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Working In These Times

Monday, Nov 30, 2009, 1:08 pm

Health Reform Debate Starts As Unions, Liberals Pressure Reid for Stronger Bill

BY Art Levine

Even as Senate Republicans led up to the floor debate on health reform Monday afternoon with more lies about health reform's impact on Medicare, unions and progressive groups are stepping up their efforts to block the tax on costly health care plans and shore up the embattled public option.

But with Reid and Senate liberals dropping, at least publicly, the use of the budget reconciliation  weapon to get around a filibuster, the prospects for retaining a public option with any teeth in it remain in doubt. (You can follow live blogging on the debate here.)

The stakes couldn't be higher as Reid tries to keep together a fragile 60-vote majority on behalf of health reform, even as criticisms of the Senate bill from the left continue to mount. As The Hill reports:

Senate Majority Leader Harry Reid (D-Nev.) will face more pressure from the left on his healthcare reform bill as unions still have a number of grievances with the legislation.

Reid has struggled to keep the more centrist members of the Democratic caucus in line during the healthcare debate. But the Senate leader will also have to improve the reform package in order to meet the specifications of the labor movement, a key Democratic constituency.

According to union officials, the bill’s employer mandate needs to be expanded to include all employers. Further, they are lobbying for the elimination of an excise tax on high-cost insurance plans, known as “Cadillac” plans. Finally, labor’s support of a robust government-run insurance plan, the “public option,” puts the Senate leader in tough spot considering centrist senators either want to jettison the plan or find a weaker compromise before voting for the bill.

Reid also faces a tough reelection campaign next year and Las Vegas is home to many union workers.

Unions are happier with the House version of healthcare reform, which has no excise tax and a stronger public option. While planning to lobby for amendments to make the Senate legislation better, several union officials said they will wait to the conference between the two chambers to push for the biggest legislative changes.

Yet, as previously reported in In These Times, concerns about the excise tax on so-called "Cadillac plans" goes well beyond the labor movement to include not only liberal advocacy groups but research by the Joint Committee on Taxation showing that, with rising health care costs, it could affect as many as 40% of all working families.

Grass-roots lobbying and continuing ad campaigns aired by progressive groups could help shape the final outcome, but Republicans will be seeking to drag out the debate and offer amendments that could lure centrist Democrats to weaken and distort the bill even further.

Yet during the holiday break, for instance, swing senators such as Sen. Blanche Lincoln of Arkansas faced mounting pressure from both sides. As the AP reported:

After casting a crucial vote on the health debate, U.S. Sen. Blanche Lincoln didn’t return to the break she may have wanted when she came home to Arkansas.

The Democratic senator tried to focus on her strong point—farming—with a slate of events centered around her agriculture committee chairmanship. Surrounded by reporters before she opened her committee’s first hearing in Arkansas, Lincoln seemed surprised that all but one question was about health care.

“Does anybody else have something else about this, I hope?” Lincoln said. “Don’t forget what we’re doing today, I hope.”

That’s easier said than done with Lincoln, whose re-election campaign has taken on national significance along with her higher profile in the health care debate.

Announcing that she would vote to let debate move forward on legislation to overhaul the nation’s health care system, Lincoln gave Democrats the 60 votes they needed to move closer on President Barack Obama’s top domestic priority...

The pressure is also likely to continue from liberal groups such as MoveOn.Org, which has been airing ads in Arkansas urging Lincoln to support the so-called public option.

Lincoln’s dismissed the criticism she’s received on both sides.

Beyond wavering Senators, GOP amendments designed as bait for centrist Democrats could also disrupt the drive to health care reform. The well-informed Jonathan Cohn of the The New Republic reports today:

You can look forward to amendments on abortion, immigration, employer responsibility, tort reform--amendments that plenty of more conservative Democrats will find hard to resist, out of either principle or political necessity, even as they further alienate the left.

You can also expect to hear complaints that the bill tries too hard to cut costs, as well as complaints that the bill costs too much. Often you will hear those complaints coming from the same people, which will make them hypocritical but not necessarily unsuccessful.

By the time all of this complaining and amending is done, legislation might end up a lot worse than it is now--which is saying something, since the bill is already full of compromises. Legislation could end up putting even less money into helping people buy insurance; it could have even weaker efforts to change the behavior of the health care industry; and, of course, it could have an even more timid version of the public insurance option.

Unions and their progressive allies, though, have their own strategies for reducing the burden on working families. As The Hill reported:

Unions will likely flex their lobbying muscle on Capitol Hill
and get behind amendments offered to the healthcare reform bill by senators allied with the labor movement. Union officials pointed to a measure being worked on by Sen. Debbie Stabenow (D-Mich.) that would raise the ceiling further on what insurance plans would fall under the
excise tax.

“We would very much be in support of anything that raises the bar higher during the legislative process before this heads to conference,” said one union official. “From a strategic standpoint, that then becomes the floor.”

Even with all the maneuvering that lies ahead, as AFL-CIO President Richard Trumka declared when the Senate cleared the way for a floor debate over a week ago, senators still “have a ways to go”before a worthwhile bill emerges.

Still, unlike some progressive bloggers, unions aren't yet ready to draw a line in the sand over the healthcare reform bill as it's currently written.

As Harold Schaitberger, president of the International Association of Fire Fighters, an AFL-CIO affiliate, told The Hill, “I am not going to ever draw any line with opposing an overall bill with so many steps in the process left. We are going to keep an eye on the ball to make the bill better.”

Art Levine, a contributing editor of The Washington Monthly, has written for Mother Jones, The American Prospect, The New Republic, The Atlantic, Slate.com, Salon.com and numerous other publications.

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