If I have understood correctly the concessions to Ben Nelson, I am prepared to support the bill - with 2 conditions - sunset the mandates in 2019 and eliminate the excise tax, using instead the House financing approach. Of course this bill is not health care reform - but it is health insurance premium assistance for the less well off paid for by the wealthy (IF the House financing provisions are used).

In order to have another chance to reform health care, the bargaining chip of the mandates needs to be put back on the table at some point in the future. Sunsetting the mandates will do that.

Nothing to have a parade about, but with those two changes, Democrats can argue they did some good with this health insurance premium assistance bill without crippling the chance for real reform in the future.

Speaking for me only

I assume Reid has paid the ransom (I see very little that Nelson got here that could not have been handled in 10 minutes. Maybe I am missing something.) If this is it - I have only one more demand and I would support this bill - sunset the mandates. If I were a House Progressive, that would be my one demand that I would think I could get and I would make it non-negotiable.

If this is the Manager's Amendment (PDF), we may have gotten off cheap on the Medicaid portion - here is a special exemption for Nebraska on Medicaid looks like:

Jon Walker has been on Ezra's case all day, worth reading, but, FDL also finds this stunning proposal from Ben Nelson, in a letter responding to Nebraska's GOP governor about the health bill:

“In your letter you note that the current Senate bill is not in Nebraska's best interest. I agree. That is why I continue to work to change it,” Nelson wrote. Nelson wrote that he has proposed that the Senate bill include an “opt-in” mechanism that would allow states to avoid the issues raised by Heineman. “Under my proposal, if Nebraska prefers not to opt in to a reformed health care system, it would have that right,” Nelson wrote.

(Emphasis supplied.) So Village Dems, Krugman, et al, you still fully support the Senate bill? Ezra reacts.

[I wrote this one a few days ago. Think it bears revisiting.]

Well, health care reform failed yet again. It's not clear what will be in the final bill that President Obama signs before the State of the Union, but it surely will not be health care, or even health insurance, reform. The question becomes will there be another crack at it in the foreseeable future? One way to make sure there is another crack at it would be to sunset the individual mandate portion of the bill (killing the mandates would be preferable but that's not going to happen.)

Given the political power of the insurance industry, the only reason there has been a discussion about health care reform this year is because the carrot of mandates could be dangled. This bill delivers those mandates to the insurance industry. Without that carrot, I can not imagine a time in the near future where health care reform is again taken up. UNLESS, the individual mandates are sunsetted. More . . .

Great post by Kagro:

Imagine if we had a "partner" (or perhaps "co-dependent") in this who's just as eager to see to it that we do get back to "fixing" this system promptly. Someone who, say, stood to profit enormously from it? And suppose the mandates also came with significant budgetary savings attached, as I anticipate will be said to be the case? Well then, we've increased the odds dramatically for getting back to the floor, haven't we?

Those mandates don't do anything for anybody for the next four years. Why do they need to sit idly in the books except as "insurance" to the insurance companies (while we get no such guarantees regarding the "fixes" we need)? Indeed, handing over the mandates now would appear to be pretty good insurance against the need for insurers to agree to allow the Congress to come back and "fix" anything.

Of course this will require actual bargaining skills from Democrats, which we know do not exist. For those interest, my bargaining gambit is a call for sunset provision on mandates.

Speaking for me only

"One shouldn't agree to deals which don't even exist." -- Atrios

Roger Hickey at TPM's "Pass The Bill" Rally:

Here's my position. In these final days of the health care fight, progressives should work hard to improve the health reform bill in the Senate and in the conference with the (better) House bill. But we should support the passage of the best bill we can get - and then keep fighting for more and better reform.

Great thinking. Let's go to the bargaining table, announce that while we want certain things, we will still do the deal even if we do not get them. So what are the chances you think that Democrats will "improve the health reform bill" when they have said they will pass anything? Yes, the chances are precisely zero. Indeed, the chances of the bill getting worse are 100% because of such a stance.

Speaking for me only

While starting with the now to be expected insulting Very Serious Person approach, what interested me about this Ron Brownstein post was this:

In his Washington Post op-ed Thursday, Dean wrote: "I know health care reform when I see it, and there isn't much left in the Senate bill." Yet the bill that Dean so casually dismisses would spend, according to the Congressional Budget Office, nearly $200 billion annually once it is fully phased in to help subsidize insurance coverage for over 30 million Americans now without it. That's real money--the most ambitious and generous expansion of the public safety net since the Great Society under Lyndon Johnson. And that money, based on the Census results, would flow most into minority and working-class white communities.

(Emphasis supplied.) Certainly expanding health insurance premium assistance for the less well off is a very good thing, but no one can seriously argue it is reform. Oh btw, 200 billion dollars annually? Where'd that number come from? And what Congress is going to approve it? I'd like to hear more about that number. Finally, health insurance premium assistance can be done via reconciliation, as Dean has called for. So the Senate bill is really not critical to what Brownstein is arguing is the key provision of "health care reform." The more they write, the more nonsensical the Very Serious People are becoming.

Speaking for me only

One way it is not YET, is that we do not know who is right, the bill proponents or the bill opponents. Indeed, as of yet, we do not even know what the bill will look like. Ben Nelson is still making demands.

One way it is like the Iraq War Debate is people like Joe Klein are castigating bill opponents for "melting down" and being NOT Very Serious People, while pointing to Very Serious People who are in support.

For the most part, the substantive arguments made by bill opponents are not being addressed by the Very Serious People. It has been very disappointing to see Paul Krugman follow that path. Which is ironic in that in 2002, Krugman was not taken seriously with regard to his opposition to the war in Iraq (I imagine Joe Klein castigated Krugman at the time.) It is strange to see him give the health bill opponents the same type of treatment he rightly chafed about regarding Iraq and other Bush policies. I guess it always is about whose ox is being gored. (See also Glenn Greenwald on the ideological divisions in the Democratic Party.)

Speaking for me only

I knew it was coming. Knew it. Ben Nelson names his price:

Earlier Thursday, in an interview with a Nebraska radio station, Nelson said even if the abortion issue were resolved, he still could not support the $848 billion package, complaining that the plan to cover more than 30 million additional Americans calls for dramatically expanding Medicaid, which is partially funded by the states. The Medicaid expansion would "create an underfunded federal mandate for the state of Nebraska," Nelson said, arguing that states should be permitted to "opt out" of that idea and find other ways to offer coverage to their poorest residents.

(Emphasis supplied.) Now what Villagers?

Speaking for me only

So says Ezra Klein about the health bill.

Should it be passed? Ezra says yes. I need to see the final product before I can make such a judgment.

This is an Open Thread.

DemfromCt discusses how the Massachusetts mandate works:

[U]sing MA as an example to compare to the Senate version of health care reform (HCR) is tricky. MA uses Medicaid/SCHIP as a "public option" of sorts, the Senate does not.

(Emphasis supplied.) Again, offering a Medicaid buy in to all mandated person is the solution to a lot of problems here. Not incidentally, it can solve the Nelson/Stupak problem.

Jed Lewison asks an interesting question:

Sen. Ben Nelson (D-Neb.) said on Thursday won't vote for the Senate's healthcare bill unless further changes are made. Nelson said that modifications to the bill, including provisions to curtail federal support for plans covering abortion, are needed to win his vote.[. . ."]I will not vote for cloture on the motion to end debate," Nelson said in an interview on KLIN radio in Nebraska.

So here's a question: Will the White House come down as hard on Ben Nelson as they have on Howard Dean?

(Emphasis supplied.) "As hard." Heh. Anyway, I think it is really time to consider scrapping the exchanges in order to solve this problem. Don't let the perfect be the enemy of the crappy.

Speaking for me only