Progressive Breakfast: Prime-Time Public Plan Pitch
By Bill Scher
June 25, 2009 - 10:29am ET
President Holds Prime-Time Health Care Town Hall
Health Care '09 rally and lobby day in DC today, organized by Health Care for America Now!
Jonathan Cohn on presidential prime-time health care town hall: "...he used the occasion to hammer away at a key point--one that, I increasingly believe, holds the key to the entire reform debate. On at least three separate occasions, Obama pointed out rising costs--left unchecked--are going to destroy the health care system. You might like your current insurance arrangements, Obama suggested, but there's no reason to think they'll be in place a few years from now. At best, your plan will simply become less comprehensive and/or more expensive. At worst, it will no longer be available to you. Or to put it more simply, change may be scary, but no change is even scarier."
I think there are some legitimate questions in terms of how the public option is designed. One thing I have to say, though, is, it's not an entirely bad thing if, as long as they're reimbursing doctors in an adequate way, and -- and -- and so not being oppressive on -- on health care providers, and as long as there are not a whole bunch of taxpayer subsidies going into a public plan, if the public plan can do it cheaper and provides good quality care, that's the competition that we talked about. I don't think you're going to get a lot of complaints from people if the deal is a better deal. If it's not a better deal, then people aren't going to choose it. And -- but what we think is, is that we can set up a system in which you are expanding choices for individuals as opposed to constricting them.
Prez reminds CBO is resistant to presuming cost savings from reform ideas, though still pledges "deficit-neutral" bill:
all of this money that I just talked about, those are hard dollars. We know where they are and so we know that this would not add to the deficit. It doesn't count all of the savings that may come from prevention, may come from eliminating all of the paperwork and bureaucracy because we have put forward health IT. It doesn't come from the evidence-based care and changes in reimbursement that I've already discussed about. And the reason is, is because the Congressional Budget Office [is] not willing to credit us with those savings. They say, that may be nice, that may save a lot of money, but we can't be certain. So we expect that not only are we going to be able to pay for health care reform in a deficit-neutral way, but that it's also going to achieve big savings across the system, including in the private sector where the Congressional Budget Office never gives us any credit. But if hospitals and doctors are starting to operate in a smarter way, that's going to help you even if you're not involved in the government system. That's how we can end up achieving cost. But it requires all of us making some up-front investments. And I think we can find a bipartisan way to do that. .
Prez signals compromise on taxing employer benefits:
What is being discussed in Congress right now is capping those -- that deduction or that exclusion at a certain level. I continue to believe that's not the best way to do it, because I think that what you would see, certainly if you eliminate it completely, essentially employers would stop providing health insurance. And then we would really have to have either a public plan or what John McCain was proposing, everybody just gets that money back in wages and then -- or tax credits and you go out and you shop by yourself. The problem is that the amount of money you're getting back is not going to be the same as the cost of an average insurance plan, especially if you're not in a pool. What's being -- that's not what is being discussed right now in Congress. They're saying, at a certain level, whether it's $13,000 or $17,000 a year, which is what they consider to be a high-end or a "Cadillac plan," maybe your deduction would phase out. I continue to believe that the better way for us to fund this is through the capping of the itemized deduction. But I think there are people, you know, in good faith who are saying a cap would at least prevent these "Cadillac plans" that end up having people over-utilizing the system. That's a debate that is taking place in Congress right now. I'm pushing my idea, other folks are pushing their ideas. There is going to have to be some compromise at the end of the day.
Senate Finance plan will have that tax. Bloomberg: "Baucus ... says the best way to pay for a $1 trillion overhaul of American medical care would be to tax health benefits provided by employers that are more generous than those offered to federal workers -- including lawmakers like him. The government benefits are worth $4,200 for individuals and $13,000 for families ... Yesterday, Baucus and Senate Budget Committee Chairman Kent Conrad of North Dakota, a Democrat, said a bill being drafted by the panel would contain the tax."
CQ reports Senate Finance looking to lower costs by preventing business from dropping coverage: "The problem is that some employers might choose to drop the insurance coverage they currently provide, or workers might find a better deal on the exchange. That would mean higher spending on subsidies, which CBO has said will drive up the overall cost of the package, pushing it well past $1 trillion. One proposed solution has been to either force businesses to offer coverage or offer incentives for them to do so. But business interests, led by the U.S. Chamber of Commerce, have opposed any mandate that they provide health care coverage ... Employers would not have to provide coverage under the ["free-rider"] proposal, but there would be pressures on them to do so: They would have to contribute to the cost of covering workers on Medicaid because of their low income and those who got coverage in the subsidized insurance exchange. In return, workers would be allowed to leave their employer-provided insurance only if the coverage available through their jobs was unaffordable."
House Dems looks to lower price tag of reform by upping doctor payments. The Hill: "House Democrats are considering a budget maneuver that would reduce the headline cost of restructuring healthcare by $285 billion ... eras[ing] the cost of the Medicare physician payment increases by making the change but not having it be subject to pay-as-you-go budgeting rules that would require the spending increase to be offset with tax hikes or other cuts."
NYT reports that "Senators" are worried "that in offering subsidized health insurance to millions of individuals and families, they could inadvertently speed the erosion of employer-provided coverage." BUT NYT only quotes right-leaning Dems, ignores new statement from 120 House and Senate members: "ROBUST PUBLIC OPTION A MUST."
Huffington Post's Sam Stein reports MoveOn pressuring Sen. Feinstein to support public plan option.
TPMDC finds potentially disingenuous GOP support for "co-op" plan: "Enzi supports the Finance Committee's process, which he said has been more transparent and bipartisan in spirit. He says the co-op proposal sounds promising, but he needs to learn more about it before he offers his full support to the provision ... This is a common position in the GOP, and, frankly, a common legislative tactic in general. It's not necessarily a wink and a nod toward a 'no' vote, but it raises concerns among Democrats--or at least it should--that Republicans might try to weaken the bill only to turn around and vote against it."
How's that free market insurance treating ya? W. Post: "Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee."
Optimism for Climate Vote Friday
McClatchy reports backers predict passage in House tomorrow: "[Rep. Ed Markey] who helped draft the sweeping climate bill that limits greenhouse gases and improves the nation's energy efficiency predicted Wednesday that the legislation would be approved by the House on Friday.
McClatchy also finds opponents still using phony numbers: "[Rep. Eric] Cantor in a statement on Wednesday cited a Massachusetts Institute of Technology study that Republicans said shows the bill would cost $3,100 per household. The author of the study earlier said the GOP misinterpreted the study to derive that amount. Another opponent of the legislation, the American Petroleum Institute, said the recent CBO study, which found the average household would pay $175 per year if the bill passed, was too rosy. It didn't include gasoline price increases that could cost $800 per family per year..." [Ed. note: it didn't include the benefits we would get from averting a climate crisis and making clean energy affordable.]
W. Post poll finds support for climate bill's provisions: "Three-quarters of Americans think the federal government should regulate the release into the atmosphere of greenhouse gases ... 56 percent would back cap and trade if it resulted in a $10 [monthly] increase in utility costs..."
Grist's Kate Sheppard on hopes for strengthening the bill later: "Environmental groups are downplaying hopes that their allies in Congress will be able to strengthen the American Clean Energy and Security Act once the House begins debate on the bill later this week, though some officials from climate action groups remain optimistic that the bill can be strengthened later in the legislative process."
Bloomberg rounds up who is lining up for and against: "Gore, the former vice president who now focuses on environmental issues, is set to appear today on Capitol Hill to endorse the bill. Buffett, the chairman and chief executive officer of Omaha, Nebraska-based Berkshire Hathaway Inc., took to the airwaves yesterday to call the legislation 'regressive.' ... About 100 environmentalists and labor leaders rallied on Capitol Hill yesterday in support of the legislation. They were joined by venture capitalist Sunil Paul of Spring Ventures in San Francisco and Bill Keith, founder of St. John, Indiana-based SunRise Solar, who praised the measure ... The American Petroleum Institute, which represents oil and gas companies including Exxon Mobil Corp., asked lawmakers to vote against the bill, saying it would raise fuel prices. American Farm Bureau Federation President Bob Stallman called the legislation 'seriously flawed'..."
Politico profiles the remaining fence-sitters in Congress
Wall Street Preparing to Fight Regs
Wall Street plots image overhaul to counter populists. Bloomberg: "Wall Street’s largest trade group has started a campaign to counter the 'populist' backlash against bankers, enlisting two former aides to Treasury Secretary Henry Paulson to spearhead the effort. In memos of confidential meetings with top financial executives, the Securities Industry and Financial Markets Association said it began this month the 'execution phase' of the operation, which pledges to 'embrace change' and accountability."
Bloomberg reports banks to fight consumer commission: "U.S. banks are fighting the Obama administration plan to create a consumer agency for financial services as they seek to protect fees, such as credit-card penalties that have almost doubled to $19 billion in five years."
Fed role in Merrill Lynch purchase under scrutiny. McClatchy: "The Federal Reserve sought to keep other regulators in the dark about problems last year with Bank of America Corp.'s Merrill Lynch & Co. purchase, according to sources familiar with documents obtained by the House committee probing the deal."
Terrance Heath contributed to the making of this Breakfast
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