Major Developments: Momentum Grows to Open PO, CPC Need Your Help ASAP!

Several major developments on the Hill. One is the Tri Caucus, lead by Rep Grijalva, is pushing to make the public option viable. As many of you know, the CBO has scored the Blue Dog's public option as costing more in premiums than private ones. Why? Adverse risk-sick people dumped into the plan driving up costs. Major risk adjustment or a robust PO will be needed so that the public option can be you know the AFFORDABLE ONE WE WERE  PROMISED.

In that spirit, Grijalva has written to the Speaker asking for a manager's amendment to fix these problems with the public option. He is also asking for a floor vote for the better medicare PO. There is as we see a major difference in cost to you between the neg rate and medicare rate Pos.

Pelosi is trying to meld the bill by Monday SO PLEASE CALL THE SPEAKER AND URGE SHE SUPPORT THE GRIJALVA MANAGER'S AMENDMENT FOR A BETTER MORE AFFORDABLE PUBLIC OPTION THAT WONT RAISE RATES. ALSO CALL YOUR REP AS WELL.
1-877-851-6437.

Also below is Grijalva's interview from today on his meeting with Obama at the WH urging POTUS to support the affordable public option tied to Medicare.

Sen Wyden got a major boost in his efforts to open the exchanges. A coalition of very key Democrats now are backing his proposal to open the public option. Senators range the spectrum from Bernie Sanders to Evan Bayh to Barbara Boxer. Wyden is no longer the lone ranger on this here. 10 senators are calling on Reid to open the exchanges to all Americans. This is significant and shows the power of the argument of choice and the realization we must have more than rhetoric on this. We must create policy that will allow most to choose a better option if their employer based plan doesn't work out.

Please read the letter from these Senators and article from The Hill on this important move on healthcare reform!

Robust FAIL. Only 6 million people covered by House public option, and not until 2019. Read it here from the CBO report: "Under the proposal, certain employers could allow all of their workers to choose among the plans available in the exchanges, but those enrollees would not be eligible to receive subsidies via the exchanges (and thus are shown in Table 2 as enrollees in employment-based coverage rather than as exchange enrollees). CBO and JCT expect that approximately 9 million people would obtain coverage in that way in 2019, bringing the total number of people enrolled in exchange plans to about 30 million in that year. Roughly one-fifth of the people purchasing coverage through the exchanges would enroll in the public plan, meaning that total enrollment in that plan would be Mb>about 6 million."

http://hellotxt.com/l/5KEYMI
http://www.politico.com/livepulse/1009/C BO_Public_option_premiums_higher_than_pr ivate_plans.html

Ezra Klein-Unless risk adjustment fixed in exchanges the PO may increase other rates!

http://voices.washingtonpost.com/ezra-kl ein/2009/10/wil_lthe_public_plan_have_hi gh.html

Oct 30, 2009

Dear Speaker Pelosi -

I am writing with the utmost urgency to ask for inclusion of certain provisions in a
Manager's Amendment in support of key elements you have currently included in the Affordable Health Care for America Act. These provisions include:

* Americans in every state in the nation must be able to take advantage of the benefits of the bill; thus the bill shall explicitly state that the public option must be available without any triggers or opt-out provisions.

* If the Secretary is forced to negotiate provider reimbursement rates in the public plan, a ceiling shall be determined and set for such rates.

* The bill shall fully repeal the McCarran Ferguson Act for health and medical
malpractice insurance, as oppose to merely amending the Act.
Swift action is needed to ensure that the above measures are included in the House's Manager's Amendment.

In addition, I shall request that the Rule allow an up-or-down House floor vote on an amendment tying the public option to Medicare rates pIus 5 percent.
Thank you for your consideration.

Respectfully,
Raui~Grijalva
Member of Congress

At the WH  meeting Rep G says:

At a private meeting at the White House yesterday, top House liberals urged President Obama to more aggressively throw his weight into a public campaign on behalf of the public option, a leading House progressive said in an interview.

Dem Rep. Raul Grijalva, the co-chair of the Congressional Progressive Caucus, says that this point was made "emphatically" to the president in the meeting yesterday with House liberals, and that his help was urgently needed in bringing centrist Dems on board.
"We need the full engagement of everybody in this discussion, and that includes the White House," Grijalva said in characterizing the message that was delivered to the president. Grijalva described the meeting in an interview with Democracy Now...

http://theplumline.whorunsgov.com/presid ent-obama/at-private-meeting-house-liber als-urge-obama-to-campaign-harder-for-pu blic-option/

From Dem Now interview:

http://www.democracynow.org/2009/10/30/g rijalva

REP. RAUL GRIJALVA: Well, the meeting was the Progressive Caucus leadership, Hispanic Caucus leadership, Black Caucus leadership, Asian Pacific Caucus leadership, and basically brought out that now that we're in this stage of having to deal with this negotiated rates that came out of the House, and something much worse coming out of the Senate, on a public option, that we felt--set some parameters of what we felt very strongly about, that the bill still needed to be strengthened; that there had to be cost controls on the private insurance companies, especially with negotiated rates, because they get to set the rates and we have to chase those rates with taxpayers' dollar; and no triggers and no opt-outs, that we feel those are detrimental to the public interest and certainly to constituencies that have lacked the ability to access healthcare in this country for so many years.

JUAN GONZALEZ: And Congressman Grijalva, did the President give you any indication that he would use of the immense persuasive powers of the White House to gain support from reluctant Democrats on the public option?

REP. RAUL GRIJALVA: Yeah, I think that was a point that was made emphatically by one of the members that was there, that, you know, while some people will say this is a victory--we resurrected the public option from the dead to where it is now being considered in both chambers. OK, that's a good step. But now I think we need the full engagement of everybody in this discussion, and that includes the White House. You know, to cater to an Olympia Snowe or to a Lieberman, that fundamentally will restructure what a public option is in a very, very negative way, is not our idea of bipartisanship. And we really do feel that that engagement from the leader of this nation is vital, necessary, if we're going to end up with anything that approaches a robust public option.

The Hill notes the broad spectrum of dems who have united to open the exchanges includes Bernie Sanders and Evan Bayh. Wyden  is no longer the lone ranger on this here in DC. He now has backing from a  key group of senior Democrats:

http://thehill.com/homenews/senate/65669 -nine-senate-dems-press-reid-on-expandin g-insurance-choice

FOR IMMEDIATE RELEASE : 10-30-09: Sen Wyden

10 Senators Ask Reid to Expand Access to the Health Care Exchanges

"It is our responsibility to make sure this foundation and these exchanges are successful."
Washington, D.C. - Nine Democratic senators joined U.S. Senator Ron Wyden (D-Ore.) today in expressing support for a version of Wyden's Free Choice proposal which would promote real competition among health insurers by increasing the number of Americans able to choose plans in the new health insurance exchanges.

In a letter (below) addressed to Senate Majority Leader Harry Reid, U.S. Senators Mary Landrieu (D-La.), Bernie Sanders (D-Vt.), Evan Bayh (D-Ind.), Bill Nelson (D-Fla.), Barbara Boxer (D-Calif.), Maria Cantwell (D-Wash.), Ted Kaufman (D-Del.), Jean Shaheen (D-N.H.), Roland Burris (D-Ill.), and Wyden reasoned that only allowing 10 percent of Americans to have access to the exchange will "limit the opportunity that the exchanges and their innovative new products will have to succeed."

"In fact," the senators continued, "[by limiting access to the exchanges] we may be sacrificing one of our best tools for containing costs -- a competitive marketplace of health care options."
The ten senators made their case to Reid as the Majority Leader continues work on a combined bill to be considered on the Senate floor. "Incorporating a version of the Free Choice proposal in the Senate bill," the senators wrote, "can help achieve the President's and our goals of increasing consumer choice, promoting competition, holding down costs and improving quality."
The full text of the letter is below. A signed copy of the letter is available at: http://wyden.senate.gov/newsroom/free_ch oice_letter.pdf.


October 30, 2009
The Honorable Harry Reid
Senate Majority Leader
S-221 The Capitol
Washington, DC 20510

Dear Majority Leader Reid:
As health reform continues to move forward in the Senate, we strongly urge you to ensure choice and competition in the marketplace for health insurance. When consumers are free to choose and change their insurer they pool their bargaining power and hold insurance companies accountable generating lower premiums, better service, and higher quality health care. That is why we support the creation of insurance exchanges where plans would have to compete on the basis of cost and quality.

We are concerned that under current proposals too many Americans will not be able to purchase insurance in the exchanges. To function properly, these markets will need to be robust enough to reform insurance industry behavior to hold down costs and improve quality. To ensure that health reform promotes real competition among insurers, we support a version of Senator Wyden's Free Choice proposal to expand consumer choice by opening up the exchanges.

Exchanges hold the opportunity to offer a range of choices to consumers. In the final health reform bill that the Senate votes on, these choices must be available to a large number of consumers in order to ensure their viability. However, if -- as CBO Director Doug Elmendorf estimates -- less than 10 percent of our country's population is allowed to choose from among these plans - we will be limiting the opportunity that the exchanges and their innovative new products will have to succeed. In fact, we may be sacrificing one of our best tools for containing costs -- a competitive marketplace of health care options.

We support President Obama's assertion that under health reform, people should be able to keep the coverage they have. Earlier this year President Obama rightly took that statement to its next logical step when he told the American Medical Association that "If you don't like your health coverage or don't have any insurance, you will have a chance to take part in what we're calling a Health Insurance Exchange." We couldn't agree more that people who do not like the coverage they currently have should be able to choose something better. Moreover, by opening the exchanges to more consumers, we will enhance competition, generate greater risk pooling, and hold down health care costs for millions of Americans, some estimate by as much as $360 billion over ten years.

At the same time, we understand the interests of those who have collectively bargained for good benefits and it is important to ensure that these plans maintain a critical mass of policy holders. Therefore, we would make an exception from this free choice provision for those employees who have opted to collectively bargain for their plans.

So far, the proposals moving through the Senate have paved the way for a new foundation of health insurance in America. It is our responsibility to make sure this foundation and these exchanges are successful. Incorporating a version of the Free Choice proposal in the Senate bill can help achieve the President's and our goals of increasing consumer choice, promoting competition, holding down costs and improving quality. We stand ready to work with you to do so. Thank you for your consideration.

Sincerely,

Tags: bayh, Boxer, Grijalva, Healthcare, obama, Public Option, Wyden (all tags)

Comments

1 Comment

Art: take a deep breath

And maybe take a look at the numbers. For example here is Table 2 of the CBO score of HR3269 online  in Jpg form
http://3.bp.blogspot.com/_fjW71B3WLTQ/Su sKedQcNFI/AAAAAAAAAU0/Xrrac0i1jeQ/s1600- h/HR3962+Table+2.jpg
In light of that the following is just offbase:

"Robust FAIL. Only 6 million people covered by House public option, and not until 2019."

Well no. CBO projects 21 million people in the Exchange by 2019 of whom 6 million would be in the PO. But they equally project that by 2015 there will ALREADY be 19 million in the Exchange suggesting maybe 5.5 million in the PO. Similarly of the 36 million previously uninsured people getting coverage by 2019, 34 million of them will be covered by 2015, not surprising because that marks Y3 or the year the Exchange is fully opened to all but the largest employers. All of CBOs projections are 10 year ones, the use of "not until" is a profound disservice to your readers here.

In 2013 or Year1 of the Exchange, 25 million less people will be uninsured than the baseline projection of 51 million. This total includes 9 million in the Exchange and since enrollment in Y1 is limited to individuals and 'smallest employers' you would expect a substantial fraction of those to be enrolled in the new PO.

I'll read through your links but so far your bolding seems to be overwhelming the substantive content of your argument. IMO Grijalva and some of his supporters and to a lesser extent Wyden and his are striking out at strawmen:

"thus the bill shall explicitly state that the public option must be available without any triggers or opt-out provisions."

Well I don't know about "explicitly" but the bill as drafted contains neither. Grijalva is arguing about potential compromises down the road while letting people conclude those weaknesses are in the bill as drafted. Well they aren't, though you have to piece through the bill and do a close reading of the CBO score to figure that out.

by Bruce Webb 2009-10-31 08:56AM | 0 recs

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