Progress Pond

Health Care Strategy

Ambulances parked in front of the U.S. Capitol Building in Washington DC.

Well, lookee here:

House Democrats insisted Tuesday they have no plans to roll over for the Senate in upcoming negotiations on a health reform bill, even as they acknowledged it would be all but impossible to reinsert a public insurance option or force the so-called millionaire’s tax on the Senate.

Either move would disrupt Senate Majority Leader Harry Reid’s no-margin-for-error 60-vote majority. But House Speaker Nancy Pelosi and her leadership team seem to have their sights set on lower-profile – but no-less important differences, like boosting affordability credits in the final bill and starting the insurance exchange a year earlier, which they did in the House…

Other differences the speaker mentioned Tuesday include: replacing the Senate’s state-run exchanges with a national exchange established under the House bill, adding tougher mandates to make sure everyone secures health coverage and closing a gap in prescription-drug coverage next year.

It’s nice to see that the House is taking my advice. I wrote the following just before the big cloture vote Monday morning.

We need to take the Senate bill and make some improvements so that the bill is better from both a policy and a political point of view. We can’t win a public option of any kind. But we can make some tweaks to improve the subsidies, strengthen the regulations, and the phase in the exchanges quicker.

It’s true that Lieberman and Ben Nelson have veto power over any changes in the Conference Committee, but they are pretty locked-in to supporting final passage now that they have secured goodies for their home states. Both of them would probably balk at a public option (triggered, or otherwise), but they’re likely to be flexible on less highly-cherished progressive goals.

One thing I would advise the Obama administration to explore is the possibility of attracting Snowe and Collins to support final passage in lieu of Nelson and Lieberman, by stripping out the abortion language. Making that switch would be extremely difficult and might cause fatal problems in the House. Bringing on Collins, in particular, might just be impossible. But there would be a big pay-off if the switcheroo could be accomplished.

In my ideal world, we would resinsert a triggered public option and strip out the abortion language, get two Republican votes, and tear up the deals with Nelson and Lieberman and tell them to pound sand. The upside is so high that it should definitely be explored. However, I don’t think it can actually be accomplished.

I think it’s bad news that they don’t think they can get final passage before the State of the Union speech.

The White House privately anticipates health care talks to slip into February — past President Barack Obama’s first State of the Union address — and then plans to make a “very hard pivot” to a new jobs bill, according to senior administration officials.

Obama has been told that disputes over abortion and the tight schedule are highly likely to delay a final deal, a blow to the president, who had hoped to trumpet a health care victory in his big speech to the nation. But he has also been told that House Democratic leaders seem inclined, at least for now, to largely accept the compromise worked out in the Senate, virtually ensuring he will eventually get a deal.

The Dems need to tighten up this schedule and get this bill passed.

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