No Public Option Is Not An Option

Representatives Lynn Woolsey and Raul Grijalva on behalf of the Progressive Caucus have sent the President a letter stating in rather unequivocal terms that any bill that does not provide a public option built on the Medicare provider system and with reimbursement based on Medicare rates is "unacceptable".

Here's the text of the letter in full:

Dear President Obama:

Thank you for continuing to work with Members of Congress to draft a health reform bill that will provide the real health care reform this country needs.

We look forward to meeting with you regarding retaining a robust public option in any final health reform bill and request that that meeting take place as soon as possible.

Public opinion polls continue to show that a majority of Americans want the choice of a robust public plan and we stand in solidarity with them. We continue to support the robust public option that was reported out of the Committees on Ways and Means and Education and Labor and will not vote for a weakened bill on the House Floor or returning from a Conference with the Senate.

Any bill that does not provide, at a minimum, a public option built on the Medicare provider system and with reimbursement based on Medicare rates-not negotiated rates-is unacceptable. A plan with negotiated rates would ensure higher costs for the public plan, and would do nothing to achieve the goal of providing choice and competition to keep rates down. The public plan with set rates saves $75 billion, which could be lost if rates are negotiated with providers. Further, this public option must be available immediately and must not be contingent upon any trigger.

Mr. President, the need for reform is urgent. Every day, 14,000 Americans lose their health care coverage. We must have health care reform that will effectively bring down costs and significantly expand access. A health reform bill without a robust public option will not achieve the health reform this country so desperately needs. We cannot vote for anything less.

We look forward to meeting with you to discuss the importance of your support for a robust public plan, which we encourage you to reiterate in your address to the Joint Session of Congress on Wednesday.

Lynn Woolsey
Raul Grijalva

The critical point is that "a health reform bill without a robust public option will not achieve the health reform this country so desperately needs." Anything less is passing the buck to a future Administration.

Only competition from a robust public option will rein in costs. Costs need to be reined in today, not down the line. A public plan will contain costs which are currently rising twice as fast as income thus eroding living standards, a public plan will toe the line on rising premiums which have surged 78% since 2001, and it will finally give Americans a choice of health plans - public and private. An analysis of the public option by the Campaign for America's Future concluded that offering "a new public insurance option to those who lack coverage would control healthcare costs and improve quality by providing an important benchmark for private insurance within a reformed healthcare framework." Universal coverage will reduce cost shifting by getting everybody covered and contain costs through investment in prevention, management of chronic care, twenty-first-century information technology, and research on and adoption of effective treatments.

Furthermore, only 60% of US employers offered health insurance to their employees as of 2007. That's down nine points since 2001. And increasingly, many employers are cutting the coverage they do provide leading to a rise of those who are underinsured. The problem of the underinsured is "the sleeping giant of the US health care crisis" because it can affect those who think they have adequate coverage until a healthcare emergency befalls them. Among adults aged 19 to 64, 25.2 million are "underinsured." The number of underinsured has increased 60% from 2003 to 2007. That compares with a 5.1% increase in the number of uninsured Americans - to about 47 million - over the same period, according to the US Census Bureau.

Low income earners have the fewest healthcare options, because the small firms they tend to work for are less likely to offer coverage. The high cost of premiums was cited as a main reason firms fail to provide healthcare coverage to their employees. The only way to extend coverage to this population is via a public option.

Moreover it is a moral outrage that some 18,000 Americans die annually for lack of health insurance coverage. We're a better country than this or so I'd like to believe.

If the final bill doesn't include a robust public option, then the Progressive Caucus in Congress should feel no obligation to support it. We're not looking for any bill. It must be the right bill and that means a robust public option.

Tags: health care reform, progressive caucus, Public Option, Rep. Raul Grijalva, Rep. Lynn Woolsey (all tags)



Re: No Public Option is Not An Option

Thus the die has been cast and the Progressives make their stand!! Thank them and thank all the people who are making enough noise against the ongoing capitulation from the WH.

by tarheel74 2009-09-03 07:17PM | 0 recs
Re: No Public Option is Not An Option

Well a) let's don't thank them until they prove they aren't going to capitulate and b) the die is now bigger than this bill (it is truly about whether progressives will have a seat at the table or not). I find it deeply offensive that Pres Obama is inviting centrists and conservatives to the WH and calling up people like Sen Coburn for advice, but has not done the same apparently with progressives. He's supposed to be about listening to all ideas, and yet, how exactly is screening out progressives about  listening to all ideas?

by bruh3 2009-09-03 07:24PM | 0 recs
one vote from a Republican senator

is worth more to the president than keeping his campaign promises and passing a bill favored by the majority of Americans. Sad commentary.

The White House clearly believes that Progressives will be rolled, which is a rational belief based on past experience. It looks like they may need to follow through and kill this bill before Obama takes them seriously.

by desmoinesdem 2009-09-03 07:28PM | 0 recs
Re: one vote from a Republican senator

Except that even his basis for believing Sen Snowe will buy the deal is false:

"Sen. Olympia Snowe (R-Maine) appears unlikely to walk away from bipartisan health care reform talks in the Senate Finance Committee to cut a side deal with the White House, but her spokeswoman said Thursday that she continues to keep an "open line of communication" with President Barack Obama."

"It's totally unclear why the White House is pushing this story," one senior Senate GOP aide said. "Have they not seen or heard the Congressmen and Senators on their own side of the aisle who have said they'll oppose various aspects of this proposal? I'm not sure how alienating Grassley and Enzi with the rest of the Republican conference and the moderates in their own party can be offset by one Senator from Maine. The math is just not on their side." l

This is a WH that is no longer based in a little thing I like to call reality.

My opinion: the reality is that Pres Obama trusted Rahm and the Blue Dogs. He is saddled with their inability to read the times properly. They are stuck in the neolibealism of the 90s while we are faced with a country still recovering great recession, the ultimate proof that neoliberalism does not work.

They are in many ways his version of the neocons, who believed that it was not that the Vietnam War was wrong, but that we did not go the distance to win the war. That they had to return America to its place of greatness.

The Obama people are like that with neoliberalism. It has no basis in pragmatism or real politics. It is totally faith based economic analysis.  Thus,  what I mean by my comparison is that we have a group of people who believe in a strategy or set of ideas so much that they just think it is a matter of implementing it properly rather than the ideas themselves being screwy.

Mix this with post partisan shtick, put in a dollup of triangulation, and bam! you got what we are seeing.

by bruh3 2009-09-03 07:42PM | 0 recs
Re: one vote from a Republican senator

Once again we are of the same mind.

by Charles Lemos 2009-09-03 07:45PM | 0 recs
Re: one vote from a Republican senator

BY the way, agree with your overall argument. If the progressives are to hold any power in DC, they can not at this jucture capitulate or they will lose on every bill that follows. Not sure if they realize this or not, but it is clearly the reality that they are playing  a high stakes game of poker that is no longer just  about this hand, but every subsequent hand that will be dealt them.

by bruh3 2009-09-03 08:03PM | 0 recs
Progressives may save Obama's presidency

if they refuse to let him hand victory to Chuck Grassley and the teabagger movement:

Arguing that the town hall forums of August have "changed the direction" of the health care reform debate, Sen. Chuck Grassley (R-Iowa), said Thursday that he nonetheless expects a bill to pass before Christmas -- though it "may be kind of miniature to what we're talking about."

by desmoinesdem 2009-09-03 07:25PM | 0 recs
Re: No Public Option is Not An Option

Try telling that to Matt Yglesias, Ezra Klein, and Nate Silver.

The one thing Obama must not do is jettison the public option Wednesday night.  I'm a bit more flexible on this than you guys, but by keeping the public option open, it will make it to conference committee (barely), and at least the the progressives will have a seat at the table.

Harry Reid is struggling back home in part due his lack of support for the public option.  He's a weak leader who would not be missed.  And if Obama does let go of the public option too soon, maybe it's time for a primary challenge in 2012.

by esconded 2009-09-03 07:42PM | 0 recs
Re: No Public Option is Not An Option

I don't recall what blogger made this argument today, but an address to a joint session of Congress is a Really Big Deal.  I have no idea what Obama is going to say, but there is no way he goes out on that gigantic stage in order to utterly capitulate and accept some small-bore measure.  We'll see.

by Steve M 2009-09-03 07:45PM | 0 recs
Re: No Public Option is Not An Option

Your argument assumes competence.  As Big Tent Democrats seems to state, that's  one of the question mark now lingering over this White House.

by bruh3 2009-09-03 08:01PM | 0 recs
Re: No Public Option is Not An Option

I have to assume at least a minimal level of competence because if it's not actually there, we're all fucked anyway.  I still think, on the whole, they're more together than Clinton was in the early days (but that sets the bar kinda low).

The wisdom of capitulation is a separate issue altogether.  What I'm saying is that if the White House brain trust has decided to throw in the towel, it's hard to imagine they would choose a high-profile address to Congress from all the possible ways in which they could announce their position.  Who knows.  Maybe they're thinking, "If we announce the capitulation with enough fanfare, no one will realize it's a capitulation!"  But that's stretching credulity just a little bit.

Soon all will know, grasshopper.

by Steve M 2009-09-03 08:11PM | 0 recs
I'm hoping against hope

that these WH leaks are lowering expectations so that we'll all be pleasantly surprised when Obama delivers a very strong speech next Wednesday, backing the kind of policies he campaigned on.

It appears more likely that he will scale back his goals in the hope of getting 60 votes in the Senate. If that's the case we need Bernie Sanders and a few other Ds to make clear that "snowe-lite" will not get 60 votes.

by desmoinesdem 2009-09-03 08:59PM | 0 recs
Re: No Public Option is Not An Option

Before you raise your expectations too high remember this, in the waning days of the 1994 fight Bill Clinton also addressed the joint session of Congress to no avail. In any case on Rachel's show she elaborated how JFK addressed the Congress multiple times only to see his medicare proposal fail every time. So the only thing this speech will do is any of the following: (1) draw the battle lines (which I hope he does); (2) signal capitulation on public option (which I fear he will); and (3) give a few details of his otherwise very fuzzy and broad principles. In any case I do not envision him getting many (make it any) converts from the Republican side of the aisle based on this single speech. All he can do is rally the base, which makes political sense if he has any of that left now.

by tarheel74 2009-09-03 08:01PM | 0 recs
This is the first time I have agreed with you

If he lets the public option go or fails on healthcare reform, it is IMPERATIVE that we see to it that he gets a primary challenge over it.  It would be worth it because it would show future Democratic Presidents not to mess around with the left when it comes to healthcare.  

by Kent 2009-09-03 07:46PM | 0 recs
You need to stop posting

here or get help. You repeadidly said we need to pass anything and now you're saying we need a public option.

Make up your fucking mind, thanks.

by DTOzone 2009-09-03 10:06PM | 0 recs
You think we can survive 2010 without healthcare?

It will be the end of the Democratic party is we know if we fail this time.  We will never get another shot at it.  

by Kent 2009-09-03 10:30PM | 0 recs
Re: You think we can survive 2010

The world ends in 2012 anyway, why worry.

by Steve M 2009-09-03 11:03PM | 0 recs

cause it was the end of the Democratic Party as we know it the other six times we failed on healthcare? lol

So you think we should just get anything to survive in 2010? or a public option? what is it, I don't understand.

by DTOzone 2009-09-04 08:14AM | 0 recs
Cheer Up, Upstate! The end of the world can be fun

by WashStateBlue 2009-09-04 08:28AM | 0 recs
Obama is looking like George H. W. Bush

after he broke his no new taxes pledge in 1990.  That was what permenantly lost him support on the right and Obama is doing the same thing on healthcare.  Bush allowed Democrats to trick him into signing the tax increase and Republicans are tricking Obama into signing a crappy healthcare bill or dropping reform all together.  

by Kent 2009-09-03 07:44PM | 0 recs
Re: Obama is looking like George H. W. Bush

Wait, weren't you just saying Obama needs to drop healthcare reform like a hot potato right this second or we're certain to lose Congress for the next 80 gazillion years?  You're all over the place!

by Steve M 2009-09-03 07:47PM | 0 recs
He has two choices

He can get it done and quickly or he can just give up and move onto other things.  There is no in the middle.  

by Kent 2009-09-03 08:04PM | 0 recs
Re: No Public Option Is Not An Option

Whoa, you just blew my mind

by KLRinLA 2009-09-03 08:26PM | 0 recs
Re: No Public Option Is Not An Option

It appears that big labor has been giving advice to the progressive caucus... This is exactly how labor negotiates... it draws lines in the sand, threatens to walk away, etc.

But, here's the kicker.  In the end, a deal is made, which usually is not the "line in the sand".  Therefore, a deal will be made.  We will get a lot from it... stuff that probably would have been jettisoned without the posturing, but it won't be everything that we want, unfortunately.

Still, it will make a real, positive difference, and thank God for the progressive caucus.

BTW, the CPC has another arrow in their quiver. The white house is VERY nervous that afghanistan funding will be blocked in the house.  The CPC can certainly use that as leverage!

by LordMike 2009-09-03 09:10PM | 0 recs
Re: No Public Option Is Not An Option

No. Sorry. But your argument is wrong. The unions can do that because they have followed through on threats in the past, and managment knows it unions are the only players on the field. Yes, their is arbitration, etc, but you are still dealing with the same people.

That's not this situation. THis is a situation of first instance where you are trying to establish the precedent that you are a litlte crazy, and the other side should not assume they can play by the same old rule book. If you compromise, then the same rule book is in play.

There's only one way to play this battle- brinkmanship or a game of chickent. Who will blink first? This again is not just about this battle. It is about the overall war for power in DC.  If prorgressives blink first it will reset to the same game as has been played for decades. That's not theory. It has played out again and again.

Sometimes you use one moment as an example so the other side will remember going forward into the future "I don't know if they are really going to go crazy on me?" "Are they?" "I don't know?" "Will they?"

You want that doubt in future bills because that's what youuse to win in future legislative battles. Certainty of behavior favors the status quo because it is what conservatives use (a la Charlie Brown and Lucy) to win these battles.

by bruh3 2009-09-03 09:27PM | 0 recs
Re: No Public Option Is Not An Option

by the way- what I just described- brinkmanship, understanding the number of players, etc, is all basic game theory. The problem until recently is that progressives did not know how to use these basic tools of negotiation to achieve a win.

by bruh3 2009-09-03 09:29PM | 0 recs
Re: No Public Option Is Not An Option

One final statement: If the progressives play their cards right, they wont have to request a seat at the table. They will be offered it as a matter of political expediency by President obama since theorectially he wants to win. Now, this may piss Rahm and Co off but who cares.

by bruh3 2009-09-03 09:31PM | 0 recs
The power wielded here is substantial

What I am seeing here is a real shift in power, and fortunately it happened fast enough that the lobbyist industry couldn't use bribery to corrupt the set of changes occuring.

It is patently obvious that the online world is going to elect the next senator, president, etc.

The price is simple. Healthcare reform means.
Healthcare. Reform.

If I can't have healthcare, is it? I am not just a member of the public. I'm an American. The idea that this reform excludes Americans - bartering for something we're going to "hold over the heads of the insurance companies"

Will only send one message - to the savvy blogosphere and online world . That the thing that the white house wants to "hold over the heads" of the insurance companies is really just the thing they're doing while someone else is putting something in their pocket.

These guys are so laughably behind the eight-ball in trying to stop reform, these  'powerful forces' lined up - against healthcare reform

(and don't even try to call it healthcare reform, unless it kicks ass)

These 'powerful forces' are the illusion of GOP participation  - and the big money coming into the dems -

Sorry. 76% of all americans want to be able to get a good health service from our Government, like the rest of the world.

Make sure not to call it anything else other than real reform. The only option thats going to be on the table - is the option of whether or not the Democrats get to call themselves the party of smart government.

Or. Not.

by Trey Rentz 2009-09-03 10:14PM | 0 recs
Re: The power wielded here is substantial

"It is patently obvious that the online world is going to elect the next senator, president, etc."

Not going to happen.  Liberals make up 20% of the country.  Of that, how many are active on blogs?  10% of the 20%?  I have many liberal friends and none of them bother blogging.  

General elections and even primary elections are decided by people closer to the center than bloggers of either side of the political spectrum.  Obama won his first and most important primary by good old fashioned retail politics, shaking hands and giving speeches.  Real people who met the candidate, elected the President, not a handful of people chatting through computers strewn about throughout the country.  

by roger2012 2009-09-04 10:15PM | 0 recs
Re: No Public Option Is Not An Option

I still see a bill getting passed, but without a public option. For Obama, getting nothing is complete failure and a political disaster. However if he gets a bill passed and achieves much else but no public option and instead the co-ops or somethign to that nature, he still wins in the general public and saves face.

For those who suggest if there is no Public option thst he face a primary challenge in 2012, that isnt going to happen. Fact is he needs independents and moderates to be relected, with a bill passage providing coverage to greater numbers of uninsured and underinsured and helping to drive down costs he gets a win. The goal here has to be cost reduction first and foremost. By reducing costs you can make healthcare more accessible. Thats goal one, affordability, the result of which becomes accessibility.

by BuckeyeBlogger 2009-09-04 05:15AM | 0 recs
Re: No Public Option Is Not An Option

Good pragmatic points, and I think had they went that route in July, it would have been fine. But things are changed with the entire focus upon it now over the past two months, and this does have the potential to be his "No New Taxes" moment if he doesn't deliver to the progressives. His best path is probably to finally engage with his backing something specific, and move it through using his political capital.

by Jerome Armstrong 2009-09-04 05:32AM | 0 recs
Re: No Public Option Is Not An Option

Either way he will look weak. Why? If he had shown leadership on this issue from the beginning that would have been one thing, instead he has consistently downplayed the public option. If he forgoes the public option he will prove to the base that he is a weak leader and a typical politician to boot, not the transformative kind he promised he would be. On the other hand if he now embraces the public option he will appear to cave-in (or that is what will be reported by the media) to progressive pressure. Personally I would prefer the latter. Better the Democratic president caves to the Democratic wing of the Democratic party than boot us to embrace conservatives.

by tarheel74 2009-09-04 07:14AM | 0 recs
Re: Either way he will look weak.

Actually, depending on what is passed and signed it might just turn out that the Obama-bashers and gloom-n-doomers are the ones perceived as 'weak'.

You're way out on that limb.

by QTG 2009-09-05 07:30AM | 0 recs
Re: No Public Option Is Not An Option

What you are saying makes sense but does not account for the litmus test this has become for 'the base'.  If this bill amounts to a mandate without a public option, they... I... will be furious and disillusioned.  

He might get our vote against Palin/Beck or whatever asshole the GOP puts up, but he might not be able to count on the enthusiasm that he had in '08.  I know I could have used those contributions for other things.  

by mikeinsf 2009-09-04 06:22AM | 0 recs
Re: No Public Option Is Not An Option

Anyone who believed they were getting exactly what they wanted in healthcare reform was either delusional or stupid? If we come out with a bill that lowers costs and thereby improves access will be a great step forward. Would some sort of public option be a good fit, sure, but will it happen, not likely.

by BuckeyeBlogger 2009-09-04 04:14PM | 0 recs
Re: No Public Option Is Not An Option

Obviously the ConservaDems have had no problem supporting Bush's failed expensive policies to invade and then rebuild other nations, yet they want to offer resistance or lack of sufficient support to rebuilding our own country via good healthcare that will make more citizens productive?

Why is it that,as a party, there is not enough respect given to the Deans,Clarks,Feingolds who have been right on the issues while theBlueDogs who are culpable in Bush's ruining of the budget and country are given more respect? Maybe it's time the Feingolds of the party negate the BlueDog effect by making their own demands leveling the"blackmailing for votes" playing field?

How can anyone say with a straight face that Nader should have worked within the party in 2000 when we have enough proof that despite the country having seen 8 years of copnservative failure, theBlueDogs are still getting way too much importance in relation to the number of times they have been right and people who triedto work with the party like Dean and Clark have been marginalized?  Kucinich has zero influence. Even Feingold is hardly a man with much influence because geezers in the party have the whole seniority crap.

by Pravin 2009-09-04 05:45AM | 0 recs
If One Senator is that important, ...

... how important would ten Progressive Senators be? After all, subtract their votes, and its no passage, not even under reconciliation.

by BruceMcF 2009-09-04 07:55AM | 0 recs
Failure is not an option

Tell people with cancer, heart disease and diabetes and are denied medical coverage that you'll be opposing the legislation that will keep them covered under health care because you "feel no obligation to support it."  

Tell poor folks who will be denied thousands of dollars to buy medical insurance that this is fine because you "feel no obligation to support it."  

Tell people who shell out thousands of dollars every year in co-pays that they should not have Obama's proposal to limit their co-pays because you "feel no obligation to support it."  

Just remember that once you've betrayed them, they won't forget it.  


The best Obama and the Senate can do is to pass the above reforms, an employee mandate and a public option trigger if we're lucky.  Using reconciliation is not realistic.  As pointed out by Lawrence O'Donnell (Former Democratic Chief of Staff of the Senate Committee on Finance and blogger at the Huffington Post):

"Reconciliation requires 50 votes plus the Vice President for final passage only.  During the process of reconciliation on the Senate floor there are countless votes that require 60 votes because it requires you to waive the rules of reconciliation - that's done constantly in every single reconciliation process that goes to the Senate floor.  They can't think about going to the Senate floor without 60 votes whether they're doing it in reconciliation or outside of reconciliation."

Source: 96599

Time Index on Video 3:30


I support all the reforms which MyDD says are vital, which is why I support getting some reforms now and some reforms later.  It's not passing the buck, it's pulling some of the load now and some of the load later and regardless of what tired and biased analogy MyDD wishes to characterize the President's compromise with, it still does not change the fact that the President's compromise is the only way to accomplish any health care reforms.  

While MyDD has every right to push hard for the public option, if it has any integrity it will recognize the good parts of a compromise bill which may emerge and not destroy reform, the Democratic Party and reforms which will follow up on a compromise bill.  Doing so would be utterly foolish and a betrayal of everything MyDD claimed to stand for.

by roger2012 2009-09-04 10:00PM | 0 recs


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