"The Case Against Holding Out For The Triggered Public Option"
Last night, when the Democrats gave in to Sen. Joe Lieberman’s (I-CT) demands and dropped the Medicare buy-in proposal, they also abandoned any hope of pursing Plan C (or T) and incorporating a triggered public option into the Senate bill.
After Lieberman announced his opposition to the Medicare buy-in on Sunday, some progressives began quietly nudging Reid to ditch Lieberman (who also opposes the trigger proposal) and save the public option by collaborating with Sen. Olympia Snowe (R-ME), the only Senate Republican to vote for health care reform and a possible 60th vote. Snowe, after all, remained open to supporting a trigger proposal and winning her support could have tainted the effort with bipartisanship. But courting Snowe would have undermined the Democrats’ self-imposed holiday deadline, delaying a vote on health care reform until the new year with no certain prospect of securing anything genuinely worthwhile and no guarantee that other issues or senators wouldn’t derail reform. “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.”
Snowe’s rhetoric didn’t reassure nervous Democrats or the White House, which remained focused on scoring a major legislative and political victory before the State of the Union and turning the corner to focus on jobs and the economy in the new year. Health care reform had hijacked the agenda, and as popular support for the Senate bill declined, Democrats believed it was better to pass something quickly than run the risk of not passing anything at all.
From a policy stand point, the White House may be right. The reality is, a robust Medicare-like public plan that uses the Medicare infrastructure to achieve administrative efficiencies and delivery system reforms is now a distant memory. Snowe described the plan as plans. Up to 50 different independent semi-private/public state-based non profit plans that would have lacked the market power or leverage to lower prices or change the way care is delivered. Had they been triggered — assuming the trigger was designed correctly — the plans would have been subject to today’s controversies. Opponents would have claimed that “factors other than health plans’ inability to manage spending caused the lack of affordability”; in the 21 states where conservatives are now leading campaigns to exempt the state from health care reform, the triggered plan would have been dead on arrival.
Lieberman may be gloating today, but given the politics of the public plan, it’s unclear that Democrats would have been better off if he wasn’t.