Learning To Count

This has been a consequential day in the health care debate, and it all started when Rahm Emanuel opened his trap and tried to turn the public option trigger into the compromise, rather than the public option being the compromise between nothing and single payer. First the White House tried to staunch the bleeding, with the President shifting the emphasis (but not really deviating from what Rahm said all that much). The advocacy groups pounced at the mention of the trigger. Sam Smith reported that Rahm has been looking to cave on this point for months:

It was, White House aides insist, far from a commitment to a trigger option. But a source close to the administration, who has been in contact with the White House on health care matters, said that Emanuel has been "floating" the trigger compromise since January.

"Rahm's problem with this is he is on the more conservative end of the Democratic Party and he is a very political guy," the source added. "He is working for a way out without a bloody fight. The problem is he doesn't mind taking that fight to the left. And what I worry could happen is the left will just quit."

Bernie Sanders confronted Emanuel directly, vowing that he had plenty of votes to scuttle any bill that didn't include a public option, and in fact taking aim at the bill being pushed through the Senate Finance Committee, which doesn't even have so much as a trigger:

"I think that it is fair to say that there are a number of us who would not be voting for anything resembling a Baucus-type plan as we understand it right now," the senator told the Huffington Post, referring to Finance Committee Chairman Max Baucus' effort at constructing a reform bill [...]

"Emanuel is dead wrong," Sanders said. "The triggers are meaningless. The American people have shown in poll after poll their contempt for private health insurance companies. They don't trust them and for good reason.

"Now, where we are right now politically is the HELP Committee, of which I'm a member, is going to bring forth a public plan," Sanders added. "The House of Representatives is supporting a public plan. And President Obama ran for office talking about a strong public plan. Why, with that political reality of the American people wanting it, the House going forward, the Senate HELP Committee going forward, would Rahm Emanuel suggest that we would compromise on this issue?"

More significantly, Harry Reid basically told Baucus that his watering-down efforts will only end in failure, and he will lose too many Democratic votes in the exchange.

Senate Majority Leader Harry Reid (D-Nev.) on Tuesday ordered Finance Chairman Max Baucus (D-Mont.) to drop a proposal to tax health benefits and stop chasing Republican votes on a massive health care reform bill.

Reid, whose leadership is considered crucial if President Barack Obama is to deliver on his promise of enacting health care reform this year, offered the directive to Baucus through an intermediary after consulting with Senate Democratic leaders during Tuesday morning’s regularly scheduled leadership meeting. Baucus was meeting with Finance ranking member Chuck Grassley (R-Iowa) Tuesday afternoon to relay the information.

According to Democratic sources, Reid told Baucus that taxing health benefits and failing to include a strong government-run insurance option of some sort in his bill would cost 10 to 15 Democratic votes; Reid told Baucus it wasn’t worth securing the support of Grassley and at best a few additional Republicans.

I don't think capping the employer deduction (which is not really taxing health-care benefits) is so horrible, but it's clearly a non-starter, to the extent that the House prefers a surtax on the wealthy to get the proper funding. And what's not said here is that all the other sops to the right that Baucus has smashed into his bill don't sit well with Democrats either and would not pass the Senate, including the removal of a public option.

Even more interesting than all that is Raul Grijalva's letter to the White House today on behalf of the Congressional Progressive Caucus, saying flat-out that the caucus will not support any health care reform bill without a "robust public option plan, akin to Medicare." And there's this extremely interesting line:

Public opinion polls show that 76% of Americans want a robust public plan option and I will stand in solidarity with them. Moreover, I consider it unacceptable for any of the cost savings that you are negotiating with hospitals and other sectors of the health care industry to be made contingent upon a robust public plan option not being included in the final legislation.

This is what I was getting at earlier today, that these deals with stakeholders are coming with some strings. Grijalva comes out and says it.

There's a lot of good news here, though of course this isn't over. The White House has learned that they absolutely don't have the votes for a plan without the public option, and hopefully this will carry over to other elements of the debate. I can envision a world with a public option but not enough subsidies, no changes to Medicaid and a health insurance exchange that isn't strong enough to force competition. And there will be other pitfalls: this notion of denying legal abortion funding inside the health insurance exchanges is horrific, for example. And there's the matter of cost, which Republicans are playing up by touting yet another inaccurate CBO score today. But what we see today is the liberals in Congress and the progressive movement standing up to announce that they will not be rolled. Not this time. The centrists threatening the Obama agenda will have to pay a price.

We're a long way from home, with lots of lobbying, both corporate and grassroots (go Mainers!), to follow. But the left is standing up, for now. Let's help them.