Max Baucus Apparently Frozen in Block of Ice

by Tim Foley

categories: National Health Exchange, Obama and Congress, Public Plan

Published July 28, 2009 @ 08:36PM PT

I was going to title this “Max Baucus is the Red Queen,” after the famous quote in Lewis Carroll’s Through the Looking Glass: “Now, here, you see, it takes all the running you can do, to keep in the same place. If you want to get somewhere else, you must run at least twice as fast as that!”  But I think frozen in a block of ice like Captain America is actually the better description.

When the Senate Finance Committee more or less dissolved into Max Baucus’ “coalition of the willing” – 4 Republican and 3 Democratic senators huddled in a room to work out one last stab at a “bipartisan” health care reform package – we were talking about taxing health benefits as income (at least partially), an amorphous and ill-conceived health co-op as a substitute for the public health insurance option, cutting out subsidies for a family of 4 making between $66,000 and $88,000 per year and delivering weaker private insurance regulations.  Now, over a month from when Baucus and Grassley first estimated they’d be voting a bill out of committee – well, we still don’t even have a draft bill.  But we do have a trial balloon floated courtesy of the AP.  And guess what they’ve come up with?  Taxing benefits, the co-op, cutting subsidies, weaker private insurance regulations – oh, and also tossing out the employer mandate for good measure.

In reaction, the progressive blogosphere has collectively thrown up.  Advocates and pundits are commenting on everything from the makeup of who’s in the room, to the states these senators come from, to who takes what money from what insurance company, to whether the anti-democratic tendencies of the Senate in a highly charged partisan atmosphere make “big change” legislation an impossibility.

But my main question is, were any staffers for these senators paying attention to what happened in between?  The answer appears to be no.  That’s why the “encased in a block of ice” metaphor is better than the Red Queen.  Not only are we making progress, this trial balloon is oblivious to progress.

Things I learned in the past month that the “coalition of the willing” did not:

• You can incorporate hundreds of Republican amendments in a bill to make it bipartisan, and most (if not all) of them will still vote against it.
• If you include an employer mandate (even a weak one) and a public health insurance option in your plan, it costs $400 billion less over ten years than if you don’t.
• Health care co-ops take, no joke, decades in order to be high-performing and competitive with private insurance.
• Oh, and Republicans also won’t vote for the co-op if it’s seeded with federal money.
• Including an employer mandate doesn’t actually “undermine [employer-based insurance] or create a perverse incentive” as Olympia Snowe, one of the “willing” fears.  It actually leads to a net increase in employer-based coverage.  So says the Congressional Budget Office, anyway.
• Not only can you supply subsidies to $88,000 for a family of four and have your price tag come in at or under $1 trillion, you’ll still be leaving middle-class people like Mark Barnes behind.

Other than that, Mrs. Lincoln, how was the play?

Nate Silver at FiveThirtyEight.com has the best summary of the whole package:

This is a pretty poor combination of attributes for a health care reform bill to have. If Baucus & Co. wanted to get the cost below $1 trillion, they could have chopped the subsidies down to, say, 350 percent of poverty, while keeping the employer mandate and the public option. As a very rough guess, a bill like that might insure another 30-35 million people at a gross cost of about $850-$900 billion. The actual Baucus bill is going to cost about the same but will be lucky to insure half as many.

We’ll see what they actually come up with.  My guess is nothing will change.  But it’ll be challenging to get this past what perhaps we should call “the coalition of the unwilling”:  Schumer, Stabenow, Rockefeller, perhaps Wyden – progressive Senate Finance Committee members who have been out of the loop – plus what is certain to be united resistance from Hatch, Kyl, Bunning, Crapo, Roberts, Ensign and Cornyn.  If it gets through that gauntlet, you have reconciliation with the members of the HELP Committee who can be justifiably proud of their own bill.  And then you have the House, where at least 50 Democrats have gone on record saying they’ll vote against health care reform without a public option.

So there’s plenty of baseball still left to be played.

(Photo credit:  Köttbullekvist on Flickr.)