Health Care Reform's Enemies Taking Heat

The difference between 1994 and today is not that there are no longer forces who wish to undermine reform and keep the health care sector safe for the profiteers, it's that this time, somebody responds.

Example #1: Ben Nelson boldly claims he will never support a public option in health care. Change Congress and other advocacy groups hammer him relentlessly and run ads in his state. Nelson decides he will not filibuster a health care bill with a public plan.

The Nebraska Democrat, who has skeptically approached the idea of a government or publicly-run insurance program, additionally told state Democrats not to assume that he will oppose such a proposal in a final reform package.

"He's not against anything right now," said Bud Pettigrew, the chair of county chairs for the Nebraska Democratic Party, who fielded a phone call from Nelson on Monday. "But he does want to read the plans that come out first and then make a judgment."

"He is open to some type of government plan but he wants to see the details first," Pettigrew added. "He wishes the liberals would give him a chance."

And yet, even if Nelson were to oppose the final bill, his vote may not hold as much significance as expected. According to Pettigrew, the senator said he will not be the 60th Senator to sustain a filibuster on a bill that he ultimately would oppose. "If it comes to cloture I would vote for it," Nelson said, according to Pettigrew. "I will not be the deciding vote."

Adam Green has done incredible work on this. According to Pettigrew, Nelson told him that "the liberals are kicking him in the ass right now and he is feeling it."

Example #2: Third Way, a milquetoast moderate group, put together a hyper-incrementalist and lame plan for a public option that wouldn't be public, wouldn't be available to everyone, and wouldn't be able to use bargaining power to control costs. Bloggers call them out on it. The aforementioned Adam Green rallied people to call the Third Way leadership. Ryan Grim finds out that the plan was written by "policy analysts with longtime connections to the health insurance industry." Third Way is forced to respond:

Third Way is committed to helping the President and Congress succeed in enacting meaningful and comprehensive health care reform.

Currently one of the most discussed aspects of the President's reform effort is a public plan option. In a draft Third Way memo that has been widely circulated and mis-characterized, we propose a number of policy ideas that would help ensure that a public plan is crafted in an effective way -- and can garner the votes needed to advance broad health care legislation.

There is an urgent need for real health care reform in America. Health care in our country has not worked for average Americans: it is too easy to lose coverage, it is too easy to see premiums rise, it is too easy to be denied access to care. Third Way's latest report found that only 64% of working age Americans have had the high standard of health care coverage: 4 years of uninterrupted private health care.

That is a crisis.

That's why we need health reform that provides stable coverage, stable cost and reliable, quality care for all Americans.

That's a backtrack. They now have absolutely no credibility on this topic.

Example #3: The Blue Dog Caucus puts out a letter laying down their principles for health care reform, including a "trigger" option that would hold back the public plan unless insurers failed to meet certain conditions. In any other time, this would immediately become the only available option in the debate. This time, Health Care for America Now, which had gotten 20 Blue Dogs previously to endorse a public plan without a trigger, called the Blue Dogs' bluff, members of the coalition jumped ship, and the Blue Dogs had to backtrack from their initial hard position, calling it instead a "starting point" for negotiations.

In the face of relentless progressive advocacy, the forces that would rather keep the status quo turn to jelly.

However, I still fear that progressives aren't aiming their guns at all the targets. Inside that HuffPo piece on Ben Nelson, he acknowledges that he opposing capping the employer deduction for health care benefits.

In addition to telling Pettigrew about his take on the public plan, Nelson also relayed word that he opposed a measure to end the tax exemption for employers who provided health care coverage to their workers. That proposal, which has gained some traction in Congress (including with Senate Finance Committee Chairman Max Baucus), is seen as a practical way to help pay for reform.

That idea has not been properly explained to the public and will get crushed if the situation persists, leaving a yawning gap of funding that nobody seems to want to pay for. And Steny Hoyer has already objected to using MedPAC to lower Medicare costs, again a policy that has been ill-explained to the public and will cause a revolt in Congress without popular support.

I love what progressives are doing around health care, but if they don't target the funding mechanism it won't pass.