Progressives Still Pushing for Public Option As Reform Roadblocks Mount

Art Levine

Progressive groups are still going ahead with campaigns to preserve the public option and oppose further weakening of healthcare reform, as chances for a public option – and even an expanded Medicare buy-in – face new roadblocks. Meaningful reform could be in even deeper trouble this week because Sen. Joe Lieberman indicated on Sunday that he would likely filibuster a measure with a Medicare buy-in for those 55 and older – a compromise deal that he appeared to support just last week.

Indeed, by early Monday evening, the AP reports, Senate Democrats appeared to be moving away from the Medicare compromise, which may be the last vestige of reform left for progressive activists to hold on to. Yet Senator Sherrod Brown (D‑OH) declared Monday on MSNBC, We’re going to keep fighting to make it better.” He added, It’s a good bill, but not a great bill.”

Most liberal groups have not yet reached a point where they’re declaring a line in the sand” against a weakened healthcare reform bill as it seems to be heading now, because the final shape of the bill hasn’t been settled yet. Unions have been relatively quiet publicly about the fast-changing provisions in the latest Senate proposals, but are still pressing for getting rid of the excise tax on costly so-called Cadillac plans.”

Leaders at SEIU, though, are also backing reforming filibuster rules to allow for an eventual cut-off of a filibuster so Joe Lieberman can’t hold health reform hostage – and further endanger the 45,000 people who die each year in the U.S. because they lack health insurance.

But without either a meaningful Medicare buy-in or a public option in a final bill, the it’s‑not-worth-it” perspective would likely gain traction on the left unless the bill is strengthened, and that view has already been emerging in the blogosphere, amplified by MSNBC’s Rachel Maddow.

In fact, there are now early signs of a potential split between progressive Democratic officials such as Rep. Anthony Wiener (D‑NY) and former Gov. Howard Dean, who have signalled an openness to the Medicare buy-in compromise, and the Democratic Party’s progressive base, which views trading away the public option as a betrayal. Budget reconciliation as a solution to preserve genuine health reform appears to be gaining ground on the left, a strategy Dean has long supported, even as Senate leaders have publicly distanced themselves from it.

On last week’s Maddow show, Dean appeared to accept a Medicare buy-in compromise approach, but a spokesperson for Democracy for America, founded by Dean, says that Dean favors keeping both provisions in the final bill.

But opposition from both the healthcare industry and liberals could sink the Medicare buy-in compromise, which would not even start providing subsidies to uninsured people 55 and older to purchase expensive Medicare premiums until 2014

The issue has now, in some progressives’ eyes, come down to two unlikely procedural actions by Senate Democrats: either change Senate rules to rein in the filibuster (the so-called nuclear option”) or use budget reconciliation as a way to save genuine healthcare reform.

As the influential Firedoglake blog wrote after Lieberman moved the goal posts again Sunday in a way that sabotages Democrats’ health care reform:

Reconciliation (or the nuclear option) now is the sole path remaining to pass anything resembling decent health care reform. If Congressional progressives back down now, there will never be a single pro-working class American bill ever again passed by Congress. From now on, it will only be massive corporate bailouts where at best regular Americans get the scraps that fall from the table. If progressives will not draw a line now with Democrats fully controlling everything, they will forever be a completely meaningless force in Washington.

I know some claim there are problems with reconciliation. The consumer protections might not be passable with reconciliation. Yet as we have learned recently, Harry Reid gutted the ban on annual limits and added a massive loophole in the rules about out-of-pocket limits. With those provisions gone, as far as I’m concerned, there is no consumer protections left, and it is now worth it to take the chance on reconciliation.

It is time to use reconciliation and pass a decent bill with a public option and a Medicare buy in. It is time for Democrats to show the American people they will not be held hostage by a handful of health insurance corporation defenders like Joe Lieberman and Blanche Lincoln. They must pass reform that will actually help the American people instead of forcing them to hand their paychecks to poorly regulated private insurance companies. This is a watershed moment where we will find out who truly rules Washington. And I promise if the answer is Joe Lieberman and the for-profit health insurance corporations, the Democratic base will not turn out in 2010.

Roll Call reported early Monday that the Medicare compromise was in trouble:

As Senate Democrats show tentative signs of coalescing around a compromise health care bill that eliminates the controversial public insurance option, some of their allies are wasting no time in trying to sink the new proposal. While lawmakers await a Congressional Budget Office cost analysis of the proposed substitute, doctor and hospital groups are already trying to scuttle part of the plan that would allow people ages 55 to 64 to enroll in Medicare. …

Liberal groups, including MoveOn​.org and union-backed Health Care for America Now, have also railed against the compromise proposal because they view the public option as central to any health care reform effort. ” Also, doctor and hospital groups are opposing the proposed Medicare expansion because they say the system already shortchanges” doctors and other providers and that an expansion would further burden an overburdened system.

What does the left do now? 

Charles Chamberlain, the political director of Democracy for America, told In These Times that it’s gathered 500,000 signatures in its ongoing petition drive to pressure Senator Reid to strip pro-filubustering members of the Democratic caucus of their chairmanships. Another pressure mechanism activists want to see: taking up budget reconciliation to save the public option, needing only 51 votes, but that’s a stance that Democratis leaders and even liberal Senators haven’t been willing to take so far. 

Americans want the public option,” he says, citing new polling showing that 58% of the public favors the public option. The Democratic leadership has to come through for the people.” He added, in a new theme that the left wing of the Democratic party is starting to embrace: Do whatever it takes.

Health Care for America Now, the labor-backed coalition with 1,000 local and national groups, declared last week:

At 4:45 pm last night, Health Care for America Now sent out an email asking our supporters to oppose the so-called compromise being negotiated in the Senate. Four hours later, over 30,000 people had signed on. This morning, we’re up well over 40,000.

The response has been tremendous. Here’s what people are saying opposing this so-called compromise:

  • From Patti in California: My son needs the public option! Please remember that young adults (part-time students & part-time work) need to have health care too!”
  • From Cheyenne in Ohio: Do not let the public option die! Please fight.”
  • From Michelle in Texas: Tell Sen. Lieberman NO! It would be nice to know how much money he’s received from insurance monopolies to betray his party and the American people on the Public Health Care Option.”
  • Nancy in New York: The vast majority of the American People WANT a public option. Give it to us or we will remember this in Nov 2010!”
  • Lois in Texas: How can one guy stop the whole process that millions of Americans want! NO!”

All of this points to a fact those in the Senate considering this compromise” would do well to remember: The public option is extremely popular in America, and a significant portion of those who say they oppose health reform say so because this plan does not go far enough.

The stakes couldn’t be higher, and progressives both in and out of the Senate have some major decisions to make in the next few days over what to do about the current legislation. As strategist Mike Lux, writing in Open Left, declared:

The health care debate has officially arrived at its most critical juncture…Absent some miracle of policy creativity or leg breaking persuasion, progressives are going to have to make a choice: do we give in on the public option but then use our leverage to demand the most progressive possible legislation on everything else in this bill, or do we say no to the whole bill, forcing Democrats to start over or give up entirely on passing the health bill? (Reconciliation in my mind is a form of starting over given how complicated it is procedurally, and given that the bill would probably have to broken up into at least two different pieces of legislation to pass it.)…

I’m holding my powder for the moment. Reid came through on putting the public option in the original merged bill, and he came through in delivering 60 votes for the motion to proceed with debate, so I’m willing to give him the benefit of the doubt for a while longer. But I go back to what I have written before, and what those of us at Openleft have demanded in our petition to Reid: one way or another, you have to deliver.

Get it done, whatever it takes, Senator: breaking Lieberman’s legs (metaphorically, at least), reconciliation, the nuclear option, they all work for me. Whatever it takes. In terms of that ultimate decision I discussed at the beginning, while I’m not ready to make that decision, I know what my inclination is: stand up to Lieberman. One man’s tantrum should not determine the fate of the entire Democratic party’s policy decisions. While I have been more understanding than many progressives of why Reid doesn’t want to go the reconciliation route, for example, I think we should be ready to do it if that is what it comes down to. It would be problematic on many different levels, but whatever we have to do to get a good bill should be done. Whatever it takes.

UPDATE: Moveon​.org Political Action sent out an alert early Tuesday morning for a rally outside the White House, responding to news reports that Rahm Emanuel has been pressuring Sen. Harry Reid to give Joe Lieberman what he wants.

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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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