In the Arena

More on the Senate Health Care Bill

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Two amplifications to my Sunday post on the Senate bill:

1. Marshall Wittman, who is Senator Joe Lieberman’s Communications Director, says I left an incorrect impression when I wrote that David Gregory should have asked the Senator if he would filibuster the bill if it didn’t cancel the insurance companies’ anti-trust exemption. He may be right. Lieberman favors cancleling of the anti-trust exemption, which is a good thing. Or he may be wrong: Wittman refused to answer when I asked him if Lieberman would filibuster a bill that didn’t cancel the insurers’ amazing exemption. So the question I raised was, and remains, appropriate.

Why is this important?

Because Lieberman has made a big deal about his plans to filibuster the public option–and he’s playing a game here. To my mind, the bill could use both an optional public option and an end to the anti-trust exemption–competition is essential to reducing costs–but neither rises to the level of an issue that should cause a Senator to actually block a vote. Both are less important than (a) forcing insurers to cover everyone at community rates, (b) subsidizing those who can’t afford health insurance costs on their own and (c) establishing a system of Exchanges–health-insurance super stores–where people can buy insurance at reasonable rates. (If neither the public option nor the anti-trust provision is included and competition doesn’t ensue, the Congress could, very easily, revisit this in future years.)

Of course, Lieberman also knows that opposing the insurers’ anti-trust exemption is a freebie because Senator Ben Nelson had it stripped from the bill. His pro-competition vehemence remains a matter of theory, rather than fact. But I’m glad he’s in favor of lifting the anti-trust provision.

Wittman also accused me of “slander” for calling Lieberman the Senator from Aetna. Slander? I will plead guilty to the charge of lame snark, but…slander? That might be appropriate if I questioned Barack Obama’s patriotism by saying he puts winning elections ahead of winning wars…oh, wait: Didn’t Joe Lieberman endorse and repeat that charge, made by his buddy, John McCain?

2. Reader Stuart Zechman points out that I did exaggerate the reach of Ron Wyden’s provision to open the Exchanges to employees who weren’t pleased with their company provided health insurance. It isn’t open to all employees:

Under the Senate legislation as it is currently written, Americans with employer-provided coverage, whose income is below 400 percent of the federal poverty level and whose premiums are between 8 and 9.8 percent of their total income will be exempt from having to purchase health coverage but will not be able to access the exchange to qualify for government assistance to purchase insurance. The agreed to amendment will make it possible for these individuals to convert their tax-free employer health subsidies into vouchers that they can use to choose a health insurance plan in the new health insurance exchanges. The Congressional Budget Office estimates a previous version of this provision will expand coverage to more than a million Americans.

Stuart thinks a million Americans isn’t such a big deal. I disagree…and it’s a first step toward making everyone eligible to join Exchanges, which would be a good thing.