Ezra Klein: The Divisions in the White House on Health Care Reform

[flpoljunkie]

The Divisions in the White House Over Health-Care Reform

This is health-care reform's endgame, or close to it. Next Wednesday, Barack Obama will give a prime-time address before both houses of Congress. But that's not all he's giving Congress. The administration is going to put a plan down on paper. The question is what it will say.

Conversations with a number of White House officials make it clear that, at this point, even they don't know. The argument was raging as recently as last night, and appears to have hardened into two main camps. Both camps agree that the cost of the bill has to come down. The question is how much, and what can be sacrificed.

The first camp could be called "universal-lite." They're focused on preserving the basic shape of the bill. They think a universal plan is necessary for a number of reasons: For one thing, the insurance market regulations don't work without universality, as you can't really ask insurers to offer standard prices if the healthy and the young don't have to enter the system. For another, it will be easier to change subsidies or improve the benefit package down the road if the initial offerings prove inadequate. New numbers are easier than new features. Creating a robust structure is the most important thing. This camp seems to be largely headed by the policy people.

The second camp is not universal at all. This camp believes the bill needs to be scaled back sharply in order to ensure passage. Covering 20 million people isn't as good as covering 40 million people, but it's a whole lot better than letting the bill fall apart and covering no one at all. It's also a success of some sort, and it gives you something to build on. What that sacrifices in terms of structure it gains in terms of political appeal. This camp is largely headed by members of the political team.

Both camps accept that the administration's proposal will be less generous than what has emerged from either the HELP or House Committees. The question, it seems, is how much less generous.

more here...

http://voices.washingtonpost.com/ezra-klein/2009/09/the_divisions_in_the_white_hou.html

[DrToast]

1. So the options are bad and piss poor?

Wonderful.

[flpoljunkie]

11. Intriguing White House officials admit they don't know what Obama will decide.

I like what Ezra Klein has written on health care reform and the public option--which I posted earlier today.

http://journals.democraticunderground.com/flpoljunkie

[kath]

19. Yeah, great - the bills out there are crappy enough, and they're going to be watered down even MORE?

Jeebus.

[DJ13]

2. So either way were screwed?

No spine.

[Jennicut]

4. Where would the votes come from? If it fails now, we get nothing.

Try again in maybe 15 more years...

[DJ13]

9. If it fails now, we get nothing.

Thats exactly what they want us to think, as it ensures the weak within our party capitulates.

The more they divide us into two camps, those who know we have the votes if we have the will, and those that just want success no matter how meaningless, they win.

[Jennicut]

3. Aha...so that is why we are seeing mixed messages in the media.

I pray the policy wonks win this debate. The political advisers would tell you anything that would "win" reelection but not necessarily what is right for the country. Bill Clinton brought in Dick Morris to turn things around after the 1994 elections and he did but at what cost?

[Pirate Smile]

7. I really want to just ignore the news until Tuesday. Nothing really matters until Wed. Obama's

at Camp David. Nothing will really happen until next week.

I'm afraid that I'm too used to being a news junkie to just go completely cold turkey but a lot of kvetching really isn't useful now.

[Jennicut]

13. True...that is when we will know what the truth is.

[grantcart]

5. Come on over Olympia you can have Joe and Conrad's chairmanships

from the article


The answer appears to hinge on Sen. Olympia Snowe. "I'm a Snowe-ite," joked one official. Her instincts on health care have proven quite a bit more liberal than those of many Democrats. In the Gang of Six meetings, she joined Sen. Jeff Bingaman in focusing on affordability and coverage — putting her, in practice, somewhat to the left of Conrad and Baucus. The problem is that Snowe is scared to be the sole Republican supporting this bill, not to mention the Republican who ensures the passage of this bill. The reprisals within her caucus could be tremendous.

[Pirate Smile]

17. CNN's Ed Henry reports, on "The Situation Room": "My colleague Dana Bash and I have learned from a

source, each one of us, that this White House right now is very quietly in serious conversations with Republican Senator Olympia Snowe, a key moderate."

[flpoljunkie]

18. Ezra Klein says Snowe is in intensive negotiations with the Obama administration, as well...

What Leverage Do Republicans Have on Olympic Snowe?
by Ezra Klein

According to a variety of sources, Olympia Snowe could pretty much write the bill at this point. According to a variety of sources and her record, she believes health-care reform to be a good and necessary idea, at least as she would compose it. But she's concerned about being the only Republican to vote for Barack Obama's health-care reform plan. Right now, the Obama administration is in intensive negotiations with her office, and the outcome is, according to all involved, uncertain. But why?

Snowe is not up for reelection until 2012, so there's no immediate threat. Moreover, she's a wildly popular politician in a deeply blue state. If her party attempted to exact revenge, she could easily become a Democrat, or follow Joe Lieberman's example and emerge as an independent. She's the ranking member of the Senate Committee on Small Business and Entrepreneurship, but surely the Democrats would let her keep that in exchange for her vote. She's moderate enough that the switch wouldn't be particularly jarring, and the fact that it came in the context of a policy priority rather than a primary challenge would make it a lot more respectable than Specter's defection.

Social pressure obviously matters a lot, and personal attachment, and there are probably other factors I'm not considering. But on the other side of the ledger is health-care reform! It's covering 40 million people, and saving lives, and averting medical bankruptcy, and making the system better for millions and millions of people. And it could be Snowe's legacy more than anyone else's. She could break the gridlock that has paralyzed this issue for decades. That's history-book stuff. Surely it's worth something.

http://voices.washingtonpost.com/ezra-klein/2009/09/what_leverage_do_republicans_h.html

[Diane R]

6. Let me guess which camp Rahm is in.....

[Pirate Smile]

20. I don't really care what Rahm wants. Some of Obama's advisers didn't want to do HCR right away

either but, guess what? Obama did so they are doing it.

[high density]

8. Less generous than the House bills doesn't sound promising.

Snowe is guaranteed a re-election in Maine until she decides to retire. I don't know what she is afraid of.

[Jennicut]

10. She's a longtime liberal Repub...the Rethugs forced all the rest out.

Should have become a Dem a long time ago but she keeps getting reelected so...

[dflprincess]

14. The House plan is a gift to the insurance agencies

and I don't suppose they're the ones who will be getting less from anything else.

If all we're going to get is more unaffordable health insurance maybe nothing should be done. The "system" we have now is going to collapse on its own and that's why Congress & the President are so determined to shore it up with faux reform. I say let it collapse and the only option will be to extend Medicare to all.

If they pass a lousy bill, we'll be told the problem is fixed and be expected to thank "our" elected officials for mandating that most of us continue to pay for insurance that does not guarantee care.

[ProSense]

12. I absolutely don't buy the BS spin even Ezra is putting on this.

Olympia Snowe is on the Finance Committee. Any negotiation with her is related to that bill and getting it out of committee. The HELP and Finance bills will have to be merged for a vote. There is nothing that indicates that the Dems have to merge a bill that weakens the public option or accepts the Finance version in the final Senate bill.

If all else fails, go for reconciliation.

[seafan]

15. Matt Taibbi's warning: 'It is a fight to the finish now between Really Bad and Even Worse.'

Ezra Klein, in the near-final wrap-up:


September 2, 2009

This is health-care reform's endgame, or close to it. Next Wednesday, Barack Obama will give a prime-time address before both houses of Congress. But that's not all he's giving Congress. The administration is going to put a plan down on paper. The question is what it will say.
Conversations with a number of White House officials make it clear that, at this point, even they don't know. The argument was raging as recently as last night, and appears to have hardened into two main camps.

.....

Both camps accept that the administration's proposal will be less generous than what has emerged from either the HELP or House Committees. The question, it seems, is how much less generous.

The answer appears to hinge on Sen. Olympia Snowe. "I'm a Snowe-ite," joked one official. Her instincts on health care have proven quite a bit more liberal than those of many Democrats. In the Gang of Six meetings, she joined Sen. Jeff Bingaman in focusing on affordability and coverage — putting her, in practice, somewhat to the left of Conrad and Baucus. The problem is that Snowe is scared to be the sole Republican supporting this bill, not to mention the Republican who ensures the passage of this bill. The reprisals within her caucus could be tremendous.

If Snowe drops off the bill, using the budget reconciliation process will probably be a necessity. The bill then goes through Sen. Kent Conrad's Budget Committee, giving him much more power over the product. The absence of any Republicans repels at least a couple of conservative Democrats. Passage becomes much less certain, which means a scaled-back bill becomes much more likely. This is the irony of the health-care endgame: The bill becomes much more conservative if it loses its final Republican.

So, we are now left to prepare ourselves for bread and water.



Matt Taibbi: 'It is a fight to the finish now between Really Bad and Even Worse.', August 23, 2009



We are at the fork in the road. Will it be a bold decision for the people of our country, or a tragically weakened one, engineered to protect the profits of the powerful?



I honestly don't think people are going to take this lying down.

[dgibby]

16. One word:

TRIANGULATION!

Working definition: Let's you and him fight. When you've almost killed each other, I'll step in and break it up.

As Keith would say, It's genius, I tells ya, genius!