corzine had about a 45% chance of winning, I would up that to about 50/50. That race should keep us up pretty late on Tuesday night.
VIRGINIA GOVERNOR: This governor's race has become a disaster for Democrat Creigh Deeds. He made some curious comments separating himself from Obama, which will significantly hurt him with Democratic turnout and enthusiasm. Meanwhile, Republican Attorney General Bob McDonnell has recovered, pretty much completely, from a scandal involving his sexist graduate thesis. McDonnell has built up a healthy double digit lead in the polls, and he is looking poised to cruise into the Governor's mansion. Two weeks ago I gave Deeds a 35% chance of winning, which seems silly every time I see a new poll in this race. I'd say Deeds is down to about a 10% chance of winning.
NY23: This update New York race is the one that has shifted most massively in the past two weeks, and the momentum is now completely with Conservative Party candidate Doug Hoffman. In fact, today the Republican candidate, moderate assemblywoman Dede Scozzafava announced that she is suspending her campaign because she has no real chance to win. This is remarkable for a candidate who was leading the race two weeks ago. Conservative activists successfully propped up local accountant Hoffman, who has slowly but surely won the support of the Republican establishment. Many Republicans, including former Speaker Newt Gingrich, spent weeks criticizing Hoffman for jeopardizing the Republican's chance of winning. But when recent polls made it clear that Hoffman's supported greatly exceeded Scozzafava's, there wasn't any more reason to stick by a Republican in Name Only (RINO). Meanwhile, Bill Owens the Democrat had spent weeks strategizing how to beat Scozzafava, and now much change his entire message to defeat Hoffman. Recent polls show Hoffman and Owens pretty much tied, with Scozzafave a distant third. Hoffman will almost certainly benefit for Scozzafava suspending her campaign, so I will give him a slight advantage in this race. Also, liberals have to face it, the anti-Washington message is a good one right now, and I think it will remain a good one until the jobs picture improves. A Hoffman victory should not send the Democrats into a panic, but it should be a warning sign of an anti-Washington attitude that will hurt Democrats next year. Last entry, I had Scozzafava at a 50% chance of winning, Owens at 40%, and Hoffman at 10%. I was WAYYY off. I would say Hoffman has a 50% of winning, Owens 45% and Scozzafava 5% (it would quite a miracle of a suspended campaign was victorious).
CA10: Finally, there's the race in California's 10th district to replace Ellen Tauscher, who now works in the State Department. The Democratic Lieutenant Governor John Garamendi has high name recognition and is in a pretty Democratic district. This seems like a good recipe for victory. The Republican David Harmer, though, has hung tough, and according to the latest SurveyUSA poll, only trails Garamendi by 10 percentage points. The race is still Garamendi's to lose, and I don't expect that he will. Two weeks ago I had Garamendi as a 75% chance to win, and I would say that's still looking pretty good.
This could either be a very good election night for Republicans (if Christie and Hoffman win) or a decent, but unspectacular night for Democrats (if Corzine and Owens win). No matter what, Democrats will almost certainly lose a Governor's mansion, and that's never a good thing. Republican pundits will take any victories Tuesday night as a sign that the Democratic brand has fallen out of favor, that next year is going to be a landslide etc. As I said last time, I think that would be overlooking some key factors not related to the national environment. Still, the Republicans have a good shot at having their first decent election night since 2004, and trust me, they will relish the opportunity to take as much meaning from these races as possible.
The one thing this election MUST NOT do is scare moderate Democrats into opposing health care or other items on the Democratic agenda. That would be a horrible way to interpret these election results. In fact, how about Nancy Pelosi bans election coverage at the capital?
See you Monday!
Friday, October 30, 2009
On David Brooks' Column Today: It's just so infuriating that he can say with a straight face, "We need a commander who has a single-minded drive and ignores everything else" when we just had that with Bush and it failed spectacularly and that's the whole reason Obama was elected! He says that without even mentioning Bush and Cheney!!!!!! Trying to think of an analogy for that, it's hard to do because it's so outrageous.
Also a lot of ridiculous, unsourced, unsubstantiated, "Look it's obvious" talk about "Look, every serious person knows that we can win in Afghanistan". That's absurd.
That kind of column just reflects everything I hate about Washington and the Establishment and the Looks and it supposedly was what Obama was running against and why I supported him: that whole thing where you can be completely catastrophically wrong, and then just keep pretending you weren't wrong and make the same demands based on the same arguments even though they were totally discredited. A great thing about sports is that could never happen.
Reacting to news that the Public Option will charge higher premiums than private companies under the House bill: Ugh that's a real splash of cold water in the face. Shows why all the fuss over the public option is very minimally related to what it will actually do - as Ezra pointed out yesterday, it's symbolic for a big fight over Obama's Presidency. The Fix is right that we're lucky that Republicans are fighting on that and not on other things. On the other hand, liberals are fighting for this policy that won't do that much, and not for tax increases on the rich, or for making it cover more people, or for better economic recovery and job creation programs and unemployment insurance and public investment. It's weird watching how both party bases can go crazy over peripheral, symbolic things and then not seem to care at all about things they should care about, about what matters to real people. That is a big sin of the Democratic base, one that's gotten better recently, but still a problem. For example in my neighborhood yesterday I saw a young leftist wearing a "Close Guantanamo!" shirt. Fine, I agree, but there's so much passion around that issue but not around job creation. I know it's because it's a Moral issue with a capital M while job creation and effective social safety net programs are nuanced cost-benefit analyses, but they still matter a lot more.
On my contention that he had flipped-flopped on the Public Option, and then comments on how to create jobs:
The public option fight has become a huge proxy battle, whether that's appropriate or not, and substantively it still has some major advantages and is a very good thing - but it is unquestionably not as important as providing all Americans with affordable and effective health insurance, or with improving the job picture, the wage picture, the general sense of stability and security. I think that winning the public option fight is crucial for creating the political dynamic where we can effectively do more, all the things we need government to do, because it's become such a battle over whether government will actively help people, or will be unhelpful and only benefit corporations and the rich.
Clearly they are doing a lot, it's not like they're just doing nothing like Bush and Co., but it needs to be ramped up a great deal, whether it's credit card protection or student loans or aid to education or financial reform to stimulate lending and investment and on and on. I just don't trust that Geithner and Summers and the rest of the economic policy team really believe in moving the economy from its old shaky foundation into the New Foundation, an economy that provides security and opportunity for all Americans. So it's not just the specific policies, it's the whole mindset, who are we working for, what vision do we have, bigger picture goals, and then we figure out the tactics to make it happen.
Thursday, October 29, 2009
HEALTH CARE: In a dramatic ceremony in front of the front steps of the Capital, House Democrats unveiled the final version of health care reform, a product of months of negotiations that took place after three committees reported bills in July. You all probably know the most publicized details by now. The bill has a public option with rates to be negotiated individually with providers. It will set up a national health insurance exchange for those who don't get insurance through their employers, and it will offer subsidies for people who can't afford to pay. It will also expand the eligibility for Medicaid to 150% of poverty. The bill will be financed by savings in Medicare and through a surtax on individuals making above $500,000 and families that make over $1,000,000. Here are some great additions to the bill that mark major improvements from the original proposal in July:
- The bill is not only fully paid for, but it will actually reduce the deficit by over $104 billion over ten years. What happens after that (the so called out years) is unclear. A lot of these savings come from the decision to further expand Medicaid coverage, since it is cheaper to cover people under Medicaid than it is to subsidize private insurance. To be fair, some of these savings come from some creative accounting. For one, the bill doesn't include the "Doc Fix" which will come to the House floor as a separate $200 billion bill. Second, the bill does not adjust the surtax for inflation. This is potentially very dangerous, because in 20 years, $500,000 might be a middle-class income. Surely, Congress, like they do with the Alternative Minimum Tax, would pass a temporary fix.
- The bill includes a provision that forces insurance companies to spend 85% of their income on health services. This superb provision would be a great way to cut into egregious insurance company profits. I doubt it will pass the insurance-owned United States Senate.
- The best part about this bill, is that many great provisions will come into effect almost immediately. Not only will this be good for American families, but great politically for the Democratic party. Here is a full list of the provisions that will come into effect next year. As the Big Picture said, "talk about delivering!"
There are a couple of kinks to work out before we can start popping the corks. Representative Bart Stupak (D-MI) has been trying to round up 40 votes to block the rule for considering the bill if his abortion amendment isn't included. The bill currently forbids federal funding for abortions (per the provisions of the Hyde amendment) but Stupak is insisting that it bar any money from government subsidies by spent to terminate pregnancy. Stupak is still trying to strike a deal with the Democratic leadership, but whether he can is still unclear. Democrats will try to pass a rule restricting amendments to the bill, because if Stupak's anti-abortion amendment passed (and it probably would), many pro-choice Democrats would vote against the bill. Stupak better not ruin this. Talk to your Michigan colleague John Dingell, Bart! He's been trying to get this done for over 40 years!
The House GOP responded to the bill with the usual laments about how long the text is. "It's 1990 pages long! Noooooo!!! We're not gonna have enough time to read it!!!" First of all, they won't read it anyway. They are completely predisposed to opposing the bill. Second of all, it is written in legalese, so reading it wouldn't help any normal person understand it. Third, is this seriously the best they've got? At the GOP press conference today, there was zero discussion about the contents of the bill besides buzzwords like a "government takeover." When reporters asked Minority Leader Boehner if Republicans would offer an alternative, he said he didn't know, but that Republicans have "ideas." I'm sure you do have ideas, but why don't you write a bill, take into consideration all of the complications with writing difficult legislation, get it scored by the CBO, make some trade offs etc. It's easy to talk about having good ideas when you don't have to make an actual proposal.
The leadership plans to begin debate on the bill in the middle of next week. A final vote would occur Thursday at the earliest, but most likely early the following week. The bill isn't perfect. I wish the public option was based on Medicare rates. But this is an exciting day. The bill will cover 96 percent of all Americans, and it will probably pass the House of Representatives in the next two weeks. Not too shabby.
THE WHITE HOUSE: The other big news of the day is that the economy grew by 3.5% during the 3rd quarter. This news is a mixed blessing for the White House. They tried to use the number as evidence that the stimulus has worked. After all, this is the first quarter that the economy has grown in a year. On the other hand, it's possible that the good GDP numbers will feed into the narrative that Obama may have saved the economy for elites, but with unemployment still hovering at 10%, what has he done for the rest of us?
I'm also worried that when the government's stimulus programs start to wind down toward the end of this year and the beginning of 2010, GDP growth might be stunted. I hope that the government has the courage to extend stimulus programs, even if doing so isn't politically popular.
The President used an address to small business leaders to talk about the GDP numbers, and also to stress that the work of rescuing the economy is still largely unfinished. He spent the rest of the day meeting members of Congress, and the Minister Mentor of Singapore.
THE HOUSE: The House today passed the conference report on the Interior Appropriations bill. This conference report included a continuing resolution that will fund the federal government through December 18th while Congress finishes the remaining 7 appropriations bills that have yet to emerge. The conference report also includes extensions of various tax credits from the economic stimulus package. With completion of this conference report (as you'll see in the next section, it passed the Senate today as well), Congress has now finished 5 out of the 12 annual spending bills. The final vote in the House was 247-178, with 10 Republicans voting yes, and 15 Democrats voting no.
Later, the House passed a popular bill to improve programs providing loan access to small businesses. It passed easily by a vote of 389-32, with all no votes coming from the GOP. The House also approved a Republican motion to recommit by a vote of 372-149. The motion instructed the Small Business Administration to conduct studies on additional credit risk factors. All no votes on the motion came from Democrats. Prior to final passage, the House considered several amendments. The full list is available here.
THE SENATE: The Senate is STILL in a stalemate over a bill to extend unemployment benefits. Republicans are insisting on votes on unrelated amendments. They have thus far rejected Democratic unanimous consent requests to vote on the bill immediately. Democrats, for some reason, have not yet called a vote on a motion to proceed to the bill, even though the Senate voted to cut off debate on that motion. Bottom line: Because Senators are acting like babies, millions of Americans are not getting unemployment benefits. It really baffles me that Senators can be so self-absorbed. I guess we'll have to wait until next week to see this bill come up for a vote.
The Senate did have time to pass the Interior Appropriations bill conference report/continuing resolution. The final vote was 72-28, with no votes coming from 25 Republicans and Democrats Bayh (IN), Feingold (WI) and McCaskill (MO). Prior to a vote on final passage, the Senate voted 60-40 to waive the requirement that conference reports only contain legislation previously passed by both chambers. That vote fell strictly along party lines. As far as I know, this was the first vote all year where 100 Senators voted, and all of them voted along party lines. 60 votes were needed to waive the requirement.
Whew. That's it for a busy day in politics. Please leave us some comments and start a discussion.
Wednesday, October 28, 2009
HEALTH CARE: Speaker Nancy Pelosi is about ready to unveil the final version of the House health care bill. Tomorrow morning, Speaker Pelosi will present the bill to members of the Democratic caucus at 9am tomorrow, and then will hold a ceremony on the west front of the capital at 10am to unveil the bill to the general public. The bill is expected to include a public option based on negotiated rates. House leaders could not corral the vote for a public option based on Medicare rates. The bill will come with a preliminary cost estimate from the CBO, although a more formal estimate won't be available for several days. The leadership is expected to bring the bill to the floor late next week, with a vote possible early the following week.
The question now becomes whether progressive Democrats, who fought tooth and nail for a "robust" public option, can accept a watered down version. Early word is that they will suck it up and vote for it (according to sources at TPM). There was a time earlier this fall when it looked like there may not be any public option at all. So progressives can take some solace that it has made a comeback. They can also get whatever joy comes from losing a noble fight. The robust public option would have saved the government more money, and would have introduced more competition into the individual insurance market. Still, the watered down public option is no reason to oppose the bill. I suspect 20-25 Democrats will oppose the bill from the right, and almost certainly all 177 Republicans will oppose the bill. Therefore, the progressives have to stay on board for the bill to pass. Early indications are that they will.
Over in the Senate, the fallout continues over Senator Lieberman's declaration that he would support a filibuster for any bill that contains a public option. Democrats seem to be dismissing Lieberman, assuming that he is just trying to get attention (like always). Lieberman's nonsensical reasoning (that the public option is an entitlement program that will increase the deficit) will eventually be proven incorrect by the Congressional Budget Office. Maybe he'll change his mind then. In the meantime, the Senate is waiting for the CBO to officially score the bill. Since Senator Reid basically wrote the bill over the weekend, it will take CBO awhile to provide a cost estimate. Therefore, debate on the Senate floor could be put off for another week or two.
THE WHITE HOUSE: Today was a bit of a momentous day at the White House. For the first time ever, a President of the United States signed a piece of gay rights legislation. The Mathew Shepard Act, which was included in the Defense Authorization Bill, expands the definition of hate crimes to include those based on sexual orientation. The President proudly signed the bill in front of Shepard's family and members of Congress. The LGBT community will now turn its attention to other items on their agenda: a repeal of DADT, the Defense of Marriage Act, and the enactment of the Employer Non-Discrimination Act. Democrats should get all of these bills done in the next year, because they may never again have the political opportunity they have now with such large Democratic majorities in Congress.
The defense portion of the bill also contained some provisions worth celebrating, most notably the elimination of the F-22 fighter jet, an unnecessary weapon that was costing the government billions. Defense Secretary Robert Gates was present at the signing ceremony to tout the revised policies. He said that more cuts to unnecessary programs will come in next year's budget, which is superb.
THE SENATE: The Senate is at a standstill due to a ridiculous dispute over amendments to the unemployment compensation extension bill. Leaders could not agree on a list of amendments, so Republicans are letting 3o hours of mandatory debate time on the "motion to proceed" elapse before Senators can even consider the underlying bill. Republicans have insisted on voting on amendments dealing with ending the TARP program and ACORN (of course). I don't even care about the substance of these amendments, but they absolutely should not be used to hold unemployment compensation hostage. Democrats should be calling out this obstruction more forcefully.
By the same token, Democrats could solve this problem very easily. Let Republicans have votes on these amendments, and then BEAT the amendments.. We obviously have the votes to do so, but many Democratic Senators are scared of taking politically-risky votes that could be fodder for 30 second advertisements. And that, my friends, is why millions of struggling Americans face the threat of expiring unemployment insurance. Ugh, the United States Senate. Unless an agreement is reached tonight, Majority Leader Reid will force the Senate to vote on the motion to proceed after midnight tonight.
THE HOUSE: Not a lot of action today over in the House, just a few suspension bills. The House will work tomorrow on a small business tax credit measure (we'll bring you details tomorrow). Both chambers must pass a continuing resolution by the end of the week to prevent the government from shutting down. It looks like the House will pass its version either tomorrow or Friday. It's possibly that the continuing resolution will be packaged with the conference report for the Interior Appropriations bill.
That's it for tonight, see you tomorrow!
Tuesday, October 27, 2009
LIEBERMAN: The grassroots progressive community has found a new enemy. Actually, it has rediscovered one of its oldest and fiercest enemies. Today, Joe Lieberman, who promised when he ran for reelection in 2006 that he would support universal health care, said that he would vote to filibuster the Senate health care bill as it is currently written. He says he is inclined to vote for the cloture motion on the motion to proceed, so that the bill can come to the floor, but he is reserving the right to vote against shutting off debate on the bill itself. In other words, Lieberman is making no distinction between a procedural vote to move the bill forward, and the bill itself, a distinction he was happy to make in 2005 when he voted to cut off debate on a bankruptcy bill that he opposed.
Lieberman's reasons for opposing the bill are absolute baloney, and I say that with all due respect for the man. Here is his exact quote:
"I think a lot of people may think that the public option is free. It's not. It's going to cost the taxpayers and people who have health insurance now, and if it doesn't it's going to add terribly to the national debt...there's so much in this health reform legislation that is so good, that I think they're just putting an unnecessary burden on top of it by creating another Washington-based entitlement program."
Does Joe Lieberman know what the public option is? It will not cost the taxpayers one DIME because it will be funded like any other insurance plan, with customers paying premiums. Secondly, the Congressional Budget Office projects that the public option actually saves the government money, as much as $100 billion if it is based on Medicare payment rates. Finally, this is not an entitlement program! I can't even believe he said that. Again, people who use it will have to pay for it, and it will only be available to those who don't have health insurance through their employers, some 10% of the population.
Either he is just plain ignorant, or he's lying on behalf of the health insurance industry that is so prevalent in his state. Perhaps its both. Ezra Klein and others seem to think that once Lieberman is pushed around a little bit by members of his caucus, he won't get in the way of reform. I think there is some merit to that. He may just be positioning himself as an opponent to win whatever concessions he wants. Or he's still bitter about losing that primary to Ned Lamont in 2006. The bottom line is that the Democrats have such a small margin for error on health reform, that they have to rely on loons like Joe Lieberman. We shouldn't have to water down a perfectly good bill to win the support of people like Lieberman who have no clue what they're talking about.
Nate Silver sums this all up very well.
HEALTH CARE: Despite Lieberman's idiocy, Senator Reid is still planning on introducing the full health care bill in the next couple of days after he gets a cost estimate from the CBO. Over in the House, Majority Leader Hoyer said that Democrats will be ready to unveil their health care bill by Thursday. The caucus is still determining whether to include the "robust" public option, based on Medicare rates, or the watered down public option. Various reports indicate that Democrats don't have the votes for the former, and will therefore have to choose the latter, which won't make the liberal members happy, but probably won't cause many of them to vote against the bill. Either way, we're hearing that a decision will be made by the end of the day Thursday. Even if a bill comes to the floor late next week, a final vote may be pushed off members have enough time to debate the bill (or so we can save ourselves from Republican complaints about the process). We'll keep you posted.
THE WHITE HOUSE: The President made an unheralded by important announcement today in Florida that he is investing stimulus money into grants for smart electric grids (grids that produce "clean" electricity.) The President promised to create a "smarter, stronger and more secure electric grid" – and pledged to make clean energy "profitable." This may seem like an insignificant announcement, but it is the biggest investment ever in clean electricity grids. It's a reminder that however frustrated we can get with President Obama, he's still doing a lot of good things.
This evening, the President campaigned for Virginia Gubernatorial candidate Creigh Deeds who appears poised to get his clocked clean in next week's election. It makes you wonder whether Obama really wants to be a part of this likely political train wreck, though it seems like he made arrangements to campaign for Deeds before Republican Bob McDonnell surged to a large lead.
THE SENATE: The Senate today finally voted to proceed to consideration of a bill to extend unemployment. Democrats have been trying to pass this bill for weeks, but Republicans have held it up because they want to consider a bunch of unrelated amendments, including one dealing with ACORN (again!!). The Senate voted 87-13 to cut off debate on the motion to proceed to the bill. This means, that if Republicans are still bent on delaying action, we'll have to wait to vote on the actual motion to proceed to the bill, a motion to cut off debate on the bill itself, and then the bill itself. That could take the rest of the week if Republicans don't agree to any sort of time agreement. That agreement can only be reached through unanimous consent, which is impossible to get with so many crazy members on the Republican
The Senate is supposed to consider several other bills this week, including a continuing resolution.
THE HOUSE: Not much action in the House today. Members did vote for a Republican motion to instruct conferees on the Department of Interior Appropriations bill. No word on what this motion stipulated, but it's non-binding, so I tend not to occupy myself with it too much. The House also disposed of a few suspension bills. They'll move to more serious business tomorrow.
That's it for us tonight. Leave us some comments!!
Monday, October 26, 2009
HEALTH CARE: For months it has seemed unlikely that Senate Majority Leader Harry Reid (D-NV) could round up 60 votes for a health care bill with a public option. Today, Senator Reid boldly announced that he is bringing a bill to the floor with a public option, albeit one that has an opt-out provision for states that do not wish to offer the public plan. Senator Reid hasn't yet lined up 60 votes for this bill, but I think his bold move today was still very wise for a number of reasons. For one, it will energize the Democratic base, and will spur activists to make phone calls to wavering members of Congress. Two, it shows that Reid won't be cowered into doing whatever Senator Olympia Snowe (R-ME) wants, just because she was the one Republican who might support reform. In fact, Josh Marshall of TPM points out that though Snowe was critical of Reid's move, she did not say she is withdrawing her support of the bill! Finally, as Ezra Klein points out, it will force centrist Democrats to actively filibuster health care reform. If Reid waited around to try to corral 60 votes and came up short, centrists would never be in the awkward position of supporting a Republican filibuster of the crowning bill in the history of the Democratic party. Reid can afford to lose 9 Democratic votes on the actual bill if he can get 60 votes to break a Republican filibuster.
Reid has sent the bill to be scored by the Congressional Budget Office. As soon as tomorrow, Reid will officially release the bill. It's possible that debate could begin as soon as next week. Democrats almost certainly have enough votes for the first test, which will be a motion to invoke cloture on the motion to proceed. If Democrats get 60 votes on that procedural matter, debate on the bill can begin.
Over in the House, no news today on when we might see the unveiling of their health care bill. We should know more after the Democratic caucus meets tomorrow morning.
Once again, we're at the point in the process when floods of phone calls and emails really make a difference. Contact us in the comments section if you want to know which members you should be calling.
THE WHITE HOUSE: President Obama was in Florida today to talk with naval officers and their families. The President assured the troops that he won't jeopardize their safety by rushing into a decision about what to do in Afghanistan. It's very encouraging that the President isn't giving in to ridiculous GOP demands to make a hasty decision on Afghanistan. The President also used the occasion to express condolences to the troops who died this weekend in a helicopter crash.
THE HOUSE: The House had a quiet day voting on a couple of suspension bills. Interestingly, there were two votes congratulating college sports teams for winning national championships, and on each of these votes, only Rep. Berry (D-AR) voted no. Is he trying to take a principled stand against silly House resolutions? Maybe.
That's it for tonight. We'll see you tomorrow!
HEALTH CARE: Once again we'll be on the lookout this week for signs of progress on health care legislation in the House and Senate. On the House side, it's still unclear whether Speaker Pelosi has 218 votes for the "robust" public option, which would provide for reimbursements to providers at Medicare rates plus 5%. It appears that the public option itself may have 218 votes, but some members may vote against the bill for other reasons. That is why Congressional deal making is such an arduous, and frustrating process. If Pelosi can round up the votes in the next couple of days, she can send the bill for a final scoring to the Congressional Budget Office, and possibly call for a vote as early as next week. Speaker Pelosi has promised to allow members 72 hours to "read the bill" before voting.
It's possibly we could see a Senate bill unveiled this week as well. Numerous Democratic Senators claim that they are withing striking range of the 60 vote threshold on a bill that includes a national public option with a provision allowing states to opt-out. Rumors swirled that the White House was cool to this plan, because it might cause Emperor (Senator) Snowe (R-ME) to renege on her support of the bill. But if Majority Leader Reid (D-NV) can round up the votes for this proposal, the White House would certainly be thrilled and supportive.
It seems like most of the negotiation stories we hear in the media have been centering around the public option. Yet, there are still many areas where important work remains to be done. Most notably, Congress still has to choose how to pay for the bill. Both the House and the Senate bills are expected to squeeze $500 billion out of Medicare to pay for most of the bill. The House bill will likely raise about $300 billion in revenue by imposing a surtax on the wealthy, while the Senate will raise the same revenue through an excise tax on expensive insurance plans. I'm more supportive of a progressive tax on the wealthy, but if I were a betting man, I would guess that the excise tax (or something close to it) will eventually be the chief revenue source in the bill. Taxing expensive plans would encourage employers and individuals to seek lower cost plans, which would help bend the cost curve of health expenses in the long-run.
Of course, we'll keep you fully up-to-date on the health care bills as they meander through Congress.
THE WHITE HOUSE: The President starts his week with a key meeting on Afghanistan. As if the President didn't have enough to worry about here at home, both Iraq and Afghanistan suffered major tragedies this weekend. A bombing of government buildings in Iraq killed 147, and helicopter crashes in Afghanistan killed 14 American soldiers. Today's meeting will be another in a series of "Af-Pak" strategy sessions with the national security team. Earlier this weekend, the Pentagon conducted war exercises to try and gauge the impact of sending additional troops to Afghanistan. Under one scenario, the Pentagon tested sending 44,000 troops to mount a major full-scale counter-insurgency effort. This would be a plan in line with the recommendation by General Stanley McCrystal. The Pentagon also tested a scenario in which 10-15,000 troops were sent over for a more limited counter-insurgency mission. I don't know much about military affairs, but I wonder if these exercises are reliable predictors of what might happen. I sure hope so.
The President then travels to Florida today for a series of events. This afternoon, the President will address service members in Jacksonville. Tonight, he will attend a fundraiser for Congressional Democrats. Tomorrow, the President will make a major announcement on a new "smart grid" electricity initiative under the stimulus package. He then travels to Virginia to campaign (most likely in vain) for Democrat Creigh Deeds, who is trailing badly in next week's Gubernatorial election.
Later in the week, we could see a very important announcement on a new Presidential proposal to deal with financial institutions that are "too big to fail." We'll give you details on this proposal when it comes out.
THE HOUSE: The House will consider suspension bills today and tomorrow. On Wednesday, the House will consider a bill to improve access to capital for small businesses. We usually see small business legislation every couple of weeks in the House, as members try to keep up their pro-small business bona fides. I expect this bill to pass easily, as it should. Next up is a conference report on the Department of Interior Appropriations bill. This would be the 5th of 12 appropriations bills to be conferenced and sent to President Obama. Because there are so many outstanding appropriations bills, the House will vote on a continuing resolution Friday to fund the federal government past the October 31st deadline (a deadline imposed by the last continuing resolution, which passed in September).
THE SENATE: The Senate's schedule is far more ambitious than it should be, given the snail-like pace the Senate has moved at since it came back from the August recess. Tomorrow, the Senate will vote to cut off debate on a measure to extend unemployment benefits. The House already passed an extension in September. The debate is not really on the extension itself, but whether it will be offset by spending cuts in other programs. I hope Congress acts on an extension quickly, because there could be nothing more crushing during a recession for families than running out of unemployment benefits through no fault of their own.
Next, the Senate will try to finish two appropriations bills by the end of the week, which I would say has about a 10% chance of happening. The Commerce, Justice and Related Agencies bill will come up first, followed by the Military Construction and Veterans Affairs bill. If the Senate can somehow finish these two bills this week, they will have completed their version of 10 out of the 12 appropriations bills. Finally, the Senate will concur with the continuing resolution as soon as the House completes its work Thursday or Friday.
That's it for now, see you tonight!
Thursday, October 22, 2009
HEALTH CARE: There was buzz all day about a possible Senate deal on a health care bill. ABCNews reported this afternoon that Majority Leader Reid thinks he has the 60 votes to cut off debate on a bill with a public option. The way Reid envisions it, the bill would come to the floor with a public option. Someone would propose an amendment on the floor to strip out the public option. The amendment would fail, because it would not reach the 60 vote threshold. The amendment would give wary centrist Democrats to go on record against the public option. Democrats would then promise to vote to invoke cloture on the bill, which would end the filibuster. As many as 9 Democrats would be able to oppose the final bill. I thought this scenario seemed too good to be true, and it might. Apparently Senator Baucus, who all summer whined about how there weren't enough votes for the public option, apparently freaked out about the deal because it could cost the support of President, I mean Senator Olympia Snowe of Maine, the one Congressional Republican who has supported a health care bill in committee. Snowe seemed to indicate that she would not vote to cut off debate on a bill with a public option. Then there was Senator Mary Landrieu (D-LA) who said that she was against the public option, using the patently false reasoning that it would add to the federal deficit (it actually SAVES money, Mary!). Then there are moderates like Kent Conrad, Blanche Lincoln, Ben Nelson, Evan Bayh and Joe Lieberman who routinely hold up bills so that they can get some time in the limelight and inevitably make the bill worse. Amazingly, none of them have thus far said explicitly that would help sustain a Republican filibuster.
The reason the public option might survive in the Senate is because of the so-called "opt-out" compromise. The plan being discussed would allow state governments to opt out of the public option. The Senate public option, unlike the House plan currently under consideration, would negotiate reimbursement rates directly with providers instead of using rates based on Medicare. The hope is that Senator Reid has come up with a compromise that can satisfy both centrist and liberal Democratic Senators. This "compromise" is so fragile and seems to be changing by the minute. We're still forced to rely on Senators bought and paid for by the health insurance industry, and centrists who care more about their own egos than sound policy. But I hold a shred of new hope today that we can get a public option out of the United States Senate.
Meanwhile, the House negotiations seem to be equally uncertain. Despite reports yesterday that Speaker Pelosi had just about enough votes to pass the "robust" public option based on Medicare rates, the situation seems pretty fluid. A group of 37 "moderates" wrote a stupid letter expressing concern that the bill does not do enough to bend the cost curve, and that they might withhold their votes. The House bill does indeed reduce the deficit, but since it does not contain a tax on high-end health care plans, it may not do as much to bend the cost curve in the long-term. Still, Democrats need to STOP writing these idiotic letters that throw stakes in the momentum of health care legislation. Listen to the President, and get this done. This is not a time to show bluster, to bloviate or to try and get some time on cable news networks. We've come too far. I say, we follow the advice Dick Cheney gave to centrist Republicans when Bush first came into office: "don't f*ck this up."
The Big Picture rightly points out that this is the time when the President desperately needs to get involved. He needs to throw his weight around both in public and behind closed doors. We're within a couple of weeks of seeing bills come to the floor of the House and Senate. It's crunch time.
THE SENATE: The United States Senate today passed the conference report for the Defense Authorization Act by a vote of 68-29. The Senate had hours before voted 64-35 to cut off debate. The bill sets defense policy for Fiscal Year 2010, and includes some very positive provisions, like a pay increase for the troops and the elimination of the F-22 fighter jets that are not used in combat. Perhaps most importantly for progressives, the bill included a non-related policy rider that expands the definition of hate crimes to include sexual orientation. Because the Senate acted today, President Obama will sign the first piece of gay rights legislation pretty much ever. There is a lot of work left to do, but today is a day for LGBT activists to pat themselves on the back. Most Republicans, by the way, are willing to vote against funding increases for the troops to protect the rights of anti-gay criminals. Ladies and Gentleman, your 2009 Republican party!
All Democrats besides Feingold (WI) voted for the conference report. Feingold probably voted against the bill because it authorizes war funding for Iraq and Afghanistan. Republicans Collins (ME), Lugar (IN), Murkowski (AK), Snowe (ME), and Voinovich (OH) voted for the conference report itself, and to cut off debate. Republicans Bond (MO), Cornyn (TX), Ensign (NV), Gregg (NH) and McCain (AZ) voted yes on final passage. President Obama will likely sign the bill in the coming week.
The Senate will work next week on two appropriations bills (they have 4 left to pass), a bill to extend unemployment benefits, and a continuing resolution.
THE HOUSE: The House passed a good bill today that expands research and development of solar energy. The bill passed by a bipartisan 310-106 margin with all no votes coming from the GOP. Prior to a vote on final passage, the House voted on several amendments, all of them passing easily except one from Rep. Broun (GA) that would have reduced funding in the bill. Add this to the giant pile of good legislation that is bound to die in the United States Senate.
The House tomorrow will finish work on a Coast Guard Authorization bill tomorrow.
That's it for today. See you tomorrow!
Wednesday, October 21, 2009
HEALTH CARE: As we mentioned last night, House Speaker Nancy Pelosi is nearing the 218 votes she needs to move a "robust" public option through the chamber early next month. The "robust" public option would allow the government to reimburse providers at Medicare rates plus 5 percent, and would save the government money over the next ten years. The Big Picture gave a very good analysis as to why the prospect of the public option has such renewed enthusiasm:
In the past few days I've changed my opinion from what Ezra Klein was saying (and I think Ezra has too) that the public option isn't the most important thing in this debate. On a purely substantive note, it's still true that we can't ignore or belittle covering millions of uninsured. But, two major points:
1) It seems so clear that the only way the bill can fulfill Obama's stated objectives of a) covering almost everyone, b) individual mandate, c) health insurance being affordable for all Americans, and d) bringing down the overall cost of health care and the cost to the government - is through the public option. That's the only way to square the circle. And it's why Republicans and centrists have created this insane game where they keep complaining that the bill doesn't do enough to make it affordable and hold down costs and cover enough people, but then are ideologically opposed to the only way to do that - the public option. Obama has GOT to call them out on this hypocrisy. It should be so easy. You just have to make that argument to the American people in terms that are easily understood.
2) Whatever the substance, it's very clear that this public option battle is THE battle for the direction of Obama's Presidency and the Democratic Party and in fact the country right now. THE ideological battle. Obama and co. can't keep trying to shoo it away - I generally agree with the "pick your battles carefully" theory, but in this case, this battle has become symbolic for what philosophy, and what groups, are going to hold sway. If we win here, it will embolden liberals. If we lose, it will embolden conservatives and big business. I think it's a real fork-in-the-road moment for the Obama Presidency. That has been created by the tireless effort of the liberal base - endlessly derided by Rahm and Co. - to not let this go away, and by Anthony Weiner and Raul Grijalva and now Nancy Pelosi to force this using the power they have. If we prevail here, it will set a tremendous tone for the rest of Obama's Presidency, it will embolden the liberal wing of the Democratic Party to set the agenda. If we lose it, we will be marginalized, shown to be weak when it really counted. This is about a lot more than the public option itself: it's about the role of government, the position of Obama and the Democratic Party, and which philosophy and which wing has the true power at the end of the day. The true litmus test.
And my response:
I mostly agree with you on these points. I think you would concur that we should not let a weak public option, or even the lack of a public option, bring down reform. But I think the recent CBO estimates have given new ammunition to the public option. I think the concept was really nebulous for awhile, but it has now become abundantly clear:
-allow people to buy into a Medicare-like program if you are under 65. The program will have low overhead costs, meaning it will be cheaper to consumers. This will force private companies to compete by offering lower prices or better services, which will in turn bring down the cost of health care for consumers, businesses and the government.
Obama was mostly right when he said that the public option is only a means to an end. If there were a better way to achieve these objectives, we should look into them. But objective analysis has clearly shown that only the public option, and particularly one based on Medicare rates (plus 5) can get us where we need to be.
You are right on though with the larger political considerations of the public option battle. I think the stakes are indeed that high, and we need to win on this.
What I think all of us need to do is to call a Blue Dog office and ask:
1. Do you believe in fiscal responsibility and reducing the deficit?
2. Do you believe in providing health coverage to as many people as possible?
3. Do you think the Congressional Budget Office is a reliable non-partisan source?
If they answer yes to all three, you have gotten them to admit that a public option based on Medicare rates is the right policy.
Just some food for thought on a day when there was little in the way of health care news.
THE SENATE: It was a surprisingly busy, though not terribly successful, day in the United States Senate. Majority Leader Reid tried to bring up a bill that would stop a scheduled pay cut to doctors under Medicare. The so-called "doc fix" is necessary because in 1997, Congress tried to cut the growth of Medicare by scheduling pay cuts based on the performance of the economy. Of course, Congress would never actually have the political courage to enact these cuts, so each year they would pass a temporary fix. This year, Democrats wanted to solve this problem once and for all by paying for the fix over the next ten years. This would have added $250 billion to the deficit, which knocked the socks off Republicans and conservative Democrats. Funny, I don't remember this deficit obsession when the $1.35 trillion Bush tax cuts passed!! Anyways, Senator Reid called a test vote today, called "motion to proceed." To cut off debate on such a motion, you need 60 votes, which gives a good indication of how many votes would be lined up on the bill itself. The effort failed miserably. Only 47 Senators voted yes, all Democrats, while 53 Senators voted no. Democratic defectors were Bayh (IN), Byrd (WV), Conrad (ND), Dorgan (ND), Feingold (WI), Kohl (WI), Lieberman (CT), McCaskill (MO), Nelson (FL), Tester (MT), Webb (VA) and Wyden (OR). Democrats will need to pass a temporary fix before the end of the year, or find a way to offset the spending.
Tomorrow, the Senate will vote on the Defense Authorization conference report, which contains the LGBT hate crimes bill. The House passed the measure a couple of weeks ago. The Senate's concurrence would send the bill to President Obama.
We don't need a full section for the House today, they just dealt with some suspension bills. They are on to substantive legislation tomorrow.
THE WHITE HOUSE: The big news out of the White House today was that the "pay czar" has decided to limit bonuses to executives of companies that received the most bailout money. This move comes after a week or so of populist outrage at executive compensation that was unearned. Count me as a supporter of this move. Politically at least, the further away Obama distances himself from the financial companies, the better.
The President also went to New Jersey today to campaign for embattled Governor Jon Corzine who is in a tight race in a couple of weeks. The results of this race, and the more difficult one in Virginia, will be a good (though not complete) picture of Obama's coattail power.
That's it for tonight, see you tomorrow!
Tuesday, October 20, 2009
HEALTH CARE: Could it be that we are seeing some movement on health care legislation in the House and Senate? Word out tonight is that House Speaker Pelosi is planning on bringing a bill with the "robust" public option to the House floor, most likely during the first week in November. Her decision is pending ratification by the full Democratic caucus this evening. This is fantastic news for progressives. The so-called "robust" public option is based on Medicare rates plus 5 percent. It is projected to save the government as much as $80 billion over ten years, and thus should theoretically prove attractive to fiscal conservatives. Blue Dogs and other rural Democrats have fought this version of the public option vociferously, complaining that reimbursement rates will short change rural doctors and hospitals. Their arguments have been undermined by cost estimates. Most of them have made a religion out of cost savings, and it would be hypocritical for them to oppose a bill that saves the government more money.
The question, of course, is whether such a bill could muster 218 votes on the House floor. I don't think Pelosi would be bringing it to the floor if it couldn't get a majority. My guess is that several Democrats from moderate districts have calmed down from the chaos of the August recess and are more open to seeing this whole effort through. Also, Pelosi is most likely angry that the Blue Dogs, like Rep. Mike Ross of Arkansas, backed away from hard-fought deals negotiated over the summer. A bill with a robust public option would not garner any Republican support, for sure. It would probably force the Democrats to scrap out the bare minimum of votes to pass the bill. But it would position the whole debate further to left as House and Senate leaders reconcile the bills in conference.
Meanwhile, Senator Reid claimed that his "Gang of 3" (Himself, Senator Dodd and Senator Baucus) have not decided whether to include the public option in the bill that comes to the Senate floor. Senator Reid says that he'll have something to send to the Congressional Budget Office shortly for a cost estimate.
THE SENATE: The Senate today agreed to the conference report to the Homeland Security Appropriations bill. Attached to this bill is a new rule allowing Guantanamo detainees to be tried in the U.S. That provision, and increased spending levels, caused 19 Senators to vote no. Democrat Bayh (IN) joined 18 Republicans in opposition. The bill has been agreed to by the House and will now be sent to President Obama for his signature. For those of you scoring at home, that's 4 of 12 appropriations bills that have now been sent to the President. It looks like some of the other bills will have to be packaged together in an "omnibus bill" if we want to get the appropriations process finished by the end of the year. The Senate has still not passed 4 appropriations bills, and time is quickly running out.
The Senate is now trying to break a logjam on a bill that fixes a schedule pay cut to doctors under Medicare. Several Democrats have come out in opposition to the fix, because it would not be paid for. House Majority Leader Hoyer, an ally of fiscally conservative Blue Dogs in both chambers, says that the bill must be paid for in order to pass the House. Members will have to find money from somewhere though, and any savings that can possibly be eked out of the current health care system have already been included in the various reform bills.
There's also the wonderful irony that Republicans, who have been telling the American people all year that they will protect their Medicare, are helping to hold up a bill that stops scheduled funding cuts to Medicare.
THE HOUSE: It was another quiet day in the House, with only a few suspension bills being considered. Majority Leader Hoyer blames the House's light recent schedule on the Senate, which has not acted on several House-passed pieces of legislation. He is 100% correct.
THE WHITE HOUSE: The President this morning met with the Prime Minister of Iraq, Nouri al-Maliki. We sure haven't heard much about that war recently. Obama then flew to New York, first for a meeting with the Joint Terrorism Task Force, and then to hold a fundraiser for Democratic candidates. Obama struck a feisty tone at tonight's event, as he has done at recent fundraisers, accusing his Republican opponents of rooting for him to fail.
Yes, they are. Ignore them and get things done.
Monday, October 19, 2009
THE SENATE: If it weren't for the United States Senate, we would have already passed a Cap and Trade bill, a comprehensive education measure, a food safety bill and all of the 2010 spending measures. Unfortunately, our founding fathers decided that the people's will couldn't be trusted, and left the fate of our country in the hands of a fundamentally undemocratic institution. Today, I read an article that proved to be a great example of why the Senate is so bad. The House earlier this year passed a measure that would end government subsidies to private student loan companies. The immense savings achieved by ending this program would be redirected to key education programs. Because of the budget resolution passed in April, Democrats have the ability to bring this bill up in the Senate under reconciliation procedures, which would only require 50 votes for passage. The chairman of the Senate HELP committee, Tom Harkin (IA), has been trying to get the bill out of the committee and to the Senate floor. But alas, "centrist" Senators have crowed in opposition. Ben Nelson of Nebraska is against the bill because he just "doesn't think we should turn this over to the federal government." I'm sure it has nothing to do with the fact that a major student loan company, NelNet is based in Nebraska. Senator Arlen Specter, who has has Sallie Mae in his home state of Pennsylvania, says he's worried about the 2,200 people in his state who work for the student loan industry. As The Big Picture points out, what about the MILLIONS who would benefit from more educational opportunities? What about the fact that we could have a more educated workforce that would increase productivity? We're seriously worried about 2,200 student loan jobs???
Several other Senators are actually worried that the bill doesn't save ENOUGH money, even though the Congressional Budget Office says it will save the government $87 billion over ten years. All of these Senators have voted for bills that have significantly reduced the deficit.
Several of these fiscal hawks, as The Hill is reporting, are the very people demanding that the health care bill be more generous in payments to rural doctors. Fiscal responsibility is great, but only when it doesn't hurt YOUR state.
A good democracy requires that politicians be motivated by what's best for their constituents. A functioning democracy is one where politicians are motivated by getting reelected. At the very least, they must be in tune with what their constituents are thinking and feeling. A bad democracy is one where politicians are primarily concerned with money and parochial interests. The United States Senate is conducive to these bad politicians. Senators are only up for reelection every six years, meaning they don't have to always be in tune with the needs of their constituents. Also, small states give disproportionate voice to certain groups of people, like student loan executives (aren't they all in the plain states and Delaware?), farmers and white people.
If Obama wants to enact change, he will need to figure out a way to beat the institutional roadblock of the United States Senate. It won't be easy.
That's it for a short entry tonight. Neither House of Congress was in session today, they'll be back tomorrow. We'll see you then.
ACTION??: The key to this week will be watching for any movement on three key items on the President's plate: health care, Afghanistan and financial regulation reform. Sadly, though, I think it's unlikely that we'll see significant action on any of these items by Friday. Each issue is in a bit of a holding pattern. Let's go one by one:
-Health care negotiations have moved exclusively to the back rooms of Congress. In the Senate, Senators Reid, Baucus and Dodd will meet again today to try and merge the HELP and Finance bills into something that can be brought to the full Senate. Baucus (D-MT), the chairman of the Finance Committee, thinks he has the upper hand in these negotiations, because his plan lowers the deficit and garnered a Republican vote. But if we wanted to lower the deficit and gain Republican votes, we would cut discretionary spending across the board. That's not what we're in this for. Dodd's bill expands coverage to more people, offers more generous subsidies, and includes a public option to compete with private insurers. Dodd is pushing Reid to include some version of the public option in the bill, because it will be difficult to attain the 60 votes to include it during the amendment process. Baucus thinks that the public option may jeopardize his hard fought compromise in the Finance committee. These negotiations are tough enough that I don't expect much movement before the beginning of November.
Meanwhile, we've heard very little about negotiations in the House. Speaker Pelosi sent two proposals to be scored by the CBO last week. One of them had the "robust" public option with payment based on Medicare rates, and the other had a public option with rates that would be negotiated with providers. As expected, the robust public option saved more money. But it is still unclear whether Pelosi has enough votes for this robust public option. The timetable for the House to pass its bill has moved to November as well.
-The future of U.S. policy in Afghanistan will probably be put off for another week as President Obama continues to discuss a change in strategy with his national security team. Pressure has increased among Republicans to send more troops, while liberal Democrats are calling for a scaled back strategy that focuses on targeting Al Qaeda. It appears as if the President will indeed by adding more troops to the region, but how many isn't exactly clear, nor is it clear while they will be fighting a more limited mission. The President, as we've said before, is wise to think this through as much as possible. Yesterday, Rahm Emanuel said that a decision would wait until the disputed Presidential election there is solved.
-Since news came out that companies receiving bailout money are doling out huge bonuses this year, we've started to see signs of increased healthy populist rage. The administration is trying to harness that rage into constructive financial reform. A very solid reform bill, which included the creation of the all-important consumer protection agency, passed the House Financial Services next week. However, with health care still looming on the Congressional calendar, it's unclear whether we'll see financial reform get done this year. I think such reform is critically important. The President has spent a lot of political capital helping out bad actors. He needs to earn that capital back by making sure we never have a financial crisis like this again. With unemployment hovering around 10%, people are rightly skeptical as to whether the government's intervention has helped them, or only the elites that got us into this mess in the first place.
THE WHITE HOUSE: The President today meets with the winners of the Youth Entrepreneurship winners (whatever that is), before huddling with North Dakota Democratic Senator Kent Conrad. Conrad has been one of the biggest Senate skeptics of the public option, and an advocate of co-ops, which the Congressional Budget Office says will not do much to bring down costs or increase access. As far as I can see, the rest of the President's week consists of meetings with senior advisers and fundraisers for Democratic candidates, including embattled New Jersey Governor Jon Corzine, Massachusetts Governor Deval Patrick and Senator Chris Dodd (D-CT).
THE SENATE: A big fight is ramping up in the Senate this week over Medicare reimbursements. Reimbursements to some doctors are scheduled to be cut in the near future unless Congress acts to maintain current reimbursement levels. Ideally, this effort would be a part of health reform. However, it costs about $270 billion over ten years, so including this provision would keep the bill from being deficit neutral. Republicans are complaining that this is a snide move by Democrats to slip this spending in as a stand-alone measure. But after a summer of accusing Democrats of wanting to cut Medicare, are Republicans really willing to let these reimbursement cuts go into effect? We'll see when the Senate votes on the proposal tomorrow. After that, I expect more work on appropriations bills.
THE HOUSE: The House will work on suspension bills tomorrow and Wednesday. On Thursday, the House will consider a bill to increase funding for solar technology. The bill will direct the Secretary of Energy to start research and development programs to enhance solar energy. Sounds like a good idea to me. I expect the bill to pass easily.
The House will then vote on a bill to reauthorize Coast Guard programs for 2010.
That's it for now, stay with us this week for your politics fix.
Thursday, October 15, 2009
HEALTH CARE: Now that all five committees of jurisdiction have passed health care bills, every days just seems to bring more confusion as to what the end game is going to be. Not only do we need to come up with a balanced bill in both chambers of Congress that can win 218 votes in the House and 60 votes in the Senate, but we have to rely on some, well, unreliable people to get it done. Take the case of Mike Ross, House Democrat from Arkansas. Ross led a revolt among Blue Dog Democrats on the Energy and Commerce committee against a public option with rates tied to Medicare, because he thought it would cause underpayments to rural hospitals. Now he says that he wants the bill to open Medicare as an option for everyone. This is just a text book intellectual inconsistency. There's Senator Ben Nelson of Nebraska, who has not commented on one single policy contained in the bill, and has instead used football metaphors to describe how far the Senate is in the process of crafting legislation.
Then there is the so-called "Gang of Three." Majority Leader Reid (D-NV), Chris Dodd (D-CT) and Max Baucus (D-MT) are working behind closed doors to meld the Senate HELP and Finance Committee bills. No one quite knows what's going on behind these doors, and no one really understands the motivation of these three men. Reid and Dodd both face tough reelection fights next year, so they may be more concerned with their political future than crafting a good health care bill. And Baucus worked so hard to secure the support of Republican Olympia Snowe that he may be overly concerned with adhering to her demands. Basically, not only is this debate dealing with extraordinarily complicated policy measures, it also involves complex political actors with varying levels of intelligence and integrity.
THE WHITE HOUSE: The President today was in New Orleans for the first time of his Presidency. He went to two town hall meetings to talk about rebuilding the city after Hurricane Katrina. The President was very well received, despite the fact that he has not acted thus far to expedite rebuilding efforts. The crowd booed when the President pointed out Louisiana Governor Bobby Jindal (R-LA). Jindal, as you recall, gave that awful rebuttal to Obama's address to Congress in February. Obama chose to defend Jindal, a major nihilistic stimulus skeptic. The President also gave a shout out to Rep. Joseph Cao, the only House Republican I could see voting yes on health reform.
THE HOUSE: It was a busy day in the House today. Members approved the conference report on the Homeland Security Appropriations Bill by a vote of 307-114. 63 Republicans voted yes, while 6 Democrats voted no. The bill includes a provision to allow Guantanamo Detainees to be tried in U.S. courts, which drew howls from Republican lawmakers. The conference report now goes to the Senate, where it will be approved presumably in the next 1 to 8 weeks or so, judging by how fast the Senate usually handles these things. For those of you keeping score at home, the House has passed 4 appropriations conference reports, while the Senate has approved to. All 12 of the appropriations bills must be approved before the continuing resolution expires on October 31st. The Senate still hasn't approved their own versions of four of these bills, so I expect we'll see yet another continuing resolution.
The House also approved the Bay Area Regional Water Recycling Program Extension. This bill extends authorization for a program that provides for recycled water systems, like for example, using somewhat dirty water obtained at a sewage treatment plant to water vegetation. I like it. The bill passed by a vote of 241-173. 6 Republicans voted yes and 10 Democrats voted no. The House will move next week to a solar energy bill, and a Coast Guart Authorization Act.
THE SENATE: The Senate took one vote today, approving the Energy and Water Development Appropriations c by a vote of 80-17. All no votes came from Republicans, except for Senators Bayh (IN) and McCaskill (MO). The bill now heads to President Obama's desk for his signature. The Senate will vote next week on a bill to prevent a pay cut to Medicare doctors.
That's just about it for today, see you Monday and have a great weekend!
Wednesday, October 14, 2009
The Top Ten Things Worth Fighting For
MORE FROM THIS AUTHOR
It’s been almost a hundred years since progressives began the campaign to make health care a right. And never before has the campaign come this far. Five congressional committees have now had their say about health care reform. And, as of Tuesday afternoon, all five have said “aye.”
At this point, passage and enactment of health care reform seems not just likely but very likely. Barring unforeseen calamity, insiders say it should all be done by New Year’s and, just maybe, Thanksgiving, although the president’s trip to Asia in November could slow things down.
But if it’s hard to imagine a scenario under which health reform falls apart, it’s not hard to imagine a scenario under which health reform turns out to be something that makes reformers wince.
In order to get legislation out of the Finance Committee with not just Democrats but one precious Republican vote as well, chairman Max Baucus had to make many compromises. He had to deliver a bill that would spend no more than $900 billion, because his committee members wouldn’t support the revenue and savings measures necessary to spend more. As readers of this space know, that meant reducing what the bill provided--covering fewer people and promising those who are covered lesser insurance--at least relative to the promises made by three House committees and the Senate Health, Education, Labor, and Pensions (HELP) Committees in the summer.
To be sure, the Finance bill has its virtues. Alone among the measures going through Congress, the Baucus bill is projected to reduce federal expenditures relative to current projections, both in the immediate ten-year planning window and beyond.
The projections come from the Congressional Budget Office, which, like any group of well-intentioned experts, could be wrong. I still think CBO didn't give enough credit on cost savings to the House bill. But most experts seem to think that the Finance bill’s chances of bending the curve are better than those of its counterparts. And that seems like a reasonable judgment.
As deliberations continue, in the floor debate and eventually in the House-Senate conference committee, the question is how these bills will come together. The best case scenario is that we get the best of both approaches--the far-reaching coverage and insurance reforms in the House and HELP bills, combined with the CBO-certified cost control of Finance. The worst case is that we get cost control like House and HELP, with coverage that looks like Finance.
As a friend recently suggested to me, the choices are best understood in the language of grade school math. Will we get the union of the two approaches--or the intersection?
The former could be pretty good. The latter? A serious disappointment.
Most likely, of course, we’ll get something in between, worse than the best-case scenario and better than the worst. And that raises a question: What elements of reform are most important at this point? What needs fixing--and saving?
Below is my list of priorities, for whatever that is worth. (Click here for another wish list, from Timothy Jost.) Each one is somewhere within the universe of political possibility, at least according to the administration and Capitol Hill sources I consulted. But that's only if you consider the priorities individually. Getting Congress to embrace many of them, let alone all, seems highly unlikely.
1. Increase the subsidies. The House and HELP bill have sliding scale subsidies that extend to people making up to four times the poverty line, or about $88,000 a year for a family of four. Finance’s bill stops the subsidies at three times the poverty level, although there’s some assistance above it, and offers less help to even those who still qualify. This is a strength of the House and HELP bill and might, in theory, seem like an easy thing to save, since virtually everybody says they worry about reform not making insurance sufficiently affordable. But more subsidies require more money. The options are out there: A tax on sugary sodas, the House's millionaire surcharge, or President Obama's proposal to cap charitable deductions. But it's when you start talking taxes than the centrists start backing away from the table.
2. Bolster the protection against high expenses. There’s no reason anybody should face out-of-pocket expenses of more than a few thousand dollars. The House and HELP bills come closer to meeting this standard, although even the protection even in those bills could stand some improvement. This, too, is not so controversial in theory. Everybody, left and right, wants insurance that protects people. But establishing a higher baseline of protection will--like more subsidies--require more funding, to subsidize the more generous insurance. That's really where the challenge lies. There may be a way out of this. If you give insurers leeways for slightly higher deductibles, the money that frees up is enough to require much tighter limits on overall out-of-pocket spending. Or so I am told. It'd be better, though, just to come up with more money.
3. Get tough with providers and producers. Both the drug industry and the hospital industry got sweetheart deals. And since the White House was a party to these agreements, rewriting them may not possible, or at least politically realistic. But there may be chances to tweak them and, if so, Congress should take them. Under the current deal, it doesn’t appear either the drug industry or the hospitals will actually be giving up much revenue; if anything, they might come out ahead. Surely it makes sense to ask them for a larger financial sacrifice, particularly if it can be done in a way that fosters more efficient care that would help reduce overall health care spending down the road. Remember, the most important aspect of these deals isn't the cash it frees up in the short term but the behavior changes it fosters in the long run. By the way, while Congress is at it, it might want to look at the other key industry groups--namely, doctors and device-makers.
4. Get a public plan (or something that serves the same purpose). Passing a fully fledged public plan, the kind that has all of the bargaining power that its architects originally envisioned, still seems like a long shot. The Senate votes just aren’t there. But idea of a public plan, or something like it, is definitely getting a second look from lawmakers who once dismissed the idea out of hand. The reasons are pretty simple: The idea continues to poll well, at least in isolation, and it eases anxiety about the requirement that everybody get insurance. The most likely scenario, I continue to think, is to arrive at some sort of trigger. But a well-designed trigger might still do some good. The key is designing one that would actually scare insurers, enough to make them provide the kind of affordable coverage we all want.
5. Strengthen the exchanges. The House doesn’t get much credit for this, but it got the exchange structures almost exactly right. In their bills, the exchanges would be national, rather than state-based, with authority to police insurers aggressively and bargain hard for lower prices. The model here is the Massachusetts Connector’s management of the CommonwealthCare program, which has successfully held down premiums for its enrollees. This is not what the insurance companies want, which tells you why it’s so important. But the idea may yet win out. According to my colleague Suzy Khimm, Olympia Snowe is already thinking along those lines.
6. Preserve the Medicare Commission. Letting Congress micromanage Medicare payment policy is a bad idea, unless you’re a lobbyist looking to get special treatment for the hospital, professional group, or maker of medical ware that pays your salary. Let an independent commission make recommendations, and then force Congress to vote on them up-or-down, as they do for closing military bases. The Finance Committee endorsed this idea. So has the president. The House disagrees. And the lobbyists are doing their best to make sure the House prevails.
7. Save the benefits tax. This is another piece Finance got right and the House, in my opinion, got wrong. Taxing high-value health benefits does more than raise revenue that can, in turn, finance subsidies. It also sets off a chain reaction that, according to most experts, will lead to lower health care spending. The Finance bill has protections that exempt workers in high-risk jobs, as the unions (rightly) asked, but the unions are trying to kill it anyway. That’d be a mistake, unless they can present an alternative--a politically realistic alternative--that can both raise money and reduce federal spending in the long run. Personally, I'd love to see labor give on this in exchange for a public plan or better subsidies, two priorities they have--to their great credit--been pushing. (For more on the excise tax and why it makes sense, consult the Center on Budget and Policy Priorities.)
8. Stiffen the individual mandate. There’s a reason that Obama, after campaigning against the mandate as a presidential candidate, has changed his mind since taking office. It’s a good idea, for all sorts of policy reasons. (Chief among them: It guarantees a broad risk pool, in which we all share the burden of paying for the high medical expenses a few of us will be unlucky enough to face.) But nobody wants to make people buy insurance they can’t afford, which was something that worried Senate Finance members as the debate came to a close. The smart answer would have been to embrace generous subsidies and strong affordability protection. That’s what HELP and the House committees did. Instead, Finance took the easy way out and just started gutting the mandate.
9. Keep a real employer mandate. Here, again, a concession to centrists--and, in particular, Snowe--has substantially weakened the Finance bill. An employer mandate is essential not so much for the revenue it generates as for the role it plays in preserving employer-sponsored insurance, at least in the short term. (Letting it whither away in the long term would be fine with many people, including me.) Snowe’s aversion to the idea is a major reason why the Finance Committee opted instead to go with a “free rider” provision that could actually introduce some perverse incentives, like discouraging workers from hiring low income employees. (The way it works, companies who didn’t provide coverage would pay a fee only if their workers ended up in federally subsidized coverage--i.e., if they were low income.) The House and HELP bills have much stronger employer requirements--and should be preserved.
10. Open the exchanges. This is Ron Wyden’s idea, as popular among pundits as it is reviled by labor and business. Under his proposal, somebody with access to employer-sponsored insurance could decline it, enrolling instead in a policy made available through an insurance exchange. And, critically, they could take their employer contribution with them. Wyden says it would give all Americans more choices, which is true, and that it would introduce more competition to the insurance market, which is also true. It would have to be crafted very carefully, to make sure--among other things--that all the healthy people don't aggregate in either the employer plans or the exchanges. But that seems feasable.
One last note: I'm sending this list out to experts and insiders whose priority lists probably differ. If I get any particularly good responses, I'll post them.
Update: My original item said enactment of health reform was a "safe bet." I'm confident but not that confident. Plus I'm cautious by nature. So I changed it to "very likely." I also added some details to the section on provider deals, making clear that the ultimate goal of any industry deal should be to foster more efficient care (i.e., not simply raising cash to subsidize coverage).