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According to Progressive Democrats of America and this OpEdNews piece, the Kucinich Amendment to waive federal ERISA regulations that might hold up state single payer movements has been stripped out of the final House health care bill. This will be a blow for state single payer movements because insurance companies may now be able to file disingenuous court cases holding up the implementation of any legislative victories. (This is reminiscent of what happened in California after that referendum on car and other types of insurance back in the 1980s.) It’s important to note that it’s not a fatal blow, however, because speaking objectively federal ERISA regulations may not actually impact single payer systems. But it’s still not a chance we wanted to take.
Also, the public plan for the uninsured is not tied to Medicare rates, which probably means that even the skimpy 9-10 million people estimated to sign up by the CBO for the original plan is a big overestimate. It is even possible, if the plan resembles the one in the Senate HELP bill, that no one would sign up for this plan; in other words the plan would be moribund.
As Pelosi said would happen some time ago, the surtax on the rich has been significantly reduced as a funding source. This raises the obvious question of where they are getting the rest of the money. I guess we’ll know tomorrow.
There was one bright light amid the darkness due to Medicaid coverage being expanded to 150 percent of poverty level, up from the 133 percent in the original versions. It will be interesting to see how many people qualify when the CBO scores the bill. This makes one thing crystal clear: the Medicaid expansion has ended up being a far more important part of this bill than the public plan for the uninsured. Back in July, they were roughly equal in importance: the Medicaid expansions would cover 11 million more people, and the uninsured plan would cover 10 million. One figure is now certain to rise significantly and the other seems destined to fall.
This puts the lie to the HCAN claims of the significance of the “public option,” or to use more honest language, the uninsured plan. The biggest expansion of public programs under this bill will now come unequivocally from the Medicaid single payer plan. The hoax has now been revealed: there will be little significant impact from the uninsured plan, and at this point it may even be advisable to stop discussing it entirely and focus any efforts on retaining the Medicaid expansion in conference.
This raises the larger question of whether we should support or oppose the House bill as it currently stands. Personally I would have supported the original House version while holding my nose, but can’t be too sure about this one without more information.
In any case, the bulk of our efforts now should go toward supporting state single payer movements like those in California and Pennsylvania, pressuring our leaders to support the Weiner amendment in its House floor vote, and certainly to replacing unproductive and trammeled organizations like HCAN with free and independent ones like Healthcare-NOW. Only once this is complete will we have any hope of achieving a humane and efficient national health care system in the United States.
8 Comments
khin, thanks for this diary. just read david swanson’s post tonight and was hoping someone would write about the hoax. do you have any idea how this bill, if passed, is expected to affect the situation in MA? not sure, but it’s starting to look like our 2006 reform, as flawed as it was, is possibly better than what is being considered nationally.
What an outrage! What a travesty! We definitely need a new party in 2012. These two are both bought and paid for. We ought to now pressure the progressives in the House to vote against the bill. It’s worse than nothing at all.
I’ve never really held out any hope that the national reforms would be that different from what was proposed in MA. It seems to be the same basic model. The main difference is that while in MA most of the population was already insured, nationally that is not true.
I don’t know what the effects will be on MA, but I would guess that they’ll be somewhat worse for you overall than for the rest of the country, simply because in MA most of the population is already insured but you’ll be taxed the same. But then, your state may rewrite its legislation before 2013 to take advantage of the national umbrella, so who knows?
Thanks for this, khin, especially for framing the ERISA issue with greater precision than I have in past diaries.
I’ve repeatedly warned that Pelosi would use the HR 676 floor vote as political cover for torpedoing the Kuncinich amendment. I’ll still be very surprised if she reneges on Weiner; it’s a lovely, cost-free, symbolic, futile exercise.
Bernie Sanders had a Senate correlate to the Kucinich amendment; I’m assuming that’s dead too?
One irony in this is that Reid’s adoption of a state opt-out on the PO opens a perfect frame for preserving the state single-payer amendment: if states have the right to opt for something weaker than a public option, they should have the right to opt for something stronger.
I have to say, I don’t think progressive organizations did a good enough job of explaining to activists that they needed to hound their representatives on Weiner but focus on leadership on Kucinich.
Abandonment of Medicare + 5% does surprise me; Democrats’ description of this rate structure as “the robust public option” was always a cruel joke, as Medicare + 5% says nothing about PO availability, scope, and infrastructure. Nonetheless, now that even fake robust is off the table, what recourse do Jane’s progressive whippets have but to vote against this bill?
also in MA, prior to the 2006 reform, we had decent (compared to much of the rest of the country) insurance regulation including community rating and guaranteed issue (with some restrictions. i can’t remember now, but i think there may have been some kind restriction on the length of time one could go without insurance and then pick up again without being subject to a temporary exclusion in the coverage for any pre-existing conditions). so prior to 2006 there was some confidence that the state could regulate the insurance companies. i don’t have that kind of confidence for, say, california.
Ok everyone, lets clap our hands together for what Obama has accomplished.
Four words: They’re dead to me
well said khin, seriously good research, seriously good blogging!