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Doing the math behind waning support for public option

What’s really behind the Obama administration’s apparent wavering over a public option in health-care reform?

It could be a simple case of math. We already know that most Republicans won’t support a public option.

President Obama told a town hall in Grand Junction, Colo., this weekend that the “public option, whether we have it or we don’t have it, is not the entirety of health care reform,” says Talking Points Memo. “This is just one sliver of it, one aspect of it.”

Meanwhile, Health and Human Services Secretary Kathleen Sebelius told CNN’s “State of the Union” that a public option is “not the essential element” of health reform. Essentials include lowering insurance premiums and stopping insurers from dropping customers with pre-existing conditions or for surpassing their coverage caps.

“I think there will be a competitor to private insurers,” she said. “That’s really the essential part, is you don’t turn over the whole new marketplace to private insurance companies and trust them to do the right thing.”

43 Dems on record in favor
Back to the math. The U.S. Senate needs 60 votes to pass a health-care reform bill. So far, 43 Democrats have gone on record in favor of the option, according to OpenLeft.com, which keeps track of members of Congress for targeting purposes. Sixteen are maybes, two are unknown and two are definite nos.

But Open Left says a public option is not dead yet. “With 43 supporters of the public option, we only need seven of these twenty Senators to flip in order to pass the public option through reconciliation. Even amid the din of right-wing astroturf protesters and a media giddy at the prospect of health care reform failure, meaningful health care reform is very doable in 2009.”

Open Left says Sen. Amy Klobuchar, D-Minn., is among the uncertainties, although Howard Dean’s Stand with Dr. Dean website lists her as a supporter on his “Where Congress Stands” list. Minnesota’s junior senator, Al Franken, is presumed to be a supporter of a public option, although he has advocated for a single-payer system. (Franken, a Democrat, apparently is so junior that he is not listed on Dean’s site.)  Open Left lists Franken as a supporter.
 
MinnPost has a call into Klobuchar’s office for comment and will update this post when we get a response.  

The FiveThirtyEight: Politics Done Right blog says it’s not entirely clear where Klobuchar stands. She is among five senators “who have either given signals that they’d support the public option or, when push came to shove, would be more likely than not to do so.” That list of five includes Sen. Herb Kohl of Wisconsin and Sen. Tim Johnson of South Dakota.

Klobuchar ‘ambiguous in e-mails’
Even so, Klobuchar has been “decidedly more ambiguous in e-mails to constituents, and Minnesota has lots of skin in the health care game in various forms,” says FiveThirtyEight’s Nate Silver. “Still — although Klobuchar is not as liberal as you might expect from a Minnesota Democrat — this seems to me like an eminently whippable yea vote.”

Klobuchar’s health-care policy statement on her website makes no mention of her stance on a public option. This statement seems to show what she supports:

“We must expand health insurance coverage and make that coverage meaningful rather than riddled with high deductibles and exclusions. But we cannot do so without simultaneously tackling a health care payment system that rewards volume rather than quality services and preventive care. As Senator, I will work to pass health care reform legislation that dramatically expands coverage and redesigns the perverse incentives in our health system that drive up health spending and make our current system unaffordable.”

Other senators are doing the math, too.

Michael Tomasky of the United Kingdom’s Guardian writes today: “If you’ve been watching this closely, you’ve known or at least suspected for some time what North Dakota Democratic Senator Kent Conrad said yesterday — that there aren’t the votes in the Senate for a public option, and ‘there never have been.’ “

Several GOP votes would likely be needed
Sen. Dick Durbin, D-Ill., told The Wonk Room that he would “reluctantly” support a bill without a public option. “We have the reality of 60 votes in the Senate and two Senators who are sick,” Durbin explained. “Senator [Robert] Byrd, who may be able to return. We hope he can. Senator [Ted] Kennedy, we hope he can return. Without them, we need at least two, maybe three Republicans to support our effort and there seems to be universal opposition to a public option among all Republican Senators.”

And the House? Republicans and Blue Dog Democrats are expected to oppose a public option. And, progressives could throw a wrench into the works of any legislation.  

“House progressives, meanwhile, have vowed to oppose a health care reform bill that doesn’t include a public option — an inconvenient reality for the White House, and one which could set the stage for a major showdown after the August recess comes to the end,” Talking Points Memo notes.

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Comments (17)

  1. Submitted by Keith Ford on 08/17/2009 - 12:49 pm.

    “…an inconvenient reality for the White House, and one which could set the stage for a major showdown after the August recess comes to the end,” Talking Points Memo notes.

    Great. Bring it on. This is important enough to insist on a major showdown. What’s the worst that can happen? The public options fails to garner enough votes and Congress passes a toothless “reform” package. That’s going to happen anyway. That’s the least they dare pass.

    Let’s go for the big kahuna!

  2. Submitted by Dave Francis on 08/17/2009 - 01:40 pm.

    If there was ever a time for a national referendum–THEN THIS IS DEFINITELY IT? Of all the issues the ones that will influence the American peoples economy, culture, language and society for decades to come, is Health care and illegal immigration. Neither political party, special interest lobbyists nor anybody else should be able to use their influence the running of our country. The United States–VOTER–should have the last word, not corrupt members of the Democratic leadership, the Republican minority party and certainly not La Raza or ACLU, US Chamber of Commerce, Council of Foreign Relations, Cato Institute, billionaire George Soros, Ford Foundation and a multitude of self interest groups. In health care the insurance companies have used their political currency, to weaken any prospect of a Canadian or European style public health care option. 2/3 of America insist on the single payer system like Canada and the European developed nations.

    The rest of these despicable organizations want the free flow of cheap labor that is already swarming across our nation, even though we are in a deep recession and millions of US citizens and legal residence are jobless. As I speak 1.5 million new immigrants entered America and that’s not counting the illegal aliens who extract from taxpayers everyday. Our politicians can no longer demand of the people, to pay for foreign national health care, when they cannot afford it for their own families? How many more years are the people to be dictated to the power of profiteering insurance companies? How many decades must taxpayers is forced to pay for illegal immigrants and families, who have already broken our laws of sovereignty and expect to be rewarded with another blanket AMNESTY.

    How can we assume our legislators to honor the “Rule of Law”, when they have already stone-walled us over the 1986 immigration enforcement law? Millions of loyal Americans who have already commanded E-Verify extraction tool in the workplace (section of the SAVE ACT) 287 G police enforcement, no match letter and the ICE raids of illegal immigrant. But we must maintain the bombardment if you want a health care public option choice? Whether you want to keep on supporting the impoverished, unschooled of foreign nations that skirt our laws? CALL YOUR SENATORS AND REPRESENTATIVES FOR WHAT YOU WANT AT 202-224-3121? NOT WHAT THE SPECIAL INTEREST LOBBY HAS PAID FOR? Read about the trillions to be spent on giving AMNESTY to illegal immigrants at the Heritage Foundation. GOOGLE more facts on the web, or search for the truth at NUMBERSUSA.

    Observe this PETITION to STOP any health care to illegal immigrants at: http://www.thepetitionsite.com/1/nohealthcareforillegals

  3. Submitted by dan buechler on 08/17/2009 - 01:43 pm.

    Very good article almost exactly what I was looking for today. Could use a lot more info on Senator Klobuchar, Kohl and Johnson (SD). If not hard info perhaps another piece that could include speculation on their political futures with their base and general electorate. Very gratified to see Minnpost referring to other near regional players (WI and SD).

  4. Submitted by dan buechler on 08/17/2009 - 02:29 pm.

    Another question and I know I am being lazy or curious here but do the 43+ senators represent a majoity of the American Population? I bet its close to 50% if not more (2 alone are from California a large economy on the world’s stage)

  5. Submitted by Tom Horner on 08/17/2009 - 02:35 pm.

    Good article, but misses some key points:

    Dems don’t need 60 votes in the Senate to pass a health reform bill. They already created the path to bypass parliamentary procedures, circumvent cloture and move directly to simple-majority passage. Whether they want to risk the politics of that maneuver is a different matter.

    While the public option has become the centerpiece of the controversy, it’s an untested reform at best. Success depends on a lot of what-ifs — e.g., a public option will put pressure on insurance plans to squeeze costs, etc. But the reality is that most health costs still are controlled by docs and a public plan does little to reduce those costs. And if we don’t reduce health costs, universal access is impossible.

    Why the all or nothing approach? There is a lot of useful reform (some of it based on what already is working in Minnesota) that could significanlty reduce the number of uninsured, improve quality and reduce costs. Why keep creating road blocks where there are opportunities?

  6. Submitted by Keith Ford on 08/17/2009 - 02:51 pm.

    Articles are starting to refer to successful health co-ops in Seattle and Minnesota. This relates to a comment from Sen Jay Rockefeller that said only two coops ni the country are working and one was HealthPartners.

    Now I’ve been a very satisfied member of HealthPartners for 39 years but don’t tell me it’s a co-op that I as a member control. That’s a myth.

    And let’s not pretend that HealthPartners has kept prices low here. I have been happy because my employers have, over the years, paid my health insurance. But I know from my stint as a union negotiator and another stint as a employer negotiator, health insurance costs at HealthPartners chewed up a ton of my employers’ employee compensation and benefits budget and I saw not evidence of a price break with them.

  7. Submitted by Tim Nelson on 08/17/2009 - 04:11 pm.

    To boldly steal a catch phrase from Sherlock Holmes, we should offer insurance companies a “7 % solution”. An insurance company that makes more than 7% in profits will be taxed for the overage, and those making less than 7% will receive a tax break, or a subsidy. Profits of 7 % across the board would bend
    the curve from the double digit increases over the past decade, while putting none of the reduced number of insurance companies out of business. Start-up insurance companies would not receive tax breaks until they can prove a 7 % profit margin.

    So, that’s my wage and price control example for today. Other ways need to make it to the bill as well. Concentrating on insurance will not be enough.

  8. Submitted by dan buechler on 08/17/2009 - 04:23 pm.

    Would Healthpartners have to operate under new rules? I have been happy with their service in my younger years but will they they still love me when I’m 64?

  9. Submitted by Kevin Judd on 08/17/2009 - 08:47 pm.

    Amy Klobuchar is an “eminently whippable yea vote”? I read Silver’s article, and the baffling quote is right there. Is Silver saying she will vote yea or nay? And who will whip her? Reid or the Right? And what aspect of her whippability makes her EMINENTLY whippable (versus merely passably whippable)? Should we who are her constituents be proud or appalled by this aspect of our senior senator?

  10. Submitted by Howard Miller on 08/17/2009 - 11:01 pm.

    I have been part of Healthpartners since 1980 (It was called group health i recall).

    I join Keith Ford – my sentiments are virtually identical re control, employer costs. Our policy has increasing co-pays, increasing total costs

    I believe that a public insurance plan would be a welcome addition to the insurance marketplace, and if negotiations with private providers (like Health Partners) can’t work out, then we develop a public health care capacity comparable to the VA system

  11. Submitted by John Roach on 08/17/2009 - 11:40 pm.

    Part of the “waning support” is because of the massive amount of money being spent to kill any meaningful reform. The health industry disclosed spending $450 million on lobbying in 2007, $490 million in 2008, and they are on track to spend around $570 million in 2009.

    This doesn’t count the undisclosed millions that are being spent on dozens of astroturf organizations like “Freedomworks”, “Patients First” and “Americans for Prosperity”. If any sort of meaningful reform passes, it will be in spite of literally billions of dollars that are being spent to stop it.

  12. Submitted by Glenn Mesaros on 08/18/2009 - 03:42 am.

    Have a little faith in the intelligence of the American people. This is the greatest debate in the history of the American Republic since the Civil War. As one lady said in Pennsylvania, to Arlan Spectre, “you have awakened a sleeping giant”. The liberals like Katy Couric are upset that the debate is messy. So what. Democracy is messy. The American people are reacting to the two worst pieces of legislation in American history: Cap and Tax $846 billion, which stems from 40 years of environmentalist lunacy, and Obamacare, which has NOTHING to do with universal health care, but ONLY to cut Medicare, in order to maintain bailouts from Bankers Boy Barack to Wall Street Hedge Funds. The big wake up call will come in November, when New Jersey and Virginia will crush the liberal Democrats.

  13. Submitted by dan buechler on 08/18/2009 - 09:51 am.

    The debate over civil rights and isolationism probably rank higher. Only time will tell. Just like when we all turn 55 or 64.

  14. Submitted by Karen Sandness on 08/18/2009 - 11:26 am.

    Back when I lived in Oregon, land of runaway initiatives and referenda financed by millionaire cranks, I once attended an informational meeting on the ballot measures to be decided in the upcoming election.

    One of the speakers described a particularly insidious measure full of booby-traps and unintended consequences, but he concluded by saying, “Fortunately, this has little chance of passing. Experience has shown that most voters automatically reject any measures that they don’t understand.”

    The overly complicated nature of HR3200 is one of the prime reasons for its declining popularity. The text appears to contain not only the outlines of the plan but all the administrative rules connected with it.

    First of all, few people are going to read all 1000 pages, and it is difficult to find executive summaries. This makes it easy for the right wing to lie about its content.

    Second, there is no easy way for individuals to find out how the proposed reform will affect them personally. I have a graduate degree from an Ivy League university, and I can’t figure out what the bill means for me, especially since the status and nature of the “public option” keeps changing.

    For health care reform to succeed, the Democrats need to come up with a streamlined bill (something like the 13-page HR676) whose essence can be boiled down into five sentences that allow the public to understand what their options will be.

    I can describe both the Canadian and British systems (they’re quite different) in five sentences each. The Democrats need to come up with a plan that is equally easy to describe.

  15. Submitted by Virginia Martin on 08/18/2009 - 12:16 pm.

    I think if President Obama put his full weight, passion, and eloquence to use to explain the public option and what it would do and not do, the public option battle could be won.
    Right now, we don’t have much to rally behind. Nothing so clear (if wrong and mistaken) as socialism and keeping the govt. from taking over health care, and all the other deliberate scare tactics the right is using.
    I think Obama administration should just go for it.
    Presidents have pushed for unpopular but needed measures before and won: President Roosevelt and social security programs, President Truman who unilaterally desegregated the military despite protests.
    We liberals are not putting our own views out strongly enough, partly because there’s no clarity on the part of the administration.
    This is still winnable; not that many more votes are needed to push it through–and why not despite the conservatives’ NO.

  16. Submitted by Bernice Vetsch on 08/18/2009 - 04:04 pm.

    It’s time for Senator Durbin and others who have supported the president’s efforts until now — even though Mr. Obama left most of the decision making to right-wing Republicans and Blue Dog Dems –to stand up and shout “We’re mad as hell as we’re not going to take it anymore. This is just another corporate handout at the expense of taxpayers and we will not stand for it.”

    The Republican/Blue Dog plan, probably with or without a public option, will be structured to leave those who profit from Americans’ sickness to ensure their ever growing profit margins.

    The answer: (1) Kill all the current plans, even the House plan where the public option would be in danger of removal or emasculation during the conference committee process.

    (2) As Doctor Dean suggests, enact legislation to correct all the gratuitious abuses now perpetrated by the insurance companies against their customers. We must also require rather than forbid drug price negotiations by Medicare.

    (3) Address the real root of this and so many other problems by enacting legislation to require all federal-level campaigns to be publicly funded. There is probably no other way to remove the terrible influence corporate dollars have upon our legislative process.

  17. Submitted by Bernice Vetsch on 08/18/2009 - 04:09 pm.

    Tom Horner (#5): I don’t believe the Democrats are planning to work around established procedure. They are returning to the procedures used before the Republicans used their majority to assure themselves the possibility of stopping any legislation they did not like by enacting the 60-vote rule.

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