The Public Option In Tonight’s Speech

If you don’t want a public option, don’t use the public option. Why can’t the right understand the word “option”?

The Democrats are hedging on this because they are gutless, value free cowards. Go ahead and drop the public option if you want a war with your base Democrats.

“This is not a national debate about whether we have a public option for the tens of millions who are uninsured.”

Right! It’s supposed to be a debate about giving everyone the right to choose between their current plan and a government run plan. It’s not just about a public option for the uninsured but about a public option for everybody.

Michael Scherer:

This is not a national debate about whether we have a public option for the tens of millions who are uninsured.

What sleight of hand is this?
.
What’s being debated nationally (and in people’s homes) is a public option that may “bring security and stability to hundreds of millions of Americans” if all Americans are allowed to have that choice.
.
This is absurd, Kafka-esque territory here, and it is absolutely appropriate that you call attention to it, Michael Scherer.
.
Some (George Orwell comes to mind) might say that it is precisely the task of a press corps in a free country to reveal the essence of such statements by government officials.
.
Thank you.

[...] of Congress. For those of you interested in the President Barack Obama’s remarks, one thing is becoming clear: he’s going to declare his preference for a public option, but he’s not going to demand [...]

But it sounds like there will be no demanding a government-run plan. So the public option will officially be dead, and most liberals will vote for reform anyway…

http://www.political-buzz.com/

Well than see ya Derek, because if they go with a trigger most Democrats will accept the win and move on. If you want to walk see ya later. I don’t bid you any ill will, But as a Democrat, I’m not going to commit political suicide in order to have everything I want, when I know the alternative might mean I get nothing. conservative Democrats are not going to vote themselves out of a job. If you want to abandon Democratic politics, rather than stand your ground and work to make your party and Americans more liberal that’s your perrogative.
.
Just remember the thing about time, it’s going to pass regardless of what you do. It took thirty years before the public realized the conservative agenda was nuts. They let them run the country into the ground before they recognized how badly the Bush administration was running the country. But today, neither Reagan or Nixon could get elected bu the GOP. They’ve been defeated and with your help we may have at least eight years to make this realignment permanent and maybe, just maybe the public will give us thirty years to make this country solidly liberal.
.
The longer we’re in charge, the more opportunity we will have to introduce more sensible and humane policies. But as long as a good number of the country considers everything the Democrats do is little more than a give away to minorities and the poor, they are going to be reluctant to give in. It’s likely that after each policy victory proves not to end up taking some thing away from them to give to the great unwashed – they will move further and further to the left.

Sorry Destor but the public option was never open to everybody. It was an option in an exchange for those who are without insurance and locked out of the private market could have an affordable option. So that’s why so many are saying this is not the whole thing. Because the 80 percent of Americans who are covered by their employers weren’t going to be eligible. that’s why the COP said it was only going to be open to about 10 million Americans.

oops that was supposed to be CBO

Stuart, The aide’s point was that under the bills as drafted, the public option is really only going to be available to those who do not have employer coverage and are not eligible for Medicaid or Medicare, a group that works out to the tens of millions. But the broader health reform effort will impact hundreds of millions.

“The public choice is a means to an end. It’s not an end in and of itself.”

The Public Option is dead! At my signal, unleash hell!

Just saw a report that says that the Dems don’t have the votes. Large swathes of moderate AND liberal democrats don’t support it. This is going to get even uglier.

Michael Scherer:
.
Really?
.
I will go read HR 3200 to verify this.
.
Thanks so much for responding to commentary and clarifying.
.
If this truly is the case, that people won’t be able to choose the public option, then…
.
…This guy Robert Reich here
.
http://www.huffingtonpost.com/2009/09/09/robert-reich-explains-the_n_280639.html
.
is a f*cking liar, even if he’s a liar by omission.
.
Thanks again, Michael Scherer.

And re: fines being proposed for people going w/out insurance: A large reason why a young person like me who takes care of themself would want to go without insurance is because of the ridiculous gouging we would receive due to state minimums and regulations. I myself prefer to have the so-called “catastrophy insurance”, with a high deductable/ low premium. I’ll be damned if I’m forced to pay more than I need to for insurance just so that other people who need to utilize more health care can pay less.

I be tryin’ t’ remain respectful o’ yer point, Dee, bu’ exact’ wha’ be th’ Democrats gettin’, in th’ absence o’ th’ Public Option? Ye be livin’ in a fairyland!
.
Wha be goin’ t’ be preventin’ insurance companies fr’m raisin’ premiums if someone gets sick, or chargin’ higher premiums for someone wi’ a pre-existin’ condition? Wha’ be goin’ t’ pr’vent ‘em fr’m cherry-pickin’ customers through premium pricin’ ‘r sellin’ sham policies tha’ be really coverin’ nothin, ‘r having extreme high deductibles?
.
Wha be goin’ t’ be forcin’ drug companies t’ pr’vide their product a’ affordable prices when it be promised not t’ try t’ negotiate?
.
How, exact’ be we goin’ t’ be goin’ t’ pr’tect Americans by givin’ away th’ store in th’ absence o’ any other option than a mandate fer ev’ryone t’ purchase private corporate insurance offered policies?
.
If this bill be passin’ wi’out th Public Option, ye be goin’ t’ be findin’ out ri’ quick ‘ow corporate health interests be able t’ game th’ system t’ preserve their profits a’ th’ expense o’ pr’vidin actual health care when it be needed!
.
It’ll be too late when ye finally see th’ pig ye bought in th’ poke – an’ I don’t want t’ be hearin’ any whinin’ ‘r complainin’ fr’m ye when ye be findin’ out ye been had!
.
Capitulation gets ye nothin’, bu’ if ye be so hot t’ capitulate, ye deserve th’ sham ye get!
.
If this bill be passin’ wi’out th’ Public Option, thar’ll be no opportunity t’ work t’ get it ri’, because a’ th’ next election cycle th’ Democrats who be votin’ fer this debacle’ll be voted out. If we be goin’ t’ be governed by th’ party o’ big business, mi’ as well be up front ’bout it an’ have Republicans instead o’ lyin cowardly Republicans in Democrat’s clothin’!
.
Yarr!

Dee are you not going to use your own situation to try and screw millions of people out of health insurance today? Appeals to emotion seem to work on a lot of people. You must be proud of your ability to think only of yourself, and fold up like an accordion at the first sign of trouble. In case you haven’t noticed the Republicans won’t support health reform, even if the public option is triggered. However, I suppose one Republican vote is worth more to you than all the Liberals who worked tirelessly to get the Democrats in power.

The Public Option is simply that: an option for those who can use it. All the blathering by Axelrod, Sen Snowejob and assorted Villagers is simply their effort to push Obama into being a centrist.

The over arch: the Republicans have to be accommodated. never mind that they are the most dishonest when it comes to debating the pros and cons. And zee Blue Dogs: they have more power than the Progressives because they are Rahm;s endangered species.

So President Obama: you decide where you stand; where your leadership stands and I will respond accordingly.

Dee, if you had a clue, you’d understand that the public option was first proposed by Jacob Hacker — and it was open to everyone.
_
It was the Hacker plan that was first presented by the Herndon group, and formed the basis of HCAN’s $40 million dollar campaign for health care reform. THE OBAMA, CLINTON, AND EDWARDS CAMPAIGNS ALL INCLUDED PUBLIC OPTIONS THAT WERE BASED ON THE HACKER PROPOSAL.
_
Your ignorance of the subject of health care reform is just astonishing, Dee.

I thought this speech was to convince the American people of the need for health care reform, but from the early press reports I think it is to convince them he has tried to be bipartisan.

Michael is telling us that the public option is dead which they already knew according to Karen and Joe that this was a give away a long time ago. Trouble is no one told the democrats and people that supported Obama on health care this was so. I have heard the President is going to give other options instead of the public plan but Michael did not mention this.

I have heard Republicans will also have another carrot dangled, Rusty’s favorite tort reform, is this true Michael?

pirate–
.
Okay maybe the problem is the Democratic failure to fully explain the public option. It’s not as if this thing was ever going to be Medicare for all — which is ultimately what we want to get to. At some point with a continued Democratic majority, we will one day have Medicare for all to provide basic coverage and private insurance would provide that which many will be willing to pay extra for that will not be covered by the basic plan similar to the Medicare part B and so forth.
.
Just like SCHIP, that doesn’t allow people to just get rid of their employer family coverage and buy on to SCHIP because its cheaper, most Americans currently receiving their employer coverage won’t be able to drop that coverage and buy into the public option. So clearly, while so many have pushed back on me — as someone who would be eligible to buy into the public option, I don’t want that used as an excuse to derail health care reform for everybody else.
.
What everyone will get is protections against the following:

1) being thrown out of their coverage for getting sick.
.
2) stop being discriminated against in the hiring process because the employer knows they will have to pay extra for someone who has a preexisting condition or is overweight etc.
.
3) It will prevent private insurance from raising the co payments and costs every year above the rate of inflation.
.
4) It will stop discriminating against genders and minorities, that it now charges more to provide coverage.
.
5) It will require transparency so that doctors offices, hospitals will no longer be able to double the price for people who are paying out of pocket.
.
6) and once we are all covered, it will eliminate the $1000 that every family pays extra to cover the uninsured that end up i the emergency reform.
.
7) Most importantly, while a public option may not be there, we will have several other options to choose from in a health exchange that will allow people like me to who are uninsured and can’t buy coverage at any price because of pre-existing conditions.
.
Now that’s just off the top of my head I’m sure there will be more. It will finally allow those of us who are uninsured to buy coverage. And those of us who are covered to not get screwed.
.
Contrary to plukasiak, I would have never advocated for something that would just be helpful to my needs,. I am actually saying I want to forgo the means that works best for me so that we lay the broadest foundation and we can build on it, may be through a trigger and eventually get a public option for all of us that can someday expand that into a single payer system that is augmented by private niche insurance and it’s not the whole deal.

You make a good case at 5:05 Dee. And since there’s a bit of Derek in me, I’d like to respond. Also b/c I may have him by a decade or so. So perhaps I’m a little less hotheaded than I was when WJC pissed me off with his DLC centrism. As much as I grew to loathe his triangulation and abandonment of progressive politics (overall), in the end, after voting for Bradley in the primaries, I wound up voting for his veep Gore in the end. Repeat (Dean -> Kerry in ’04). This past year was the first time that I voted for the same candidate twice.
.
Anyway, we progressives get worked up the most after helping to get a person elected, only to see them rule from a more centrist position than we may like (though more cynical folks do expect it). But inevitably, in the end, when confronted with W. or Johnny “Bomb Iran” Mac, most of us aren’t going to embrace Ralph Nader. Most, mind you, but Gore 2000 sure should be a terrifying cautionary tale for Obama, the party and the nation (WJC did alienate enough progressives, enough of his base, convincing them that the two parties weren’t that different, that they sat home or voted for Ralph).
.
You say “if you want to abandon Democratic politics, rather than stand your ground and work to make your party and Americans more liberal that’s your perrogative.”
.
That sounds great, the “stay and fight” mantra, and though you don’t make the comparison, it is indeed possible. Look at how the base of the GOP has taken complete control of their party. If they can stay in the wilderness (a la ’32 to ’68, the arc of democratic supremacy, all in my pre-history, sadly) for the long haul, you’re right, inevitably our party, yours and mine, will swing to the left.
.
But surely you’d also agree that Derek’s opinion, which I’d say is ‘I’ve not abandoned democratic politics’ but ‘democratic politics have abandoned me,’ is a reasonable conclusion too?
.
You continue: “But as long as a good number of the country considers everything the Democrats do is little more than a give away to minorities and the poor, they are going to be reluctant to give in.”
.
Is this your perception of the progressive agenda alone and not the administration? I agree that your quote accurately sums up a good number of Americans’ view of progressive politics, but you’d also agree that they’re wrong, right? Helped along by a look!-a-sex-scandal!!! (MS) media, you admit that this is a deeply flawed perception of progressive politics.
.
But yeah, I get you on one level, that perhaps we can’t achieve what we want now, that we have to get modest reform first and slowly educate Americans about why progressive legislation, once we’ve cut through the sh!t-storm of mis & dis-information, they’ll hear the gospel and support truly progressive legislation.
.
And deep down, I long to believe this too. God knows it’s the only reason I’m still dialed in at my age, well, that and the fact that I literally swam in the Potomac stew as a youth. But like you, I’ve been around for a while, and one thing America seems incapable circa 2009 is reproducing a Great Society or offering up a New Deal. These seminal democratic achievements (enacted over 40 years ago) were possible b/c our politics was not inherently tainted by the rise of corporate sponsorship.
.
Quite simply, I fail to see how change can be enacted from within that wholly corrupted institution. But the system is so gamed that as much as I long for a 3rd party (I see it as the only way to effect real change on a failing system) I know it’s unrealistic that it can have more than temporary (Nader 2000) impact. Well, at least until a 3rd party realizes that to be successful that have to run not only for the WH but for offices large and small from coast to coast. Anyway, until that mythical time, come Nov. 2012 et al, I’ll probably be mailing my ballot in for the corporate-friendly democratic candidate.
.
What I’m saying is, all things considered you may have the practical read right, but Derek’s, how shall I say it, despair (maybe betrayal if he is a youth), is also right.

stuart…
What came out of the Energy and Commerce committee is based on what blue dog Mike Ross wanted — is significantly difference from the bill that the other two house committees passed, and would result in fewer people being eligible for the public option.

JC I’m in my mid 50s and if Obama turns out to be another member of the centrist cult it will be a pleasure to work, in a small way, to make sure he doesn’t get reelected, or a Democrat loses because a third party candidate splits the left vote. If enough liberals do the same maybe some day the party will pay attention to us, and give us a seat at the table, along with the bought and paid for Bush Dogs.

Michael Scherer:
.
OK, I’ve got the bill in front of me. It’s

H.R.3200 – America’s Affordable Health Choices Act of 2009
.
To provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.

So that’s the House bill under consideration at the moment.
.
Let’s go to the part about the public option, shall we?

Subtitle B–Public Health Insurance Option
.
SEC. 221. ESTABLISHMENT AND ADMINISTRATION OF A PUBLIC HEALTH INSURANCE OPTION AS AN EXCHANGE-QUALIFIED HEALTH BENEFITS PLAN.

OK, so what do they say about eligibility to participate in a public option plan?

(b) Offering as an Exchange-participating Health Benefits Plan-
(1) EXCLUSIVE TO THE EXCHANGE- The public health insurance option shall only be made available through the Health Insurance Exchange.

Hmmm…so what does the bill say about eligibility to get into this “Exchange” in which a public plan is to be offered?

SEC. 202. EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS.

Aha! We’re in the right part! Let’s see here..

(a) Access to Coverage- In accordance with this section, all individuals are eligible to obtain coverage through enrollment in an Exchange-participating health benefits plan offered through the Health Insurance Exchange unless such individuals are enrolled in another qualified health benefits plan or other acceptable coverage.

Err..that doesn’t sound good…unless they’re talking about Medicare. If someone’s covered by another public plan like Medicare, it would make some sense that this plan isn’t open to them…kind of…
.
So what do they mean by “another qualified health benefits plan”? Do they mean Medicare or any employer-based plan? Let’s find out…

(c) Transition- Individuals and employers shall only be eligible to enroll or participate in the Health Insurance Exchange in accordance with the following transition schedule:

OK, there’s a schedule of eligibility, I get that. Some people will be eligible later than others…for “transition” purposes. Got it. So what’s that “qualified health benefits plan” that means I can’t buy into the public option? Where is it?

(1) INDIVIDUAL DESCRIBED- Subject to the succeeding provisions of this subsection, an individual described in this paragraph is an individual who–
.
(A) is not enrolled in coverage described in subparagraphs (C) through (F) of paragraph (2); and
.
(B) is not enrolled in coverage as a full-time employee (or as a dependent of such an employee) under a group health plan if the coverage and an employer contribution under the plan meet the requirements of section 312.

That’s really, really not looking good. But they’re not making this easy to be totally clear on, and they’re still not totally clear I have to find section 312 to see what kind of employer they’re talking about.
.
First, though, let’s see if I was right about that Medicare-type ineligibility:

(2) ACCEPTABLE COVERAGE- For purposes of this division, the term ‘acceptable coverage’ means any of the following:
.
(A) QUALIFIED HEALTH BENEFITS PLAN COVERAGE- Coverage under a qualified health benefits plan.
.
(B) GRANDFATHERED HEALTH INSURANCE COVERAGE; COVERAGE UNDER CURRENT GROUP HEALTH PLAN- Coverage under a grandfathered health insurance coverage (as defined in subsection (a) of section 102) or under a current group health plan (described in subsection (b) of such section).
.
(C) MEDICARE- Coverage under part A of title XVIII of the Social Security Act.
.
(D) MEDICAID- Coverage for medical assistance under title XIX of the Social Security Act, excluding such coverage that is only available because of the application of subsection (u), (z), or (aa) of section 1902 of such Act.
.
(E) MEMBERS OF THE ARMED FORCES AND DEPENDENTS (INCLUDING TRICARE)- Coverage under chapter 55 of title 10, United States Code, including similar coverage furnished under section 1781 of title 38 of such Code.
.
(F) VA- Coverage under the veteran’s health care program under chapter 17 of title 38, United States Code, but only if the coverage for the individual involved is determined by the Commissioner in coordination with the Secretary of Treasury to be not less than a level specified by the Commissioner and Secretary of Veteran’s Affairs, in coordination with the Secretary of Treasury, based on the individual’s priority for services as provided under section 1705(a) of such title.
.
(G) OTHER COVERAGE- Such other health benefits coverage, such as a State health benefits risk pool, as the Commissioner, in coordination with the Secretary of the Treasury, recognizes for purposes of this paragraph.

OK, that’s what I thought, they’re excluding all kinds of government health insurance programs. I don’t think that’s necessarily good, but it’s not what I’m looking for.
.
I need to be crystal clear on whether or not currently insured employees can get out of their plans and into the public option…I really need to read section 312, because that’s where they defined the requirements in “coverage and an employer contribution under the plan meet the requirements of section 312“.
.
What is section 312 called?

SEC. 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS EMPLOYEE AND DEPENDENT COVERAGE

…not looking good…

(a) In General- An employer meets the requirements of this section with respect to an employee if the following requirements are met:

OK, if I work for this kind of employer, then I can’t get in to the public option through the exchange. What are these requirements that disqualify me as an employee?

(1) OFFERING OF COVERAGE- The employer offers the coverage described in section 311(1) either through an Exchange-participating health benefits plan or other than through such a plan.

They’re not making this easy at all. Now I’ve got to look up section 311. But before I do, is there any other disqualification?

(2) EMPLOYER REQUIRED CONTRIBUTION- The employer timely pays to the issuer of such coverage an amount not less than the employer required contribution specified in subsection (b) for such coverage.

Christ! On to subsection b where we find out what that minimum amount is…

(b) Reduction of Employee Premiums Through Minimum Employer Contribution-
.
(1) FULL-TIME EMPLOYEES- The minimum employer contribution described in this subsection for coverage of a full-time employee (and, if any, the employee’s spouse and qualifying children (as defined in section 152(c) of the Internal Revenue Code of 1986) under a qualified health benefits plan (or current employment-based health plan) is equal to–
.
(A) in case of individual coverage, not less than 72.5 percent of the applicable premium (as defined in section 4980B(f)(4) of such Code, subject to paragraph (2)) of the lowest cost plan offered by the employer that is a qualified health benefits plan (or is such current employment-based health plan); and
.
(B) in the case of family coverage which includes coverage of such spouse and children, not less 65 percent of such applicable premium of such lowest cost plan.

Wow this is tough. It can be understood by humans, though.
.
If the employer pays an insurer more than a certain amount, than I’m out of luck.
.
What is that f*cking amount in an entirely different law (section 4980B(f)(4) of the Internal Revenue Code of 1986)?
.
Using teh Google, I see that this IRS Code section is actually COBRA

Section 4980B of the Code requires certain group health plans to make continuation coverage available to certain individuals who would otherwise lose their coverage under the plan as a result of certain occurrences (the “COBRA continuation coverage requirements”).

.
So they are saying that, if your employer isn’t too small of a business to meet COBRA mandates, your employer does provide you with coverage, but that coverage’s premium is more than three-quarters (for individuals) or two-thirds (for families) of what COBRA premiums would be for you if you lost your job,,,basically they are saying that I’m out of luck.
.
They are saying that if I get coverage through my employer or if my employer blows off coverage and makes their new penalty contribution requirement, I don’t get to choose the public option.
.
Robert Reich either didn’t read the f*cking bill, or he is a liar.
.
We’re being had, Michael Scherer.
.
That aide to the President is right. The House authors of this bill have made it so that only the self-employed or the very underemployed can choose the public option, and it will be as expensive for them as it would be for employers, without the tax break employers get. That’s the “level playing field”.
.
I wonder if the House Progressive Caucus has read the f*cking bill, Michael Scherer?
.
Has anybody read this bill? The public option is not what we’re being sold on by proponents. Under this bill, HR 3200, it’s not a real choice being offered for the vast majority of Americans.
.
Thanks so much for working through this with me, if you’re still reading this far, Michael Scherer.
.
I need a drink right now…

Paul Lukasiak:
.
What version of what House bill doesn’t fail on the public option the way that HR 3200 explicitly does?
.
Can you help a brother out here?

[Sigh…] it’s Cause célèbre.

Ye’re a lost cause, Dee, b’lievin’ all those things, be comin’ t’ pass — th’ corporations tha’ bought this “reform” be just standin’ by t’ be turnin’ th’ screws once th’ vote be o’er. Yer list be soundin’ nice – bu’ whar be th’ consequences should thar be ways ’round all these things – an’ I be sure as cannon shot they’ve got th’ workaround all figured out already!
.
Ye’re goin’ t’ be sorry – mark me words – an’ I’ll be ‘avin’ no whit o’ sympathy fer ye since ye were so loud’ insistin’ on capitulation!
.
Yarr.

thanks. fixed.