This week is when the most intense negotiations are going on in the Senate. The most contentious part is the fate of the Public Option, with the Senate A%#hole Caucus (Lieberman, B. Nelson, Lincoln and Landrieu) threatening to torpedo the bill if it contains it and several progressives (Sanders, Burris) threatening to vote against a bill that doesn’t contain a public option. The newest trial balloon (in addition to the expanded exchanges) is a Medicare buy-in for people ages 55-65:
Sources who have been briefed on the negotiations say that Medicare buy-in is attracting the most interest. Expanding Medicaid is running into more problems, though there’s some appeal because, unlike increasing subsidies, expanding Medicaid actually saves you money. There’s also ongoing discussion about tightening regulations on insurers, but I don’t know the precise menu of options being considered.
The negotiations are fluid right now, and there’s nothing close to agreement. But there is interest, and everyone remains at the table. The broader point is that the public option compromise is increasingly becoming a health-care reform compromise, and the focus is returning, usefully, to the goals of the bill. That’s good for both moderates and liberals, as everyone who votes for this bill has a stake in seeing it work, and the intense attention to the increasingly weakened public option had begun to distract from the need to improve other elements of the legislation.
I think this is a positive development and will certainly help a lot of people but there still needs to be an option for the rest of us. Perhaps we can have a trigger for Medicare buy-in for the rest of us? I just don’t see how we can start dealing with the cost inflation issue without addressing the monopolies of the private insurance companies. We’re only going to be band-aiding the current system until we start to address this issue.
What do you all think? If the public option is dropped, what do you want in return?