Tomorrow night the Senate is supposed to vote on whether it will take up the health care bill released this week. They need 60 votes, and it’s a big question mark whether they will get 60 votes.
The Senate bill is somewhere between “not what we wanted” and “better than nothing.” It pulls back a bit on the House bill’s draconian abortion restrictions, but it adds a “national plans” provision that would allow insurance companies to sell policies without regard for state consumer protections.
Conservatives and the insurance companies love the national insurance idea. The insurance companies could all set up shop in Texas and sell cheap junk policies to healthy young people in any state. Most of the young folks likely would pay premiums for quite some time before they make a claim and realize their policies are a ripoff and their insurance doesn’t cover whatever it is they have. Big profits to be made. But if enough healthy young people drop out of the state insurance pools, the not-so-young and not-so-healthy will be paying higher premiums.
The public option will be available only to people who can’t get insurance any other way, and because it will attract a less-than-young and healthy (hereafter abbreviated Y & H) risk pool it is expected to actually be more expensive than private insurance. Robert Reich explains.
The Senate bill has a state “opt out” provision that many leftie bloggers don’t like. I think that if there have to be compromises (and why is that true?) this is one of the less onerous ones. If the public option were to be more robust, and go into effect sooner, I think it would actually hurt conservative state-level politicians in the long run to opt out. As it is, I’m not sure it will make a whole lot of difference to many people.
Many of the provisions of the bill won’t go into effect until 2014. I think this is a colossally stupid move on the part of the Democrats. I know Reid put that in to make the bill cheaper. But it will give the Right plenty of time to spread more “death panel” stories to scare the public with. If they manage to take back the House or Senate in 2010 or 2012, expect them to try to kill the legislation before it goes into effect.
Jon Walker at FireDogLake explains these and other issues with the bill. At the Washington Post, Ezra Klein explains the actuarial values thing. He also explains what parts of the bill go into effect before 2014. The New York Times presents the major provisions of the Senate and House bills side by side.
Between now and then, expect to hear all kinds of rumors and speculation about how senators Baucus, Landrieu and Lincoln will vote. Michael Tomasky argues that obstructing the health care bill would be bad for their political careers in the long run, even if they might take a hit from their conservative constituents in the short run.
As I’ve written many times over the recent months, the political paradox is this, at least for Nelson, Landrieu and Lincoln. As individual senators from red states where Obama has lower approval ratings, they would be rewarded in the short-term by blocking reform. But as members of the larger group of Democrats who represent states where Republicans tend to win statewide elections, a collective party failure is far more likely to hurt them in the long run than it is to hurt safe, blue-state Democrats.
If they’re really thinking long term, they should want reform to succeed. And oh yes, there’s this, too: the fact that they represent poor-ish states (especially Lincoln and Landrieu), where many families are uninsured and would benefit from being able to purchase insurance with a decent federal subsidy. This should make them want a bill.
Emphasis on should. We’ll know more soon.
Yes, I guess we will.