Health Care Reform: The Day After

Well, it’s one day after Harry Reid’s big announcement that the Senate bill would include the opt-out public option. The next big thing is ironing out the details of each bill in the House and the Senate. Democrats are taking a look at some details and proposing some changes, most notably speeding up implementation of the bill.

The most significant changes to the health care system wouldn’t kick in until 2013 — two election cycles away. With Republicans expected to make next year a referendum on health care reform, Democrats are quietly lobbying to push up the effective dates on popular programs, so they’ll have something to run on in the congressional midterm elections.

Democrats are anxious to mix the good with the bad since some of the pain would be phased in early, including more than $100 billion in industry fees that critics say could be passed on to consumers.

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Under the Democratic wish list, senior citizens would receive discounts on brand-name drugs next year. Small businesses that provide insurance would see tax credits. And a $5 billion high-risk pool would cover people with preexisting conditions.

Democratic strategists expect the 2010 election to present a stark contrast between the parties, particularly if the health care bill receives minimal Republicans support. The front-load strategy could help blunt GOP attacks on the bill as a toxic mix of higher taxes, rising premiums and cuts to Medicare.

The strategy also could ease some of the disappointment among voters who expect more immediate reforms than the bill can deliver, including on the much-debated public insurance option. Democrats in both the House and the Senate are closing in on finding the votes to include some form of a public option in the bill, but a government-run insurance plan would likely be one of the last pieces to kick in fully, if it passes.

I’m not sure why Democrats are just figuring this out now, but better late than never. It will be hard to run as the party that fixed health care when no one can see any difference.

As expected Republicans aren’t happy. They’ve responded by attacking the messenger:

“A primary reason Harry Reid is one of the most endangered incumbents facing re-election in either party next year is due to the fact that he is viewed by many of his constituents as a partisan bully. His decision to write a health care bill behind closed doors, bow to pressure from the far left, and ram this bill through the Senate will only further cement that negative image.

“It also reaffirms the importance of restoring checks-and-balances in Washington next year. As Democrats prepare to run up the national credit card even higher, it’s clear they didn’t learn a thing from the failed stimulus boondoggle. They are attempting to spend their way out of our nation’s economic crisis with little thought or regard to the debt being passed on to future generations.

“One thing is clear though – Harry Reid and his Democrat colleagues who decide to bow to pressure from the left and continue to rubber-stamp this liberal, partisan agenda of Washington-run health care and reckless government spending will be held accountable by voters next November.”

Harry Reid is such a big meanie. And, oh yeah, SOCIALISM!

In case their was any doubt, Dick Durbin says that the inclusion of the public option was due to pressure from progressives:

Democratic leaders were forced to include a national public health insurance option as part of health care reform by progressive Democratic senators who refused to support anything less, Senate Majority Whip Dick Durbin (D-Ill.) said on Monday.

Durbin’s assessment was made to a handful of reporters following the announcement by Senate Majority Leader Harry Reid (D-Nev.) that after weeks of talks with his colleagues he had determined that including a public option that states could opt out of was the best way to go.

For many years, it’s been centrist and conservative-leaning senators who have been scoring legislative victories by digging in their heels, so this represented a quite dramatic turnabout. It is difficult to remember the last time that progressives won a legislative victory by laying down firm demands and sticking to them. In the House, the Congressional Progressive Caucus has found its feet, too, and is locked in a final battle with conservative Democrats over the shape of a public option.

The public option has been declared dead by political pundits more times than I can count, yet it never died. It stayed alive thanks to the relentless pressure by progressive activists who kept reminding Democrats – the public option IS the compromise.