Dems Strike Deal to Get 60th Vote in Senate
by Jonathan Singer, Sat Dec 19, 2009 at 06:29:33 AM EST
With Ben Nelson signing on to the Senate leadership's healthcare reform package, the Democrats now appear to have 60 votes in favor of their bill. Here's The Washington Post on the deal, which you can read in full as a very large .pdf here:
Under the new abortion provisions, states can opt out of allowing plans to cover abortion in insurance exchanges the bill would set up to serve individuals who don't have employer coverage. Plus, enrollees in plans that do cover abortion procedures would pay for the coverage with separate checks - one for abortion, one for rest of health-care services.
Nelson secured full federal funding for his state to expand Medicaid coverage to all individuals below 133 percent of the federal poverty level. Other states must pay a small portion of the additional cost. He won concessions for qualifying nonprofit insurers and for Medigap providers from a new insurance tax. He also was able to roll back cuts to health savings accounts.
Per The Post, the ultimate bill looks a great deal like the bill initially released by the Senate, expanding coverage to an additional 31 million Americans while reducing the deficit by about $780 billion over 20 years. The manager's amendment, however, does not include a public option.
Instead of a public option, the final product would allow private firms for the first time to offer national insurance policies to all Americans, outside the jurisdiction of state regulations. Those plans would be negotiated through the Office of Personnel Management, the same agency that handles health coverage for federal workers and members of Congress.
The Associated Press calls such a provision "a consolation prize for liberals, who failed to include a government-run alternative." For more details on the bill, here are links to coverage from The Post, The AP, The New York Times, the Los Angeles Times, and The Hill.
Update [2009-12-19 12:29:57 by Jerome Armstrong]:
My favorite part of the deal with Nelson is his effort to install an entirely federally-paid government-run Medicaid plan forever, for Nebraska alone:As part of the deal to win Nelson's support, the federal government will pay for Nebraska's new Medicaid recipients. It's a provision worth about $45 million over the first decade. Medicaid is usually paid for with a mix of federal and state funding, but Nelson's carve out means that any Medicaid beneficiaries who join the program after the bill passes will be paid for in full by the federal government. It's a sweet deal considering that many governors are worried that the Medicaid expansion will further strain already stressed state budgets. The deal is emblematic of the kind of horse trading that gets done to win votes on any landmark piece of legislation. Senate Majority Leader Harry Reid sent $300 million in Medicaid funds to Louisiana as a sweetener to secure Landrieu's vote to begin debate on the bill. Nelson would not comment on the provision, saying that he would leave it to Reid to discuss details. "I'm comfortable it is taken care of," he said of his state. Reid defended Nebraska's special treatment saying, "Youll find a number of states that are treated differently than other states. Thats what legislating is all about. It's compromise."Isn't that a giant step toward a government run healthcare? The polls are showing a slippage of about 5-7% week over week for HCR, now in the low 30's. I'm wondering what sort of earful that they are going to get outside the DC bubble that reflects that reality. What would probably suffice for more unity is for the House re-insert something of the Medicaid language, rolling back Lieberman, if that can be done. I think there's a strong case for putting the deal on the back of Lieberman if he wants to kill HCR or not.