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Unions Ramp Up Pressure to Save Public Option, Drop Tax on Health Plans

Art Levine

Despite the votes on Saturday to proceed to a floor debate, the fate of the Senate version of a healthcare reform public option is still in doubt—and unions and progressive allies, including the Health Care for America Now coalition, are also pushing halt to alter or block the 40% excise tax on high-cost plans still in the Senate bill. The public pronouncements by national union leaders are more measured than the grassroots pressure growing on centrist Democrats in swing states.

While national unions and progressive groups hailed the bill’s progress, they’re also working to generate grassroots activism targeting Democratic Senators in key swing states. These include — in addition to the four key Senators who’ve threatened filibustering — Montana senators Max Baucus and John Tester, and Virginia senators Mark Warner and Jim Webb.

We’ve been mobilizing members to advocate a healthcare plan with a public alternative to insurance companies, no tax on workers’ health plans, and a mandate for employers,” one veteran union activist says. And, he points out, we don’t favor a trigger,” although it’s now increasingly in play in the Senate.

Richard Trumka, the AFL-CIO president, was generally positive in his assessment of the bill, but noted the continuing opposition to a funding plan that could ultimately tax 40% of families with employer-based health care, according to the Congressional Joint Committee on Taxation.

As Trumka said last week:

The Senate leadership bill takes the strongest steps yet to bring down costs. But the bill is not perfect. It retains a version of the excise tax from the Senate Finance Committee bill. We continue to believe that a tax on working families’ benefits is the wrong way to finance healthcare and we will work hard to eliminate this provision as the bill heads to the floor.

But Trumka, joined by other mainstream progressive groups, also praised the bill for moving toward health reform, even as the public option provision remained relatively weaker than the House version — and remains under assault by conservaDems and Lieberman.

Even so, Trumka said:

We commend Senate Majority Leader Harry Reid for bringing forward a health care bill that moves us closer to the historic goal of health care for America – high quality, affordable health care for all in our rich nation…Today another hurdle is cleared and we are optimistic that good, affordable care for working families will soon be law.

Unfortunately for progressives, there’s still plenty of weakening of the public option waiting to happen. As the New York Times reported:

Anxious that Saturday’s party-line Senate vote to open debate on a health care overhaul gives them little maneuvering room, Obama administration officials and their Congressional allies are stepping up overtures to select Senate Republicans in hopes of winning their ultimate support….

Sharing the center of attention with Maine’s senators are a handful of swing senators from both parties whose votes are up for grabs on this issue.

On Sunday, there were already flurries of bargaining, including over their opposition to the kind of government-run insurance option that is in the Senate bill. Senator Ben Nelson, Democrat of Nebraska, said on This Week” on ABC that while he opposed this even if states could opt out of it, I would look at a public option where states could opt in.”

And NBC News reported Monday afternoon the latest cloakroom dealings that seem quite able to throw progressive goals on the public option under the bus:

Senate Democratic aides say that Majority Leader Harry Reid and his leadership team have begun searching for a fix on the public option. At least four Democratic Senate moderates made it clear this weekend they would block the final passage if it included the current version of a government-run insurance program.

As Reid needed 60 votes to get the bill on the floor, he’ll also need 60 votes to pass it – every member of his Democratic caucus. But drawing his moderate members into the fold may simultaneously push out liberals.

After Sen. Mary Landrieu gave a speech on Senate floor Saturday voicing her support to start debating the bill, she told a small gaggle of reporters the failure to find a compromise with centrists could blow up the whole effort.”

I believe it’s going to be very clear at some point very soon that there are not 60 votes for the current [public option] provision in the bill,” she said. And that the leader and the leadership are going to have to make a decision. And I trust they will figure out how to do that.”

Democratic sources say the leadership has started feeling out the caucus for two possible compromises. 

One alternative, called the trigger” or fallback,” has been offered by Republican Sen. Olympia Snowe. Under her plan, if private insurance failed to offer affordable insurance by a certain time, a non-profit public insurance plan would kick-in or be triggered in that state. The White House has been supportive of Snowe’s proposal in the past.

The other alternative is offered by Democratic Sen. Tom Carper. He calls his plan the hammer.” While admitting it’s a work in progress, it would work like Snowe’s trigger concept but would also allow states to opt into a public plan. (The bill before the Senate would let state’s opt-out.)

These weakening amendments are gaining in strength, in part, because it’s now increasingly clear that there’s little interest in the Senate in using the much-vaunted budget reconciliation” approach to avoid a filibuster with a majority vote on budget-related items. That potential budget vote could be on the public option, in theory.

Other provisions cracking down on health insurance abuses and denials couldn’t even be addressed by a budget reconciliation approach. But even the staunchest proponents of the public option in the Senate have apparently abandoned reconciliation, along with Majority Leader Harry Reid, as I reported last week in Truthout​.org.

But union leaders and other progressive activists remain optimistic that the political value to Democrats of an effective law and grassroots pressure will preserve a decent, if imperfect, bill. Says one health reform advocate,”It never feels like we’re winning, but look where we are today compared to where we were six months ago.” He adds, We’ve falling uphill.”

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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