Just days after signaling that he would not oppose a Medicare buy-in, Sen. Joe Lieberman (I-CT) announced yesterday that he would vote against the health care bill if it included the measure. Appearing on Face the Nation, Lieberman told host Bob Schieffer that he did not know “exactly what’s in it” but pledged to oppose the Medicare buy in “because it has some of the same infirmities that the public option did”:
LIEBERMAN: But I will tell you that on one part of it the so-called Medicare buy-in, the opposition to it has been growing as the week has gone on. And– and though I don’t know exactly what’s in it, from what I hear I certainly would have a hard time voting for it because it has some of the same infirmities that the public option did. It– it will add taxpayer cost. It will add to the deficit. It’s unnecessary. [...]
SCHIEFFER: So you can’t vote for the bill right–
LIEBERMAN: Yeah– [...]
LIEBERMAN: You got to take out the Medicare buy-in. You got to forget about the public option. You probably have to take out the CLASS Act, which was a whole new entitlement program that will in– in future years put us further into deficit. And you got to adopt some of the cost containment provisions that will strengthen cost containment that all of us favor….So it’s time to get reasonable.
Lieberman’s opposition leaves Senate Majority Leader Harry Reid (D-NV) with a set of difficult, if not unfortunate choices, that could very well doom any hopes of passing the Senate health care bill before Christmas. Insiders suggest that if Reid does not file all three cloture votes — one on the manager’s amendment, one on the bill substitute, and one on the final bill — by Thursday, he will not have enough time to pass the bill before or on December 23 or 24th.
Reid’s best hope is for a positive CBO score that would win over Sen. Olympia Snowe (R-ME) or bring Lieberman back to the negotiating table. Reid could try to pass the health care bill through reconciliation (which he has taken off the table), broker another compromise that satisfies Lieberman’s concerns or abandon the public option and the CLASS Act altogether. Ditching the long-term care insurance provision could prove difficult however, since the program’s revenues account for more than half of the Senate bills’ deficit reduction in the first 10 years.
Alternatively, Reid could ditch Lieberman and offer a triggered public option that could win the support of Snowe. But that would only further delay the process. “It isn’t enough to say let’s get it done and not worry about the specifics that are in the legislation,” Snowe has said. “The more they try to, you know, sort of drive this process in an unrealistic time frame, you know, the more reluctant I become. … I don’t think we should be concerned by this artificial timetable. There’s always January.”
Of course, if Lieberman was truly interested in voting for health care reform he would offer substitute policies that could achieve the goals of the public option — increased competition, lower costs, and care quality. Lieberman could offer to strengthen the Medicare Commission (now known as IMAC), allow all state-based exchanges to act as prudent purchasers and select only the most efficient insurers, work to strengthen the consumer protections in the bill or bolster the mechanisms that oversee insurer compliance with the new regulations.
But it’s unlikely that Lieberman will offer Democrats a real compromise. He has no real plan. In fact, his initial uncertainty about the Medicare buy-in may be the result of his absence from the original negotiations (Sen. Tom Carper (D-DE) sat in for Lieberman during those talks). He is not very interested in health care reform, but at least he’s with us on the war.