" States 'opting out' is a healthcare option"

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" States 'opting out' is a healthcare option"

Post by racehorse » 10-24-2009 01:47 AM

http://www.latimes.com/news/nationworld ... rint.story

latimes.com

States 'opting out' is a healthcare option

Letting states decline a government insurance plan could help unify congressional Democrats, says House Speaker Nancy Pelosi.


By Noam N. Levey and James Oliphant

October 24, 2009

Reporting from Washington

House Speaker Nancy Pelosi (D-San Francisco) said Friday that states might be able to "opt out" of any nationwide government insurance plan, a compromise that she suggested could unify congressional Democrats and enable President Obama to sign a healthcare overhaul bill later this year.

Pelosi remains a leading champion of the "public option," which would establish a federal health insurance program that would give consumers who don't get coverage through their employer an alternative to plans offered by commercial insurers. But she told reporters at the Capitol that she did not "think there's much problem" with the opt-out alternative, which had sparked interest among moderate Democrats in the Senate.

"The robust public option is, in my view, a preferred way to go," the speaker said. "It's not the only way to go."

A group of Senate Democrats is also trying to build support for such a plan in the healthcare bill that Senate Majority Leader Harry Reid (D-Nev.) is planning to bring up for a vote next month.

Reid and Pelosi are advancing separate healthcare bills in the Senate and House. The House is not currently considering a proposal that would allow states to opt out of a federal insurance plan. But Pelosi's remarks Friday opened the possibility that the opt-out alternative could be included in a reconciled bill that would be sent to the White House.

In the Senate, the opt-out proposal, which is being championed by Sens. Charles E. Schumer (D-N.Y.) and Thomas R. Carper (D-Del.), has sparked interest among some moderates who like the concept of allowing states to regulate their own insurance markets.

And some liberal groups like Health Care for America Now, a leading consumer coalition pushing for a public plan, have expressed openness to the idea under some conditions.

"We prefer to see something in every state on Day One," said the group's national campaign director, Richard Kirsch. "So if you have an opt-out, you'd like to see something that was available immediately."

But Democrats in the Senate remain divided. With a 60-40 majority, including two independents who caucus with Democrats, Reid has to hold all his members or pick up Republicans to head off a Republican filibuster.

Sen. Bill Nelson (D-Fla.), a former state insurance commissioner, has expressed deep reservation about a plan that allows states to choose not to have a public option. He noted that insurance companies, which vehemently oppose a government-run option because it might undercut them, could pressure states to opt out. "I saw how the most powerful lobby in the state legislature was the insurance industry, and they could pretty well get what they wanted," he said.

Other conservative Democrats in the Senate do not want any new government program, even if states can opt out. "Medicare is going bust in seven years," Sen. Mary L. Landrieu of Louisiana said Friday, citing fiscal problems with the existing insurance program for the elderly.

Obama has expressed interest in creating a "trigger" that would establish local public options only if commercial insurers do not provide affordable plans to consumers, an idea proposed by Sen. Olympia J. Snowe of Maine, the only Republican to back the Democratic healthcare campaign.

The president discussed this idea Thursday with Senate Democratic leaders at the White House, according to senior Democratic aides briefed on the conversation.

But the "trigger" idea enrages many Democrats who believe a government plan cannot be postponed.

"The only way to curb price-gouging by health insurance companies is with real competition on Day One. That is the public option," Sen. John D. Rockefeller IV (D-W.V.) said Friday.
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Post by racehorse » 10-24-2009 01:41 PM

http://www.kentucky.com/1084/v-print/story/989443.html

Saturday, Oct 24, 2009

Moderate Democrats hold health bill's fate in their hands

David Lightman
McClatchy Newspapers

WASHINGTON -- A handful of moderate Senate Democrats will determine the fate of this year's health care overhaul, and they're sending strong signals that while they're willing to compromise, they're wary of a strong public option.

"I've ruled out a government-funded and a government-operated plan," said Sen. Blanche Lincoln, D-Ark., who faces a tough re-election fight next year. Added Sen. Mary Landrieu, D-La. "I don't believe Americans want a (new) government-run health care system."

Democrats control 60 of the 100 Senate seats, enough to overcome procedural hurdles if they stick together. But they've been struggling to find consensus, because moderate senators, most from the South and Midwest, hear lots of skepticism from the folks back home.

The informal centrist roster includes senators who have broken with the party the most this year -- Indiana's Evan Bayh and Nebraska's Ben Nelson -- as well as Tom Carper of Delaware, Joseph Lieberman of Connecticut (an independent who caucuses with the Democrats), Mark Pryor of Arkansas, Mark Warner and Jim Webb of Virginia, Jon Tester of Montana and Kent Conrad and Byron Dorgan of North Dakota.

Nelson and Sen. Olympia Snowe of Maine, the lone Republican to vote for a Democratic-authored health care plan in the Senate Finance Committee earlier this month, hosted meetings Tuesday and Thursday with a small group of moderates, including Sen. Susan Collins, R-Maine. Some centrists have had lengthy, private meetings with President Barack Obama at the White House.

Their chief messages: Constituents are confused and wary of changes to the nation's health care system, and if a plan is perceived as too expensive and complex, there could be political consequences.

"We need to make constituents understand what we're doing. We need a tutorial," said Snowe.

The moderates, though, are up against powerful political forces. Democratic leaders in the House of Representatives have pledged to include a strong public option in their bill, which is expected to be debated next month. In the Senate, Health Committee Chairman Tom Harkin, D-Iowa, estimates that a strong public option has at least 52 Democratic votes.

Leaders talk of pushing a public option that would allow states to "opt out," but that's not generating enthusiasm among the moderates.

Polls illustrate why both the leaders and the skeptics think their positions are strong. A Pew Research Center survey conducted Sept. 30 to Oct. 4 found 55 percent of respondents preferred a government-run plan.

But the poll also found 47 percent opposed to health care proposals being discussed in Congress, compared to 34 percent supporting them.

People like the concept of a public option but are more tentative about details of a comprehensive package -- especially one they don't yet know, said Carroll Doherty, the poll's associate director.

In states where voters are more conservative, health care change is emblematic of something bigger, something analysts say could hurt those states' Democrats in next year's mid-term congressional elections. Thirty-eight Senate seats are up next year; each party now holds 19 of those.

In more conservative areas, "the mood we're seeing out there is not just being driven by health care, though health care may be the tipping point," said Jennifer Duffy, senior editor for the Cook Political Report. "People are unhappy about deficits, bailouts, and just see too much government."

The Arkansas Poll this week made that point. Of 381 adults it surveyed in that state, 43 percent said that if the health care system changes, the quality of care would get worse, while 15 percent said it would improve. Thirty-one percent said it would stay the same.

Asked if they backed a government-run plan to compete with the private sector, 40 percent said yes while 45 percent said no.

"Arkansans remain unsold on the need for change," said poll director Janine Parry. And Sen. Lincoln, up for re-election next year, will be running in a state where Obama won only 38.8 percent of the 2008 vote.

Voters also see the federal deficit, which hit a record $1.4 trillion in fiscal 2009, as a symptom of out-of-control government. That concern was apparent this week when 12 Democrats and Lieberman defied the party line and voted against cutting off debate on a plan to stabilize Medicare doctors' fees.

The $247 billion, 10-year proposal would have increased the deficit, and moderates rebelled. The cost "is not an insignificant amount of money, and the Senate should be up front about the true costs of health care reform," said Dorgan, who faces re-election next year.

Where, these moderates ask, will Washington find the money to fund health care? The Senate Finance version is estimated to cost $829 billion, and part of the cost would come from taxing high-end insurance policies, a tax that Nelson found his constituents fear will be passed on to them.

"One question that keeps getting asked by constituents is, 'If you're going to tax insurers, won't that add to our costs?'" he asked.

Despite all the anguish, the moderates won't rule out some sort of compromise; after all, they note, health care legislation is likely to be so all-inclusive that no one will be completely satisfied.

Conrad suggests that he could entertain a public option if the new plan would allow health care providers to negotiate rates, rather than rely on Medicare, whose reimbursement levels, he says, hurt his state. Bayh, who is up for re-election next year, said after meeting with Obama recently that "the primary focus for moderates is getting costs under control for middle-class families and small businesses, and passing fiscally responsible reform that reduces the federal deficit over time."

So far, though, common ground has been hard to find.

In the House, 52 members of the Blue Dog Coalition, a group of conservative Democrats, have reservations similar to those of moderate senators. Senate Majority Leader Harry Reid, D-Nev., has been negotiating with top Democrats all week to write compromise legislation, and they had hoped to finish this weekend.

That's now unlikely to happen, unless centrists are satisfied that they can go explain the bill at home; so far, that hasn't happened.

"In my mind, there is a compromise position," Landrieu said, "but I don't know what it is yet."
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Post by Bobbi Snow » 10-25-2009 12:21 AM

If states could "opt out" of Social security and Medicare, where would we be today? Georgia and Missippi (to name 2) would have people dying at age 62! All because they didn't have a parachute. What kind of nation are we willing to become... again?
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Post by racehorse » 10-25-2009 10:42 PM

I agree, Bobbi Snow. Either there should be a universal "public option" applicable in every state or there should be none at all.
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Post by Rombaldi » 10-26-2009 03:10 PM

and that's what we will have, only if a state legislature/governor is so STUPID to take away the public option.. well we'll have a lot of new legislatures/governers.
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Post by Joolz » 10-26-2009 03:20 PM

From what I've read, they won't be able to opt-out until 2014. I agree that it's doubtful many, if any, will actually take the opt-out, especially at that point. I would also rather have a PO that doesn't allow any state's to opt-out, but I'm enough of a pragmatist to see that if it's the compromise that will allow us to move forward on health care, then that's what has to be done. It's what's possible at this time, and that's the best we can hope for. I think once the legislation is passed, then it can and will be fine-tuned further. The trick is to get something passed in the first place so that there's something in place to work with. IMHO.
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Post by racehorse » 10-26-2009 04:05 PM

http://www.politico.com/blogs/glennthru ... ption.html

Glenn Thrush

October 26, 2009

Reid announces push for public option

Senate Majority Leader Harry Reid announced this afternoon that he plans to push ahead with a public health insurance option that includes an opt-out provision for states – even though he's currently short several votes for passage, according to people close to the situation.

"It's the fairest way to go," Reid said at a news conference, where he said he’ll send the state opt-out plan to the Congressional Budget Office. States would have until 2014 to opt out.

Reid, who spoke with virtually every member of his 60-member caucus this weekend, currently has between 56 and 57 votes for a proposal to create a national insurance plan but allow states to opt out of it, according to Democratic aides.

But Reid said he will not send the "trigger" option to the CBO -- which endangers the support of Sen. Olympia Snowe (R-Maine), who has not signed on to the opt-out idea. Snowe wants a public insurance option to kick in only if private insurers don’t expand coverage fast enough.

Asked about Snowe's lack of support, Reid said: "We are going to have to move forward on this."
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Post by racehorse » 10-26-2009 04:25 PM

Joolz wrote: From what I've read, they won't be able to opt-out until 2014.
Apparently they can opt-out until 2014 when they would be prohibited from doing so. Dates of when they would be able to start opting out appear uncertain.
Originally from the Politico Article posted by racehorse
http://www.politico.com/blogs/glennthru ... ption.html

Glenn Thrush

October 26, 2009

Reid announces push for public option

Senate Majority Leader Harry Reid announced this afternoon that he plans to push ahead with a public health insurance option that includes an opt-out provision for states – even though he's currently short several votes for passage, according to people close to the situation.

"It's the fairest way to go," Reid said at a news conference, where he said he’ll send the state opt-out plan to the Congressional Budget Office. States would have until 2014 to opt out.
...



http://www.politicsdaily.com/2009/10/26 ... reid-says/

Patricia Murphy

Public Option In Senate Bill, Sen. Harry Reid Says

Posted:
10/26/09

Sen. Harry Reid said today that the unified bill he negotiated with the White House and the chairmen of two other committees debating health care this year will feature a government-run health insurance option that states can opt out of if they don't wish to participate.

Reid called a press conference today to share a few, and we do mean a few, details about the bill he worked out with senior White House officials and Sens. Tom Harkin and Max Baucus, the respective chairmen of the Senate Health and Finance committees.

Reid would not say when states can begin to opt-out, but did say they have until 2014 to decide. He also said a public option "is not a silver bullet," and that the bill will include non-profit co-ops, a measure agreed to in the Finance Committee negotiations.

It will also include a tax on employee benefits, which union leaders opposed today as "a tax on the middle class." Reid responded to that charge by insisting, "This bill is for the middle class."

Although Reid said he "feels good about the consensus that was reached," agreement among senators on the bill may be difficult to find. Sen. Olympia Snowe (R-Me.), the only Republican to vote for health care reform so far, has already raised objections. "I spoke to Olympia on Friday," Reid said. "She does not like a public option of any kind." In addition to Snowe, several Democrats, including Sen. Ben Nelson of Nebraska, have raised concerns over the opt-out mechanism that the bill includes.

When Reid was asked if he has 60 votes to pass the bill in the Senate, he said, "I believe we clearly will have the support of our caucus to move forward to the bill on the floor." He did not say whether he has the support to actually pass the bill on the floor.

The bill will now go to the Congressional Budget Office for a budget evaluation and then to the full Senate for debate, amendments and a vote.
Last edited by racehorse on 10-26-2009 04:40 PM, edited 1 time in total.
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Post by Joolz » 10-26-2009 07:13 PM

racehorse wrote: Apparently they can opt-out until 2014 when they would be prohibited from doing so. Dates of when they would be able to start opting out appear uncertain.

OK. Thanks for the clarification, racehorse. I was just going on what I'd read in comments made during Reid's presser. I wasn't able to actually hear what he said myself at the time. We have an injured puppydog right now and was having to stay with him at that time, so couldn't get up and go turn the TV on without waking him and making him want to follow me, which he shouldn't do. Otherwise, I would have listened for myself, as usual. ;)
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Post by Biker » 10-26-2009 11:09 PM

Yup, our Taarna tore her ACL just running/ playing outside in the yard. If she needs surgery, the Vet says it'll be about $3000.

Trying to keep her still is a real chore.:eek:

Good luck with your Pup.

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Post by rumike » 10-26-2009 11:27 PM

I am delighted with this outcome. I didn't know Reid had it in him, but hey, he surprised me. I guess polls matter after all.

There was an interesting discussion on the Jim Bohannon Show with Paul Howard, Manhattan Institute's Center for Medical Progress, which generally takes a conservative stance on health care policy.

Anyway, Howard postulates that the "opt-out" will have strings attached, much like the federal speed limit. You don't have to adopt the speed limit, but if you don't, you don't get club fed highway funds. So everyone adopts the speed limit.

Now Howard thinks this is a bad thing, I say the more strings the better. The best strings are the ones the voters will manipulate.
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Post by Joolz » 10-27-2009 12:53 AM

Biker wrote: Yup, our Taarna tore her ACL just running/ playing outside in the yard. If she needs surgery, the Vet says it'll be about 00.

Trying to keep her still is a real chore.:eek:

Good luck with your Pup.

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Thanks, Biker.

I hope Taarna is going to be OK! How old is she and what breed? (Just curious. :) ) Hope you can avoid the surgery. Not only is it expensive, but knee surgery on a dog is tough to deal with (we went through it for a tumor removal). If you have to do it, let us know, though, and I'll tell you about the little britches I made to keep him from chewing his stitches (was the ONLY thing that worked with him!).

This isn't as serious as Taarna's injury, but he's on up in years and that complicates things. He slipped on the tile floor, fell, and injured his leg. The vet thinks it's a pulled muscle rather than a knee, hip, or spinal injury, which is good. But it's still difficult to deal with. He can't walk by himself right now without falling, so we can't leave him alone for a second if he's awake because he'll try to follow us. He can barely get himself up, and sometimes not at all, but he sure tries. We're having to hold his tail and use it like a rudder to help steady and steer him when he does get up and walk. whew... Hope we can keep him still enough for this to heal up without leaving him lame.
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Post by Joolz » 10-27-2009 12:55 AM

rumike wrote: I am delighted with this outcome. I didn't know Reid had it in him, but hey, he surprised me. I guess polls matter after all.

There was an interesting discussion on the Jim Bohannon Show with Paul Howard, Manhattan Institute's Center for Medical Progress, which generally takes a conservative stance on health care policy.

Anyway, Howard postulates that the "opt-out" will have strings attached, much like the federal speed limit. You don't have to adopt the speed limit, but if you don't, you don't get club fed highway funds. So everyone adopts the speed limit.

Now Howard thinks this is a bad thing, I say the more strings the better. The best strings are the ones the voters will manipulate.

I'm pretty happy with it, too, rumike. Interesting 'string theory' there. ;)
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Post by joequinn » 10-27-2009 06:59 AM

What the hell? When the Senate pigs pass Obama's health care "reform" bill and the fine print is revealed, the depravity of the entire thing will be revealed for all to see. But even if Obama's health care "reform" bill turns out to be a socialist's wet dream, what of it? The option for the states to opt out of the plan is the death knell for the whole enterprise from the get-go.

The reason why that ****'s health care plan was so scary in Halloween of 2008 was precisely because it was not --- and could not be --- optional: it was a clear and present danger to the degenerate capitalist pig as he sat wallowing in his dollar-green feces. Now, in Halloween of 2009, the ****'s health care plan is as scary as a Saturday morning showing of Casper the Friendly Ghost. Enough, already! Enough!

And the worst part of it all is that, here as everywhere else, we are learning that the Obama is not even a ****. No self-respecting, watermelon-chewin' ****, with a knowledge of four hundred years of Amerikan history written on his back with a bullwhip and engraved in his memory, would evah think of tolerating such a compromise with that pack of dead, white, penised, rich, fascist whores! Not one!
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Post by cherry » 10-27-2009 07:20 AM

joequinn wrote: What the hell? When the Senate pigs pass Obama's health care "reform" bill and the fine print is revealed, the depravity of the entire thing will be revealed for all to see. But even if Obama's health care "reform" bill turns out to be a socialist's wet dream, what of it? The option for the states to opt out of the plan is the death knell for the whole enterprise from the get-go.

The reason why that ****'s health care plan was so scary in Halloween of 2008 was precisely because it was not --- and could not be --- optional: it was a clear and present danger to the degenerate capitalist pig as he sat wallowing in his dollar-green feces. Now, in Halloween of 2009, the ****'s health care plan is as scary as a Saturday morning showing of Casper the Friendly Ghost. Enough, already! Enough!

And the worst part of it all is that, here as everywhere else, we are learning that the Obama is not even a ****. No self-respecting, watermelon-chewin' ****, with a knowledge of four hundred years of Amerikan history written on his back with a bullwhip and engraved in his memory, would evah think of tolerating such a compromise with that pack of dead, white, penised, rich, fascist whores! Not one!


Hate speech, joequinn. :(


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