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Wednesday, December 9, 2009

As Progress is Made on Health Reform, Public Opposition Solidifies

Update II: Senate Democrats have reached an agreement and the Public Option is gone. This clears one hurdle, but another has popped up. The Senate rejected Ben Nelson's abortion funding amendment making the math of 60 votes still a difficult equation.

Update: Late word indicates that GOP moderate Olympia Snowe is not a fan of the new compromise that would expand Medicare and Medicaid, this could make it very hard for Democrats to reach 60 votes. Especially if they lose Ben Nelson over the issue of abortion coverage.

News today suggests that significant progress is being made in the Senate on compromise health care reform as Democratic Party leaders seek a path to 60 votes. It is increasingly clear that the Public Option that Majority Leader Harry Reid had included in the bill will be dropped - but progressive members of the Democratic caucus have not simply surrendered, rather they are using the elimination of the Public Option to bargain for new and potentially far reaching concessions. Multiple sources are reporting that the Public Option would be replaced with a new nationwide nonprofit health plan to be administered by the federal Office of Personnel Management (the same agency that administered the federal employee health benefit system). The new national plan would be offered by a private insurance company. Party leaders hope that progressives will find this to be an acceptable alternative to a Public Option run by the government. In exchange for dropping their demands for the Public Option, progressives have pursued amendments to the current legislation in the form a significant expansion of the Medicare program – the nation’s health insurance system for those over the age of 65. Under the proposal currently being discussed, the Medicare program would be opened to Americans over the age of 55. This is a population that can face great difficulty obtaining affordable coverage – especially if they suffer a job loss. Also being pursued is a proposal to open the new national health insurance exchange to more Americans. As originally proposed, the exchange would have been limited to a select few small employers and uninsured Americans, perhaps as few as 15-30 million. Adoption of these compromises would have a far more significant impact on health reform and coverage expansion than would the limited Public Option and progressives would be wise to pursue them.

Interestingly, or perhaps distressingly for Democrats, just as progress is being made on reform public opposition is on the rise and public support is collapsing. According to the latest tallies from Pollster.Com a majority of the country now opposes reform and less than 40% is in support. As heated debates remain over touchy issues such as abortion and funding – to say nothing of a needed reconciliation with the House – Democrats in tough re-election fights need the cover of public support - at the moment they do not have it. Only time will tell if that changes as details of these new negotiations emerge.