You Don't Think They'll Just Give Up, Do You?

(I'm a blogger fellow for Brave New Films and their Sick For Profit campaign)

After today's announcement from Harry Reid, adding a public option to the Senate health care bill, some might think that a great victory has been achieved. And it's a significant accomplishment to this point. But we're at the beginning of the end, not the end. And now that this public option, with a state opt-out, represents the lower bound of health care reform, you can bet that the insurance industry will redouble their efforts to kill the bill and retain the status quo. In fact, they've already started. Blue Cross/Blue Shield of North Carolina has begun to lobby their customers to work against the bill, asking them to contact Senator Kay Hagan (D-NC). Not a front group, or some ad hoc organization funded by BC/BS. No, just the company itself.

(The mailer) reads:

Public option?
Government Cooperatives?
Community plan?
Single payer?
No matter what you call it, if the federal government intervenes in the private health insurance market, it's a slippery slope to a single payer system.

Who wants that?

The enclosed postcard to Hagan reads:

Senator Hagan,
Please oppose government-run health insurance. We can meet our health care challenges without the government unfairly competing with the private sector. Tell Senate leaders that North Carolina doesn't need government-run insurance.

They've also deployed lobbyists and shills to Capitol Hill to make completely dubious arguments. At a hearing about the insurance industry's anti-trust exemption, this amazing exchange occurred:

University of Arkansas business professor Lawrence Powell, who testified on behalf of the medical malpractice insurance industry.

"The best possible outcome from repealing McCarran is continuation of the status quo," he said. "However, it is also likely that repealing McCarran would have negative consequences for consumers, by decreasing competition and accuracy in insurance pricing."

Rhode Island Democrat Sheldon Whitehouse pointed out that the professor was relying on outdated information.

"You cite for the proposition that insurance markets are highly competitive an article by Paul Joskow. Do I have the date of that article correct, it's 1973?" he asked Powell. "I believe so," came the answer.

And, they've started to push their message out to media, getting an AP reporter to buy the canard that poor, henpecked insurance companies just don't make a lot of money.

WASHINGTON – Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They're all more profitable than the health insurance industry.

The missing ingredient here is scale. Tupperware is more profitable than health insurance on a percentage basis, but 1/6 of the US economy doesn't go through Tupperware. In real dollars, the insurance industry makes a mint. And remember, "profit" doesn't count salaries, not even what's given to CEOs.

The truth is that, even with this public option, insurers will do just fine in the health care bill. They get millions of new customers, with competition that is limited (not everyone can get the public plan, under even the most expansive version). But it's just not good enough for them. The notion that they might have to offer coverage with actual benefits, and not cherry-pick the healthy to pay their premiums, which would cut into those profits, is just distasteful to them. So they will fight. And we will be ready.

The Senate Progressive Block

Jason Rosenbaum has the news on that secret letter I was talking about yesterday that Senate Democrats were pushing, demanding that Harry Reid include a public option in the bill that comes to the floor. We now have the letter, and it calls for a "robust, Medicare-like" public option, which is right where the House Progressives have drawn the line. The letter has 30 signatures:

Sherrod Brown (D-OH) John D. Rockefeller (D-WV)
Russell D. Feingold (D-WI) Patrick J. Leahy (D-VT)
Daniel K. Akaka (D-HI) Tom Udall (D-NM)
Kristen E. Gillibrand (D-NY) Roland W. Burris (D-IL)
Ron Wyden (D-OR) Debbie Stabenow (D-MI)
Barbara Boxer (D-CA) Sheldon Whitehouse (D-RI)
Michael F. Bennet (D-CO) Dianne Feinstein (D-CA)
Jack Reed (D-RI) Jeff Merkley (D-OR)
Frank R. Lautenberg (D-NJ) Benjamin L. Cardin (D-MD)
Al Franken (D-MN) Robert P. Casey, Jr. (D-PA)
Barbara A. Mikulski (D-MD) Daniel K. Inouye (D-HI)
Edward E. Kaufman (D-DE) Arlen Specter (D-PA)
Maria Cantwell (D-WA) Robert Menendez (D-NJ)
Bernard Sanders (I-VT) John F. Kerry (D-MA)
Herb Kohl (D-WI) Paul Kirk (D-MA)

Some VERY interesting names on this list. Michael Bennet. DiFi (!). Arlen Specter. Newest Democrat and former pharma lobbyist Paul Kirk. Ron Wyden.

To be sure, nobody here is saying that they won't vote for a bill without a public option in it. But these would be the main possibilities for such a strategy. And you would only need 11 of these 30 to pull that off. And really, you would only need one, if you're tying it to a 60-vote filibuster-proof hurdle.

Despite the rumors and compromises being floated, it is NOT a given that Harry Reid puts a public option in the merged bill. This show of support by fully 1/2 of the caucus - and with public option supporters who voted it out of committees not on this list, the real number is higher - is very important to reaching that goal.

The Secret Letter

I'm hearing from sources about a letter to Harry Reid from a collection of liberal Senators, led by Sens. Jay Rockefeller and Sherrod Brown, insisting that Reid publicly commit to putting a public option in any health care bill that reaches the Senate floor. There's a big difference between having a public option in the bill before the fact or trying to get it in by amendment. It's likely that amendments to the bill will require a 60-vote threshold, therefore it would take 60 votes to get a public option into the bill if it's absent, or 60 to get one out of the bill if it's present. Nobody has said that there are those numbers of votes to do either of those actions. So whether the bill comes to the Senate floor with a public option or not is a crucial decision. The four people in that room making that decision are Max Baucus of the Finance Committee, Tom Harkin of the HELP Committee, Harry Reid and someone from the White House. A lot of this will depend on the White House's inclination, and they certainly floated their support over the weekend. But Reid's public statements have been noncommital.

The liberal faction in the Senate, led by Rockefeller and Brown but also for the first time including Sen. Barbara Boxer, want a real commitment. According to sources, Sen. Reid will meet with this faction at 5pm ET. Senator Reid's office confirms that this meeting will be held today. So presumably, some kind of accommodation will be offered, although the liberal Senators in the meeting will seek a definitive commitment, I'm told.

There have been various talks from public option supporters in the Senate about wanting to see it in the final bill, but this is the furthest it has gone, to my knowledge. Some Senators, like Sen. Boxer, are going on the record insisting a public option for the first time. Of course we don't know what form this "public option" will take - the Wall Street Journal reports today that Tom Carper's state-based approach is gaining support among Senate moderates, and Debbie Stabenow in a press conference today confirmed that this is a possibility:

In a press conference this morning with other Democratic senators, Sen. Debbie Stabenow (D-MI) -- member of the Senate Finance Committee and a supporter of a robust public option -- says it's a "broad definition."

"The states are one way to go," she said

Sen. Robert Menendez (D-NJ), who also sits on Finance and supports a public option as enthusiastically as Stabenow does, added, "There are state options that are devised in such a way that only a region of the state is included, in which case that's not really a significant public option."

"If the whole state is included in a public option -- they have that option -- well that's a much more significant standard than some that have been proposed," Menendez told reporters.

I would assume that Reid may offer this as a compromise inclusion in the bill. We'll see if the Brown-Rockefeller faction will take the deal. Certainly they are pushing very hard for a higher standard than that. And with the House of Representatives close in getting majority support for a public option using Medicare +5% rates, perhaps that gives them some leverage too.

...Greg Sargent reports that Nancy Pelosi just floated a lesser public option with negotiated rates, not Medicare +5%, to the Dem caucus, prompting outrage. I'm seeing a convergence here, with the Senate pushing up from the rank and file to get any public option into the bill, and the House pushing down from the leadership to get a public option that can pass the Senate.

The Waiting Is The Hardest Part

Determining whether a public insurance option will be in the final health care bill from Congress has been excruciating, and it's not about to get any better. I guarantee you it's going to look dead and buried or a rock-solid cinch about half a dozen more times before this is over. Here's what happened just today:

• Raul Grijalva said that his public option whip count is down to 46, from 60. And he wouldn't announce the names, which made it look like he was shielding the members who dropped off. Bad!

• Later, 51 Democrats in the House write to Steny Hoyer and Nancy Pelosi affirming their strong support for the public option. Good!

• Harry Reid backed off his remark that the final bill will have a public option. Bad!

• Later, we learn that the Grijalva whip count is probably bigger than 46 members; they just stopped the whip count once they had enough votes to block anything without a public option. Good!

• There's now a new whip count of all members of the Democratic caucus, on a public option tied to Medicare +5% rates. So far 170 members of the caucus support this. Good! But they need 218 for passage. Bad! But they're not done yet and Chris Bowers hears it's higher. Good!

• Andy Stern says there will be a price to pay for any Democrat who joins a Republican filibuster of a health care bill, regardless of whether a public option is in there or not. Good!

• Nobody wants to be the one to kill a public option. That's actually good! But they'll try to call whatever compromise that's inoffensive to the insurance companies a public option as a way out. That's bad!

I would recommend David Waldman's piece, because I think it's closest to the actual scenario on the minds of the Senate and the White House right now. Chasing this rumor or that can make you weary, however.

What's In A Name?

What's In A Name?

by dday

Harry Reid is now saying there will be a "public option" in any final health care bill. I'm sure nobody knows precisely what he means by that.

U.S. Sen. Harry Reid, D-Nev., said today there will be a "public option" in whatever health insurance reform bill comes out of Congress.

"We are going to have a public option before this bill goes to the president's desk," Reid said in a conference call with constituents, referring to some kind of government plan.

"I believe the public option is so vitally important to create a level playing field and prevent the insurance companies from taking advantage of us," he said.

Tom Harkin said almost exactly the same thing today - and he said that Republicans wouldn't be at the table when the two Senate bills get merged together.

Here's the good news about this. Reid is acknowledging that he absolutely cannot get away with having a final bill without something he can call a "public option." And progressives have done a good job of very specifically separating out triggers and co-ops as something that would not fit that definition. This is almost entirely due to grassroots activism. The public option would have been thrown out months ago if nobody was advocating for it from the bottom up. It was certainly not the intention of anyone in Washington to go into October with this issue still up for grabs. They were perfectly content to jettison it to protect insurance industry profits.

That said - there is no definition here for what public option means. And if you asked Sen. Reid point-blank, I'm sure he wouldn't give you a definition. He wants something that he can call a public option so the grassroots can be satisfied. What will that be? Probably not co-ops or triggers because they've been too well-defined by the grassroots. There are other alternatives coming in their place.

Tom Carper is pushing the idea of giving the states the ability to create a public option, which states could then link together for increased bargaining power. They wouldn't be able to use Medicare bargaining rates and they wouldn't have Medicare's provider network. And being state-based, they wouldn't have much leverage to gather the client base necessary to force a lot of competition with the private market. Of course, a lot of the "public options" out there offer weak, "level playing field" provisions similar to Carper's amendment. Jon Cohn says that actually, this is already in the bill:

One interesting question is whether the proposal is already redundant, thanks to an amendment that another member of the Finance committee, Ron Wyden, introduced that Chairman Max Baucus accepted before the hearings even began.

It's Wyden amendment C8, which appears on page two of the modified bill Baucus introduced formally for markup:

Amend Title I, Subtitle A to allow a State to be granted a waiver if the state applies to the Secretary to provide health care coverage that is at least as comprehensive as required under the Chairman’s Mark. States may seek a waiver through a process similar to Medicaid and CHIP. If the State submits a waiver to the Secretary, the Secretary must respond no later than 180 days and if the Secretary refuses to grant a waiver, the Secretary must notify the State and Congress about why the waiver was not granted. – Insert at the end of b)(1) ―and with citizen input through a referenda or similar means;‖ – In b)(2) strike ―a‖ and insert ―this‖ – Insert b)(4) ―the State submits a ten-year budget for the plan that is budget neutral to the Federal government.‖ – Insert at the beginning of c)(2) GRANTING OF WAIVER.— The Secretary shall approve the plan only if it meets criteria consistent with that of the America’s Healthy Future Act, including that it shall lower health care spending growth, improve the delivery system performance, provide affordable choices for all its citizens, expand protections against excessive out-of-pocket spending, provides coverage to the same number of uninsured and not increase the Federal deficit.

What does the gobbledygook mean? Wyden's staff says it's designed to encourage state experimentation. I haven't yet gotten an official reading from Finance Committee staff on their interpretation.

But my own reading, which I've run by a few analysts, is that it gives states the ability to implement coverage schemes that bolster coverage, control costs, and improve quality at least as well--and hopefully better than--the Senate Finance bill. That would include creating a public option. (You could even read it to allow a state-based single-payer plan.) So it's the Carper amendment, but without the restrictions.

Cohn notes that the HHS Secretary would have to rule, in the Wyden Amendment, on whether any state proposal met the proper criteria. Which means that, under a Republican Administration, you could see nothing helping people allowed to go through, or even scale-backs to benefits (though there is presumably a federal floor).

Still, maybe this is what Reid will determine as a "public option." Or maybe he'll dump Wyden's amendment and pick up the Carper idea and call that a public option. Or maybe Maria Cantwell's proposal, which allows states to negotiate on behalf of the uninsured below 200% of poverty level for a basic plan, will fit the bill, even though it sounds like a good policy but in no way a substitute for the public option.

The point is that all the activism and advocacy has gotten us far further than we would normally be in this debate. But there are still plenty of compromises out there that politicians will call "the public option" as an escape valve. It will be important to see these policies for what they are, instead of applying the name and being done with it.

Here's A Thought, Take The Popular Option

Kevin Drum is as shrill as he gets, which is to say, measured, polite, and miffed.

In case you missed it, Jon Stewart had a good riff on this last night. His question: Why are Democrats so lame? It's a good one! They have a huge majority in the Senate, the public is strongly in favor of a public option, and yet....for some reason they can't round up the votes to pass it. Hell, they can't even round up a normal majority to pass it out of the Finance Committee, let alone a supermajority to overcome an eventual filibuster.

If Democrats really do lose the House next year (about which more later), this will be why. If they don't pass a healthcare bill at all, they'll be viewed as terminally lame. If they pass a bill, but it doesn't contain popular features that people want — like the public option — they'll be viewed as terminally lame. At a wonk level, a bill without a public option can be perfectly good. But wonks aren't a large voting bloc, and among people who do vote, the public option is very popular. So, um, why not pass it?

I will minimally defend Democrats. The Finance Committee has a 13-10 split, which is a bit less of a majority than the 60-40 overall split. Stewart's point was that Democrats had a supermajority and didn't use it in the Finance Committee is inaccurate. Furthermore, there's no such thing as a supermajority in the patently undemocratic confines of the Senate. Because the public option isn't popular among land as well as people, it doesn't have 60 votes in a Senate organized around land. There's also the problem of unanimous opposition from an entire political party, which really does represent a crisis of governance.

That said, yes! Democrats are lame! Especially in this case, where they have a popular policy that also happens to be the policy that best brings down costs and provides competition in the insurance market. As for Drum's point that a bill without a public option can be good at a wonk level, he's talking about something like the Swiss health care system, where private insurers exist without a public alternative, but are strictly regulated. Which is perfectly fine except for a few things:

1) It is the second-worst system in the world in terms of costs, rivaled only by... the United States.
2) We have no history of regulatory strictness, in fact we have the opposite history, so actually pulling off a regulation-based check on the insurance companies is a real long shot.
3) The Swiss have higher co-pays, insurance premiums and out-of-pocket expenses than Americans, which politically would not fly at all. People are already crushed by the burden of high-dollar health care here.

The truth is that the difficulty of Democrats to include a public option - though I don't think it's dead yet - reflects the breakdown of our political system and the influence of corporate money. The Swiss have their health care plan because they put it in place relatively recently, and the large health interests didn't want a public component. It's the same here, and frankly politicians in both parties have been bought off.

As I said, I don't think this is quite over. Labor won't budge on their insistence on a public option, and for a White House obsessed with keeping their majority that's a big deal - lose the support of the AFL-CIO and you lose seats, period. What's more, progressives understand the pressure points now - mainly, the White House and Harry Reid. If he includes a public option in the merged Senate bill it will be very hard to get it out, and then Senators will be faced with the unpleasant choice of filibustering a bill that has the overwhelming support of the Democratic caucus and the White House to protect insurance company profits.

I'd make two calls today - Reid's office and the White House switchboard.

Tracking The Public Option Through The Senate

Those who have been paying attention understand that today was actually a pretty good day for the public option. We learned that Sens. Wyden, Carper and Nelson (FL) support it in some form, and that there are at least 51 votes for it in the Senate. However, yesterday Chuck Schumer did acknowledge that there aren't 60 votes at this time. Ezra Klein asks the right questions:

There are two questions here. The first is "60 votes for what?" Do they not have 60 votes in favor of a health-care plan that includes a public option? Or do they not have 60 votes against a filibuster of a health-care plan that includes a public option? If it's the former, that's okay: You only need 51. If it's the latter, that's a bigger problem. But I'd be interested to hear which Democrats will publicly commit to filibustering Barack Obama's health-care reform bill. If that's such a popular position back home, why aren't more Democrats voicing it loudly?

Second, why give up the public option now? If these moderates want to kill the measure, let them get full credit for doing so on the floor. They can sponsor an amendment to strip it out of the final legislation and go home to their districts having played a clear and undeniable role in the elimination of the public option.

The former is really the question. There are definitely 51 votes for a public option. It's unclear whether there are 60 for a final bill with a public option. And more specific than that, are there 60 to allow a vote on a final bill with a public option?

Mary Landrieu has come the closest to saying that she would filibuster a bill with a public option. Ben Nelson and Joe Lieberman are probably right with her. But I'd sure like to see them try to defy the President and doom a health care bill 40 years in the making over one provision. Reconciliation is always an option, given that you would only need 51 votes, but it's highly unlikely to get a public option that way. The main reason is that the Budget Committee would control the process, and Kent Conrad just voted against public option amendments yesterday, and would be highly unlikely to allow one to go through a 51-vote process. Heck, he doesn't want reconciliation at all. So Chris Bowers surmises that Harry Reid and the White House are the real pivot points right now, when the Senate merges the bill from their two committees:

The next step in the process does not actually involve Kent Conrad's Budget Committee, as I had previously reported (the Budget Commitee only comes into play with reconciliation). Instead, a source on the Hill confirms to me the Senate HELP and Senate Finance committees will be merged by an informal, behind the scenes process involving the four major players in the Senate: Tom Harkin (Chair of HELP), Max Baucus (Chair of Finance), Harry Reid (Majority Leader), and the White House. Together, these four will meet and decide what sort of bill to send to the Senate floor for debate and amendments.

During this process, we can guarantee that Harkin will push for a HELP or Schumer-like public option to be sent the floor, while Baucus will push for no public option to be in the bill at all. Given his recent statements, the best bet is that Reid will probably push against a public option too, and instead favor either triggers (which he has called a good idea) or co-ops (which seems to be the sort of public option he likes best). With two against and one in favor, this means that the only way a public option ends up in the bill that is sent to the Senate floor will be if the fourth major player, the White House, demands it.
It is all up to the White House now. If it pushes for a public option to be included in the health care bill sent to the Senate floor, then a public option will pass as part of health care reform (at that point, all we would need are 60 votes for cloture, and from what I hear we have 57 already). However, if it allows a health care bill to go to the floor without a public option, it is pretty unlikely that a public option will pass as part of health care reform.

Bowers doesn't think any floor amendment would need less than 60 votes, and while there are conflicting reports on that, he's probably right. He also doesn't think conference committee is an option, but I'm not sure I agree there. The House will almost certainly pass a bill with a public option. So it would depend on the White House umpiring that argument in committee. And that will almost certainly be decided by what they think can pass. If the Progressive Block in the House holds firm, and looks like a higher mountain to climb than getting 3 Democrats just to flip on cloture, the White House could go the other way at any step of this process.

Igor Volsky thinks we may see a new compromise floated:

Instead, the very same Democrats who defeated the national program during mark-up, will likely resurrect a discarded idea floated by the New America Foundation and momentarily embraced by the White House. That compromise will create a network of public options modeled on state employee benefit plans. The proposal could be triggered by Snowe’s amendment if reform did not meet a low affordability measure, but any state-based proposal would lack the market clout to lower overall health care spending, reform health care delivery, or hold private health insurers accountable.

Today may have been the death of the public option and the birth of state-based public options.

State-based plans won't have the economies of scale to really pressure insurers, but neither would Schumer's "level playing field" public option. Therefore, given that we're going to have to improve whatever inevitably comes out of the legislation, I'm inclined to say this is better than nothing. Apparently Tom Carper has started floating this behind the scenes.

I'm not as optimistic as Robert Creamer, but I do think that the public option still has a chance to survive in some form, and can be improved after the fact.

The P.O. Yo-Yo

Harry Reid pulled the yo-yo trick today. First some anonymous staffers were quoted in the NYT that the Majority Leader's merged bill that will go to the Senate floor would not include a public insurance option. Then Reid's spokesman denied it to Greg Sargent.

These yo-yo maneuvers really dispirit people, and I don't know if they're meant to be trial balloons or what, but the leadership needs to at least try to crack down on the leaks. Anyway, the public comments are quite enough, thanks. Reid himself called Olympia Snowe's trigger option "pretty doggone good" last weekend. Bill Clinton did the same thing on Meet the Press. There's no need for an additional article contributing to the death narrative. It saps the energy for reform from the most vociferous reformers, and that's probably by design.

The public option will come up for a vote in the Senate Finance Committee as soon as tomorrow. Liberal supporters admit they don't have the votes. But it will force many centrists to go public on the issue, opening them up to criticism. And even if Reid doesn't include the provision in the bill, he'll certainly allow amendments to that effect on the floor. So this is really just the beginning of a fight that will continue right through to the conference committee.

In the end, whether or not the public option survives depends on the White House's advocacy. So the only tea leaves worth reading are the ones about which politicians they are pushing to support the bill.

...I've now seen a couple assertions that 60 votes will be required for any strengthening amendments on the Senate floor. I'm not sure where people are getting this, but historically that has been something used to preserve the final bill. If this is the case, then, as Chris Bowers writes, Reid's inclusion of a public option in the merged bill really is the hinging point for whether or not it will ultimately be included.

"They aren't friends to consumers."

Harry Reid doesn't appear to be receptive to canceling the insurance industry's anti-trust exemption:

Reid (D-Nev.), who will play a key role crafting the final Senate healthcare overhaul in the next few weeks, is excluding a proposal to repeal a loophole that exempts health insurance companies from federal antitrust laws.

Although the proposal is very popular with Democrats and liberal groups, Reid has concerns that attaching it to the healthcare legislation risks damaging prospects for an effort already facing significant hurdles.

Republicans say Reid is being calculated in a different manner, dangling the standalone bill as a way of intimidating the companies into making concessions on Obama’s broader healthcare objective. But they will have to overcome recent testimony from former Senate Republican Leader Trent Lott, who backed a broader effort to lift the exemption for the entire industry.

Many Republicans actually support the end of the anti-trust exemption because they believe it would be a vehicle to expand interstate sale of insurance and essentially deregulate the industry, which would not be to the benefit of the consumer. And Reid himself has backed a repeal of the McCarran-Ferguson Act, which gave the industry the exemption, for many years. So if he's brandishing it as a club, he doesn't appear to be doing much of a job of it.

Unfortunately, there are too many people in the halls of Congress willing to give the industry exactly what it wants - a forced market without competition from a public option. Future Congressman John Garamendi, who for eight years was California's Insurance Commissioner, explains why that is a disastrous outcome.

Some in Washington are seriously considering penalizing Americans for being unable to afford care in a marketplace that doesn't control costs. If voters in the 10th Congressional District choose me to be their representative in Congress, let me be clear. I will not vote for any bill that includes the individual mandate unless I am confident that bill offers generous subsidies for Americans struggling to make ends meet and unless that bill includes the public option to provide real competition in the health care marketplace. I regulated the insurance companies for eight years as California's State insurance Commissioner, and I know those companies well enough to know that we can trust them to put profits before people. They aren't friends to consumers.

In California in the first half of this year, according to data provided by the insurance companies to state regulators, PacifiCare denied 39.6 percent of all claims, Cigna 33 percent, Anthem Blue Cross 28 percent and Kaiser 28 percent. 45,000 people died last year in the United States because of a lack of health care coverage. These are not statistics you see in the rest of the industrialized world. Profits ahead of people, greed ahead of the general good is no way to run a health care system.

The Democrats had better figure this one out. If the public gets the sense that their representatives are being run by the insurance companies, they will take their frustrations out in next year's elections.

Kent Conrad's Sneak Attack

Kent Conrad wants things his way. He's turning out to be as devious as anyone in the Senate. Brian Beutler reports on his effort to get the health care bill outside the window for reconciliation, which is the clear intent of this stalling tactic:

Sen. Kent Conrad (D-ND) indicated today that there may be major delays in the health care process going forward. During today's health care hearing, he told CBO chief Doug Elmendorf today that the Senate Finance Committee must be provided with a complete CBO score of the final package before the panel can hold a vote on it.

"With respect to the issue of when scoring might be available, because...it is critically important that we have scoring before a final vote is cast in the committee," Conrad said, "it is important for us to know, once there is a package, after the amendment process here, can you give us some rough estimate, in days to have a CBO score."

How long will that scoring take?

Elmendorf estimated that the full reporting could take two weeks:

"I think we can update our preliminary analysis...within a few days of the package actually being set. A formal cost estimate would require...two weeks of work by us, once the package is settled."

Conrad ultimately suggested that the committee could hold its vote on the basis of the preliminary analysis, but that two week window would presumably still apply to progress beyond the committee's vote. It would, after all, take a similar amount of time to complete a final cost estimate of the package that ultimately comes to the Senate floor.

Kate Pickert has more on this, though she curiously removes Conrad's name from it. He does appear to be the prime mover. He never agreed with the option of reconciliation, and if he can push the bill past October 15, a sort of deadline for that process, he can assure that all the legislation would have to move through a 60-vote process. Since nobody is suggesting that a public option has 60 votes in the Senate, it would essentially doom that measure, and boost Conrad's preferred co-op option, which would give millions in seed money to Blue Cross of North Dakota, which has 90% of the state market, because they could conceivably as a non-profit pass for a co-op.

It's not that Conrad really cares about the score of every item in the health care bill - after all, when the CBO produces a score he doesn't like, he's happy to ignore it.

When the Star Tribune asked Conrad if he agreed with CBO director Doug Elmendorf's conclusion that, "They seem unlikely to establish a significant market presence in many areas of the country," Conrad answered:

I do not agree with the Mr. Elmendorf's assessment on co-ops. Based on the advice of leading actuaries, we are providing enough federal seed money for these co-ops to insure 12 million Americans.

If Conrad doesn't care what the CBO assigns to his own preferred policies, why should it matter to get a complete score before voting the bill out of committee?

Conrad laid it on thick yesterday, trying to use the experience of countries like France, Germany and Japan - which do things like guarantee a baseline level of coverage for all citizens and ban insurance companies from making a profit - as proof that no government-run program is needed. But of course, Conrad's conception of health care reform bears no resemblance to those systems at all, and a public option offering baseline care at an affordable price actually does.

Harry Reid's still out there talking about reconciliation if 60 votes cannot be attained. Is it worse if he doesn't know that Conrad is pulling out the rug from him, or if he knows?

...Olympia Snowe supports this delay as well. Amazing that the two Senators with lots at stake in their own non-public option alternatives would want to delay the bill past the reconciliation window! Ezra notes that this kind of delay would be unprecedented in the history of the Finance Committee.

...This amendment was defeated. Blanche Lincoln voted with the minority, but Conrad didn't.

Teddy's Replacement Coming Soon

The Massachusetts State Senate just passed the bill allowing for a temporary appointment to the US Senate seat held by Ted Kennedy. The Governor will sign and the Democrats will be back to 60 seats perhaps by the end of the week.

This is probably the best practice for Senate vacancies - a temporary appointment because of the disproportionate impact of losing one Senator out of 100, followed by a quick election within a few months. It ought to be the standard.

Most speculation on the seat has centered on former Governor Michael Dukakis, or someone with ties to the Kennedy family or Teddy himself, like a former staffer. At any rate, that vote will certainly be fairly Democratic.

Obviously this raises the possibility of demanding Democratic unity on allowing a final vote on health care to go forward, even if they don't approve of the final bill. There's the matter of Robert Byrd (who ought to resign and live the rest of his life in peace), but essentially, Democrats will have the votes to block a filibuster if they hang together. And if Harry Reid cannot figure out how to enable a vote the the overwhelming majority of his caucus supports, then he doesn't have any power whatsoever. Reid is still raising the possibility of reconciliation, but that's a bluff for Republicans. It's the Democrats in his own chamber who need the nudge, although perhaps reconciliation is a warning to them as well.

If The Congress Won't Do It, The EPA Will

Harry Reid is signaling that health care and financial regulatory reform will take precedence in the Senate over the climate change bill, which could push the legislation into next year. The problem with that is the Copenhagen conference coming up in December, and the need for the US to bring something tangible to the table if there is any hope for an agreement. Indeed, the Europeans are already angry at the US approach, and not having some movement on the climate in hand will probably kill it completely. So the Administration has taken the law into their own hands, as allowable under the Supreme Court mandate to regulate greenhouse gas emissions.

The Obama administration on Tuesday formally proposed new fuel efficiency standards for cars and trucks, a move that signals the first federal limits on greenhouse-gas pollution.

In May, President Obama announced in a Rose Garden ceremony that cars would be held to a higher environmental standard. On Tuesday, officials filled in the details, linking fuel economy to emissions from vehicles.

The net effect would be to require manufacturers to ratchet up fuel economy 5 percent per year. In 2016, new cars and trucks would have to achieve an average rating of 35.5 miles per gallon. Cars currently must average 27.5 miles per gallon; light trucks must average 23.1 miles per gallon.

If this is any indication, it's only a first step, leading to other command-and-control measures from the EPA and other regulatory agencies in the absence of a climate deal from Congress. Power plants, one presumes, would be next. In fact, they've already started revising the rules on waste discharges from coal plants.

It's probably not the best practice, but under the current gridlock, it's the only tool available to the Administration. So members of Congress, particularly Republicans, have a choice to make. Legislation or regulation?

Polluting industries certainly didn't give up the fight against legislation in the face of regulation, and they'll continue to fight tooth and nail against the regulation in an attempt to run out the clock and maximize profits. David Roberts says that's why Obama needs to get involved and get a climate bill passed.

The war against EPA regulations will also be waged with aggressive public relations campaigns. There will be great hue and cry about the economy-destroying burden that command-and-control regulations impose on American business. And unlike with a climate bill, responsibility (read: blame) cannot be dispersed. There is no hint of bipartisanship. Responsibility for EPA regulations will fall entirely on Barack Obama and his administration, not on Congress—which is probably how Congress prefers it. If it’s a total mess, or demagogued as one (as is all but certain), it’s Obama that takes the hit. That is yet another reason he’d rather avoid it.

Greens are fighting to preserve EPA authority in the climate bill. Some have even said that it would be preferable for legislation to fail and the EPA to take over. It’s not hard to understand why—something needs to be done about existing coal plants, and there aren’t many tools in the climate bill toolbox to address them. But no one should be under any illusions. The NSR/PSD/BACT approach is grossly suboptimal for the job that needs doing. It might have the intended effect—killing coal plants—but there’s potential for unintended effects as well, including substantial political blowback.

Both sides, greens and industry, have reason to fear if the climate bill fails. It’s terra incognita, a volatile and unpredictable situation. Obama doesn’t need any more problems like that. That’s among the reasons he is likely, this fall, to put some of the time and energy toward lobbying for a good climate bill. From his narrow political perspective, virtually any bill is preferable to catching the EPA tiger by the tail. That tiger eats bunnies.

In this case, the House has already passed a bill, so really we're looking at the Senate as the holdup here. But the dynamic of Senators not wanting to be responsible, pushing all the political liability on to the President, will be difficult to change.

Not So Fast, Mad Max

Jay Rockefeller is actually the chair of the health subcommittee in the Senate Finance Committee. Any "Gang of Six," or really any legislation on the Committee, should at least have his input, if not his controlling hand. Yet Max Baucus froze him out of the legislation in favor of Republicans who will never sign on to the final version and worthless schemes like the Conrad co-op proposal (which is just a thin ploy to get Blue Cross of North Dakota, which controls 90% of the market in Conrad's state, the "co-op" label so it can access federal start-up funds). Rockefeller may have the last laugh when the bill moves into the full committee.

U.S. Senator John Rockefeller, a Finance Committee member and a strong backer of a government-run insurance option, said on Tuesday he will not support the panel's healthcare bill in its present form.

Rockefeller told reporters he was unhappy with the lack of a government-run "public" insurance option in the bill, which is scheduled to be made public on Wednesday, and had problems with some of its changes in children's health insurance and Medicaid, or healthcare for the poor.

In particular, Rockefeller wants a public insurance option instead of the weak co-ops, better affordability provisions so working people can actually use the bill, and changes to the way that Baucuscare deals with the Children's Health Insurance Program and Medicaid.

Rockefeller specifically said "There is no way in its present form that I will vote for it... unless it changes during the amendment process by vast amounts." Now, getting amendments through may not be an easy task. Each Rockefeller amendment in that committee would have to get the votes of all the Democrats plus at least a couple Republicans, if Baucus and Conrad hold firm on them. Considering that 10 of the 13 Democrats on the panel were completely shut out of the process during the Gang of Six talks, I'd expect a lot of support for what Rockefeller wants to do, but Baucus and Conrad can basically nullify anything meaningful on their own, should they want to.

Still, Rockefeller's advocacy is important because it sets the tone for Democrats with the full Senate, where votes like his will be needed. Jon Cohn explains.

A little over a month ago, right before the August recess, I spoke with Rockefeller at some length. And he was clearly wrestling with how to position himself.

No living senator has done as much to promote health reform as he has. It's the cause of his life and, for the first time, the goal is within reach. He admitted that voting against a package, even a flawed one, was difficult to imagine.

But Rockefeller also made clear his frustration with the compromises Baucus was making, whether it was replacing the public plan with a co-op or gradually reducing the subsidies to help people pay for insurance. He was particularly incensed about the changes to Medicaid and CHIP, programs to which he's devoted much of his time--and on which many West Virginians rely.

At the time, it seemed like Rockefeller was still on board, if only to help get a bill out of the Finance Committee and onto the Senate floor. But you got the feeling--well, I got the feeling--that he was near the breaking point.

Sometime since that interview, clearly, he's hit it.

Every vote is precious in the Senate, given that votes on the Republican side other than Olympia Snowe and maybe Susan Collins will not be forthcoming. Harry Reid has laid down the marker that anything less than 60 votes will lead him to go through the reconciliation process (and I don't think Reid's low poll numbers in Nevada will be much of a factor - the consequences of doing nothing on health care would be far graver for him). Therefore everyone in the Democratic caucus, essentially, represents an interest group to be satisfied. Rockefeller is standing up and saying that he's perfectly willing to vote against something that doesn't fulfill the promise of health care reform as he sees it. Bernie Sanders probably feels the same way. Maybe Barbara Boxer does. Or others. Max Baucus and his cronies will have to wrestle with that.

...Incidentally, the fact that we could have a new interim Senator from Massachusetts as soon as this week makes things even more interesting.

We Need To Send One Strategic Thinker To Washington, Just One

I actually don't buy this for a second:

Environmentalists hope the push in Congress for climate change legislation is not overwhelmed by the debate dominating Capitol Hill over changing the U.S. healthcare system. But it might be.

Already two months behind schedule and unsure whether enough Democrats will play along, Senate leaders still aim to pass a bill by December when a United Nations summit convenes in Copenhagen to set worldwide goals for reducing carbon dioxide and other pollutants.

But as the debate over healthcare legislation rages and with President Barack Obama due to address a joint session of Congress on Wednesday to try to rescue the faltering plan, it was unclear whether rattled lawmakers will have the time -- or the inclination -- to take on climate change.

It's inclination, not time. The primacy of the health care debate is the best thing to ever happen to the climate change bill. It can slink around in the weeds, and Barbara Boxer can go to work on it and spring it on Congress before the teabaggers have time to react. It's already passed the House, so a quick strike in the Senate - even if it's a bad bill without a cap and trade plan - shouldn't be too difficult while everyone's head is turned. Because health care has taken center stage, the climate bill is popular at this point. The Democrats could markup on Wednesday and pass by Friday if they really wanted to do so. It would be the perfect way to bring the hammer down on Republicans for elongating the health care debate.

But I don't expect that to happen. Because too many Democrats want no part of a climate bill. The concessions made in the House should be enough to satisfy the Senate, but people like Ag Committee Chair Tom Harkin want to put their thumbprint on it as well. And there's no Progressive Block to get in the way of the endless concessions.

A strategic White House would have told Harry Reid today to schedule the climate bill for Thursday. It would have messed with everyone's head. But we have no strategic thinking on Capitol Hill, and these are the results.

How The Media Actually Can Help Bring About Change

While I agree that too many traditional media stories fail to offer context and explain the nature of the policy, those stories can be found if you know where to look. For instance, Jonathan Cohn offers a pretty comprehensive look at the White House's ill-fated deal with the pharmaceutical industry, where drugmakers traded an insignificant hit to their bottom lines for the protection of their record profits far into the future.

The drug industry was first in line, according to several sources familiar with the discussions. But its list of demands was long. It strongly opposed letting the federal government negotiate directly with drug companies over price, the way governments in other countries do; it didn't want to give the government rebates on drugs it purchased for Medicare recipients; and it didn't want to let Americans buy cheaper drugs overseas. All three positions ran counter to Democratic Party orthodoxy. (Later, the industry made clear its opposition to a public insurance option, as well.) Pressed to give up something, the drug-industry officials indicated that they would be willing to put up with several other changes designed to reduce its revenues--like giving the government a larger rebate on drugs purchased for Medicaid recipients--but only to the extent they reduced revenues by $50 billion over ten years. Anything more, they said, was unacceptable.

Neither the staff of Baucus's Senate Finance Committee, which had been leading the discussion with PhRMA, nor officials from the administration, who had since joined the talks, were thrilled with this offer, according to people with close knowledge of the negotiations. For one thing, the administration and Baucus believed the drug industry would ultimately make money from reform, since more people with insurance coverage was bound to mean more people buying drugs. (PhRMA countered these arguments with a dubious analysis arguing that reform would not mean much new business, partly because most of the newly insured would be relatively healthy and thus need few drugs.) Obama and his allies also thought $50 billion over ten years just wasn't a lot of money, particularly for an industry that has consistently ranked among the most profitable in the country. They had a bigger number in mind--something closer to $100 billion.

A breakthrough finally came when Obama and his allies indicated they wanted to fill in the "donut hole"--the gap in coverage for seniors who opt for Medicare drug coverage. At that point, the drug industry volunteered to sell its name-brand drugs at a discount to consumers, worth about $30 billion over ten years. It wasn't much of a sacrifice for the industry; the discounts would come almost entirely out of new drug sales, not existing ones. But it helped seal the deal.

The White House would tell you - in fact, they told me - that it's better to have Big Pharma on the side of reform, and $80 billion is a significant savings for the government and its people, and it's better to get that than to get no reform at all. But the measure of how this deal resonated with the public, which did actually find out about it, is how Congressional leaders have walked away from it ever since.

Senate Majority Leader Harry Reid said Friday that he was not bound by a controversial deal negotiated between the White House and pharmaceutical companies, telling thousands of Nevada voters on a conference call that “I have not agreed with anybody to do that.”

The drug industry told the White House this summer that it would cut future drug costs by $80 billion in exchange for assurances that any health care legislation would prevent the government from negotiating for lower drug prices. As a result of the deal, the industry is bankrolling an ad campaign touting Barack Obama’s health care overhaul.

But Democrats in Congress have balked at the agreement.

“I’m a Democrat in the Senate, and I haven’t agreed,” Reid told a caller.

Guess what, in the end, this pharmaceutical deal will probably be in the final bill, they will give up a minimum of profits, and we won't import drugs from Canada, or negotiate on prices, or restrict patents on biologics. Because corporations still rule our government, and their power has grown immensely over the past several years. But if it holds that the drugmakers take a real hit, that would be entirely because the media reported on this, and made it an issue (helped along by some Democrats, like Henry Waxman, who yelped about it). That's the value an aggressive press could add to this debate.

Reid On Board With Public Option

Strong words from Harry Reid on the public option.

Reid opened a private meeting of health care providers in Las Vegas on Tuesday by saying, according to one attendee who took notes: “We have a problem in America and it’s called the private insurance industry.”

Reid went on to express support for a public option, the proposed government-run insurance plan that he compared to Medicare, saying any meaningful reform legislation would have to include a public component.

Nevada’s main progressive group said the majority leader’s comments during Tuesday’s meeting of about 20 hospital CEOs, doctors and other health care providers was among the most significant statements they have heard on his thinking.

“We’re energized and we’re also confident that Sen. Reid is on the right side on this issue,” said Michael Ginsburg, a community organizer at the Progressive Leadership Alliance of Nevada, who attended the meeting. “That’s something we can take to our supporters and reassure them.”

Couple things here. First of all, Reid is up for re-election and it's going to be a dogfight, with Reid already behind in the polls. Because of his leadership position, he is caricatured by the right as a liberal ideologue, and members of his own party find him not able to compete procedurally in the Senate and get the Democratic agenda passed. But Reid has always been solid on fighting the insurance industry, which he once called the enemy of most everything we do today. And that principle has held up, despite his re-election battle. Surely Reid knows that Democrats must pass a bill if they have any hope of a decent showing in the 2010 midterms.

Second thing is that this offers good evidence that Reid may split the bill, getting the public option and other budget-related measures through on reconciliation, with the non-budget items coming in a second bill under regular rules with 60 votes. The second bill could wait until a successor is elected for Sen. Kennedy, by January 26 at the latest, if not earlier if the law is changed. Anthony Wright has a good piece about bill-splitting examples in the states when it comes to health care reform. Policy should trump process in this case.

Third thing is that Reid should threaten to repeal the McCarran-Ferguson Act that gave the insurance industry an anti-trust exemption. This has allowed the insurance industry to highly concentrate in almost every state market and has offered precious little choice. Just the buzz of repealing McCarran-Ferguson will send the insurance industry into battle mode, and the public option would be seen as practically benign by comparison.

...or, maybe, not at all.

During a tele-townhall with constituents today, Senate Majority Leader Harry Reid said he supports a public option...but then he added an extremely important caveat. Reid said he doesn't think the public option ought to be a government run program like Medicare, but instead favors a "private entity that has direction from the federal government so people that don't fall within the parameters of being able to get insurance from their employers, they would have a place to go."

That sounds suspiciously like Reid would prefer a so-called co-op system, which almost all reformers regard with suspicion, and many regard as a non-starter.

Establishment Coalescing

Here are a couple headlines that I didn't think I'd see. One, Tom Daschle saying that budget reconciliation may be the only way for health care reform to pass. Two, and this one is really a stretch, Terry McAuliffe saying health care reform is a failure without a public option:

Former Democratic National Committee Chair Terry McAuliffe is demanding his party take a stand on health care legislation that the president and many others aren't willing to take: Pass a bill with a public option for insurance coverage or don't pass anything at all.

The long-time adviser to the Clintons, striking an atypically progressive tone, urged the White House to get more assertive in its handling of health care reform and described a bill without a public plan as a "failure."

"If we don't have the public option, we are wasting our time," McAuliffe told the Huffington Post. "To chalk something up and get something that is not the right thing to do is morally wrong... To pass something just so you can go home and go into election saying we passed something is not why lawmakers are sent to Washington."

After a bit of silence following his loss in the Virginia Democratic gubernatorial primary, the former DNC chair has come out swinging on the year's most important legislative issue. On Thursday, McAuliffe agreed to host a fundraiser with the first Virginia pol who insisted that a public option be in the bill. The offer, he said, extends to Sens. Jim Webb and Mark Warner -- both of whom have been sour on the idea of a government-administered option for insurance coverage. He's also involved in whipping support in Congress for the public option.

McAuliffe is the first business-friendly Democrat making the business case for competition in health care, saying that the status quo is bankrupting individuals and companies. But more important, he's a figure with ties to the donor class and the Third Way wing of the party. That he's arguing so strongly for a public option suggests that he's placed a bet that the party would benefit from going that route, and more important, would suffer from failing to do so.

Now it's basically up to the leadership to decide which way to go. Nancy Pelosi has said that her chamber cannot pass a bill without a public option. Steny Hoyer cut her off at the knees yesterday, saying "I'm for a public option but I'm also for passing a bill." Of course, in the House, those two statements are not mutually exclusive, but Hoyer clearly counts on progressives caving. $361,614 says they won't.

As for the Senate, Harry Reid has a choice to make. He can include the public option in the elements of the bill to pass through the reconciliation process, or turn the screws on ConservaDems to invoke cloture on the bill, or he can continue to allow the Baucus caucus to hijack the process. Reid has the ability to bypass the Finance Committee completely, if he chooses, and bring a bill to the floor. And he can use reconciliation for the elements about which Baucus and his cronies feel squishy.

Reid can't do it alone, of course. The President would have to get involved behind the scenes. But Democrats who are losing their base had better think of something to get this through.

Baucus Caucus: Less Health Care For America NOW

The six-headed Presidential hydra, also known as the sub-group in the Senate Finance Committee, has decided to ignore everybody and keep working diligently to do absolutely nothing on the health care bill.

Senate health-care negotiators agreed late Thursday to ignore the increasingly strident rhetoric from Republican and Democratic leaders and to keep working toward a bill that can win broad support from the rank-and-file in both parties, according to sources familiar with the talks.

In a conference call, the three Democratic and three Republican members of the Senate Finance Committee agreed to redouble their efforts to craft a less costly alternative to the trillion-dollar initiatives so far put forward in Congress. They discussed the possibility of also reining in the scope of their package, the sources said.

The senators rejected the idea of imposing a deadline on their negotiations, and they agreed to talk again Sept. 4 -- four days before lawmakers are scheduled to return to Washington from their August break. The consensus, one participant said, was "to take your time to get it right." [...]

Before leaving for the month-long recess, Baucus had pegged the cost of the negotiators' ideas at less than $900 billion over the next decade. Thursday's discussions focused on driving that cost lower, the sources said.

Their draft bill was already woefully short in terms of subsidies for those who can't afford insurance. The Gang of Six wants to drive them even lower.

I'm sure the people most enamored of themselves did reject having a timeline on their circle jerk. But look who is making these decisions. Chuck Grassley has basically said he'd vote against his own bill, even if he gets everything he wants, if he cannot get more than 80 Senators total on board. The #2 ranking Republican in the Senate has already said that votes for reform aren't coming. So Grassley, one of the key negotiators here, has admitted that he won't support anything the Gang of Six does. Mike Enzi is probably stronger in that direction. Olympia Snowe admitted today that the public option was never on the table in this Gang of Six, and that co-ops are worth exploring, even though two months ago she called them worthless. Kent Conrad has been ideologically opposed to the public option for as long as anyone can remember, and came up with co-ops, in all likelihood, as a way to steal seed money for the "non-profit" Blue Cross of North Dakota, which has captured 90% of the market in his home state. Max Baucus admitted as far back as March that the public option was nothing but a bargaining chip. Jeff Bingaman hasn't been getting nearly enough heat for being part of this charade, but he has talked the talk on co-ops as well.

These six Senators, who come from states representing 2-3% of the population, have proposed ideas out of step with 77% of the public, and think they're entitled to hijack the entire process in Congress to serve those ends.

The question is what to do about this. 270,000 people listened to the President's strategy session yesterday, and over 5,600 supporters have contributed almost $350,000 to lawmakers standing up for the public option. These six lawmakers, most of whom probably want no bill at all, know that the longer they hold up the process the harder it becomes to pass anything. Harry Reid needs to use whatever means necessary to force a bill out of the Senate - discharge petitions, going around the committee of jurisdiction, whatever. At that point, we're talking about a conference committee. Which is what Obama has asked for all along. The problem is a matter of trust, as Paul Krugman put it today.

...Chris Bowers is right that this is the worst part about it - the Senate Finance Committee has decided to take two additional weeks off before meeting again. They are so bound and determined to get health care right that they'll do nothing for weeks, presumably in the hopes that health care reform will die on the vine and they won't have to do anything at all.

7-10 Split

FTW:

The White House and Senate Democratic leaders, seeing little chance of bipartisan support for their health-care overhaul, are considering a strategy shift that would break the legislation into two parts and pass the most expensive provisions solely with Democratic votes [...]

Most legislation in the Senate requires 60 votes to overcome a filibuster, but certain budget-related measures can pass with 51 votes through a piece of parliamentary sleight-of-hand called reconciliation.

In recent days, Democratic leaders have concluded they can pack more of their health overhaul plans under this procedure, congressional aides said. They might even be able to include a public insurance plan to compete with private insurers, a key demand of the party's liberal wing, but that remains uncertain.

Other parts of the Democratic plan would be put to a separate vote in the Senate, including the requirement that Americans have health insurance. It also would set new rules for insurers, such as requiring they accept anyone, regardless of pre-existing medical conditions. This portion of the health-care overhaul has already drawn some Republican support and wouldn't involve new spending, leading Democratic leaders to believe they could clear the 60-vote hurdle.

I wouldn't call budget reconciliation, which is how the Bush tax cuts came into being, a "sleight-of-hand." It's been on the Senate rulebooks for decades. Furthermore, passing something by a majority vote should NEVER be seen as something foreign and exotic. It happens to be the prevailing law of the land. Only recently have we had this magic 60-vote requirement on all legislation. Only recently have Republican obstructionists used it in every single case they can. THAT would be the sleight-of-hand, getting the media to believe that a definitive 60-vote standard exists.

I don't think Republicans would sign on to the less controversial elements of reform knowing that the more controversial ones will go the reconciliation route, so you'll still need to convince all Democrats to support cloture on the insurance reform/individual mandate section of the bill. But if the leadership can get that done, I'd say go for it. Jim Manley, Harry Reid's spokesman, said in the article, "we are determined to get something done this year by any legislative means necessary."

This, by the way, is an absurd statement by Olympia Snowe:

The idea of using reconciliation angers even such moderate Republicans as Ms. Snowe. "At a time when we need to bolster the public's confidence in whatever we do with health care, I don't think the reconciliation process will serve the purpose of providing affordable health security for all Americans," she said.

Nobody in America cares about the process used. People aren't staying up at night angered that the Bush tax cuts used a particular Senate process to pass. They may be angry that George Bush cut taxes on the wealthiest Americans in a time of war. If the bill actually provides affordable health care for all Americans, the number of votes will not have any bearing whatsoever on public confidence. In fact, the public does get confused when they hear 58 Senators voted affirmatively for something and the bill failed. The byzantine, anti-Democratic process of the Senate is what saps the public confidence in government.

Going Into Overtime

The successful Cash for Clunkers program is coming down to the wire in the Senate. They have until the end of the week to pass the bill before they head into an August recess. But if they try to change the bill from what the House passed already - which was just a straight extension - the bills would have to be reconciled, and that would require the House coming back from its recess. Otherwise, it'll get signed into law too late for the program to stay in business. What will Sen. Reid do?

The $2 billion cash infusion granted Friday by the House to the overwhelmed cash-for-clunkers program must be accepted by the Senate this week without amendments — or it won’t be signed into law until September.

The House has adjourned for its summer recess, and some Senate lawmakers want to change the bill, which will likely force Reid into a days-long cloture process.

And that's in addition to trying to move the Sonia Sotomayor confirmation, which will probably take multiple days of floor debate, even though the outcome is assured. There's simply no way the Senate can plow through all that by the deadline of Thursday night. It's not possible.

Senate Minority Whip Jon Kyl (R-Ariz.) said his party will push a go-slow approach on cash-for-clunkers so that the program’s solvency and effectiveness can be examined. Without knowing how many claims are still in the pipeline, Kyl suggested a similar mistake could be made again.

“We need to have a time-out to see how much money was spent,” Kyl said. “Before you authorize more money, wouldn’t you like to know how much you’ve spent and how it took to spend it, and what kind of things you might want to do to modify it?” [...]

The GOP staffers pointed to Democrats like Dianne Feinstein of California, Claire McCaskill of Missouri and Mark Warner of Virginia, who in recent days have all expressed skepticism about the program. However, Feinstein and GOP Sen. Susan Collins (Maine) indicated on Monday evening they will support the measure. Warner wants the program to have higher mileage requirements while McCaskill has sounded skeptical about how it will be funded.

But other Democrats strike a common refrain: The sudden demand on the cash-for-clunkers program proves it is working.

With Feinstein and Collins singing off after seeing the unexpected increases in fuel efficiency coming from this program, it's safe to say that this has a good chance of passage. But Republicans will obstruct, and slow down, and gum up the works, and try to add amendments and poison pills, all the while saying that they just have to get home for the August recess. And so a program with demonstrable success that has led to the highest light vehicle sales in a year might get scrapped because of the old stopwatch.

What a wonderful political system we have.