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Elin — Out with the Old, In with the New

January 10th, 2010 admin No comments

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Elin Nordegren — who we’re told was staying at the Windermere mansion guest house last night — is getting rid of anything that might bring up bad memories … in this case, her hybrid Cadillac Escalade.No, not that one — Elin has her own … and …

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Obama Pushes Excise Tax, House Dems Fight It

January 8th, 2010 admin No comments

President Obama remains steadfastly committed to forcing the Senate’s Chevy tax on health plans over the House’s millionaire’s surtax.

WASHINGTON — President Obama told House Democratic leaders at a meeting on Wednesday that they should include a tax on high-priced insurance policies favored by the Senate in the final version of far-reaching health care legislation, aides said.

The White House has long expressed a preference for the excise tax on high-cost plans, which health economists say could be an important tool in controlling long-term health care spending for the government and for individuals and families….

Senate Democrats are generally believed to have greater leverage in the negotiations to reconcile the two bills because they cannot afford to lose a single vote and some centrists have warned that they would turn against the bill depending on how it changes.

The Senate approved its bill on a party-line vote, 60 to 39, on Dec. 24.

But the House does not have much wiggle room either. It approved its bill on Nov. 7 by a vote of 220 to 215, with just one Republican joining 219 Democrats in favor. That means Ms. Pelosi could spare just two votes without jeopardizing the bill’s chances.

This is undoubtedly not a smart tax in terms of politics.

Rep. Joe Courtney (D-Conn.) notes that Obama pledged not to raise taxes on anyone earning under $250,000 and that he attacked Sen. John McCain (R-Ariz.) on the campaign trail in 2008 over his plan to do away with the tax-free treatment of employer-provided benefits. Pro-Republican groups are already turning the tables by running ads accusing Democrats of wanting to tax benefits.

“It’s a plan that has great political risk for the Democrats,” Courtney said.

And it’s so unpopular in the House that Courtney has the signatures of 190 Dems who oppose it.

Courtney actually collected the signatures against the excise tax back in September and October, but he said that in the only caucus of House Democrats before Christmas, the majority of comments from members objected to the tax. He said that the Senate is “leaning hard for their position,” and they have some support from the White House. But judging from Nancy Pelosi’s recent comments, “this is where there’s the most resistance to the Senate plan because she knows this is where the caucus is.”

Courtney believes that the feeling has intensified among House Democrats because of input from constituents at town hall meetings and polling, both public and private. He cited several public polls showing 2-1 opposition to the excise tax, and said that members have conducted their own polling showing the tax to be “politically toxic.” He added that “on policy and political grounds, the House approach is right approach.”

The millionaires’ surtax, supplemented by the Medicare tax on individuals earning more than $200,000 a year from the Senate bill, is much fairer, better politics, and doesn’t have the potential policy problems that the excise tax could bring.


Richard (RJ) Eskow: Weird Science: Why Politicians and Pundits Cling to the "Cadillac Tax" Idea

January 8th, 2010 admin No comments

The theory behind the “Cadillac tax” on health plans is little more than wishful thinking based on dubious research. Advocates believe that forcing employers to cut benefits will lead to cheaper, better care. That’s like preventing rain by outlawing umbrellas. Yet the President has reversed his campaign opposition to the tax and now supports it. John Kerry, who I respect, is defending it too.(1) Why?

They’re poorly served by their advisors, and by pundits who cling to the idea in the face of new evidence. Although the Washington Post got it right, too many analysts and journalists are beholden to ideas that Art Levine rightly dubbed “voodoo economics for the punditocracy.”

Why do President Obama and his advisors keep touting the tax? And why do journalists like David Leonhardt of the New York Times keep asserting that “health economists” think it’s a good idea? Uwe Reinhardt – the most respected health economist in the country – said the idea that “with high cost-sharing, patients will do the only legitimate . . . cost-benefit calculus … surely is nonsense.”

The best-known advocate for the tax is MIT economist Jonathan Gruber, who was hyping it as recently as a week ago, without mentioning new and contradictory data.

The Post described Gruber in 2007 as “possibly the party’s most influential health-care expert and a voice of realism in its internal debates.” How can a “voice of realism” claim that this is “a tax that’s not a tax,” one that affects “generous” plans? That statement was published only nineteen days after a paper in the influential journal Health Affairs (summarized here) disproved it. Using actual benefits data, the authors showed the tax would not target “generous” plans. Instead it would unfairly affect plans whose enrollees were older, worked in the wrong industry, or lived in an area where treatment costs are high. A leading actuary came to a similar conclusion.

Gruber also claimed that the money employers save (by slashing benefits to avoid the tax) would be returned to workers as wages or other compensation. But two leading health benefits firms (2) had already published surveys in which the vast majority of employers polled insisted they would do no such thing.

These are intelligent, ethical, dedicated people. So what’s going on? I suspect the problem is an inability to reject an attractive idea, even when confronted with contradictory facts. There is a simple truth in the world of ideas: Theories can be beautiful. Reality can be ugly.

This “beautiful” idea was born in research. The RAND Corporation published the results of its long-term Health Insurance Experiment (HIE) in the 1980s. Researchers claimed that forcing people to pay more for their medical treatment leads to reduced use of medical services, which saved money without making anyone sicker.

The HIE suggested that people who had to pay more for their care avoided treatments their doctors considered medically necessary about as much as those considered unnecessary. Yet, surprisingly, it concluded that they were no less healthy. The HIE became the theoretical foundation for 25 years of benefits-cutting, providing moral cover for a generation of analysts as they shifted medical costs back to patients. (I was one of them.) Now it underlies the thinking behind the “Cadillac tax.”

Here’s Problem #1: The HIE’s been challenged by a number of economists. As University of Minnesota economics professor John Nyman told me, “I don’t believe you can have a reduction of 25% in hospital admissions and not have it show up in any health measures.” While we don’t have space here to tackle the debate, it’s fair to say that the study’s conclusions are controversial at best. Gruber, a RAND defender, described the study as the “gold standard.” Others disagree.

Problem #2: Even if you accept RAND’s findings, you have to believe they still apply after widespread changes in society, the economy, and employer/employee relations. And then you have to believe Gruber’s assertion, based on long-term wage and benefit trends, that employers will give most of that money back to workers as compensation.

Even though surveys say they won’t …

So let’s review this fragile latticework of assumptions: First, that the RAND study is sound. Second, that the tax will only target ‘generous’ plans, despite a very thorough study disproving that. Third, that employers will give much of this money back to workers, although they say they won’t.

On that thin reed of assumptions the White House, many Senators, some economists, and the tax’s editorial supporters (Leonhardt, Ezra Klein, etc.) are prepared to support a policy that by 2016 will reduce coverage for one American in five with employer insurance. That’s more than eleven million people – and the figure would rise sharply each year.

What went wrong? I can’t know for sure, but here’s a thought: Experts can have an “aha” moment, a flash of insight, even when the pattern they perceive isn’t really there. They can build models and theories – even reputations – around that pattern. When evidence proves the pattern is false, they literally can’t see it.

Fortunately, it’s not too late. We can see it. There’s still time for the President, Senator Kerry, and other leaders to change course. Prof. Gruber and other tax advocates can still review these new findings. They and their advisors can discard an attractive but disproved theory and do the right thing for the American people.

_________________________

(1) Although it was gratifying that Sen. Kerry acknowledged that the tax’s thresholds are too low.
(2)Towers Perrin Employer Survey, “Health Care Reform 2009: Leading Employers Weigh In,” (pdf), September 17, 2009; Mercer, “Majority of Employers Would Reduce Health Benefits to Avoid Proposed Excise Tax,” December 3, 2009

Richard Eskow is currently working with the Campaign for America’s Future to stop the health excise tax. He blogs at:

No Middle Class Health Tax
A Night Light
The Sentinel Effect: Healthcare Blog

Website: Eskow and Associates

More on Barack Obama


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Pelosi Pushing Against Excise Tax, Obama Commits to Affordability

January 7th, 2010 admin No comments

While Obama and Dem Congressional leaders might have agreed to “a fast-track alternative” on the non-conference conference, there are still critical issues to be worked out, and Pelosi doesn’t appear ready to roll over for the White House or Senate on a key issue.

[A]ides say she’s particularly steamed that the White House wants her to largely adopt the Senate bill in its entirety. And she’s particularly unhappy that the White House has thrown its weight behind the Senate bill’s chief funding mechanism: an excise tax on so-called “Cadillac” insurance policies, which she and many in her caucus have long believed violates President Obama’s pledge not to raise taxes on the middle class. According to one aide, that–not the public option–was likely the reason she ribbed Obama at her press conference yesterday, quipping, “there were a number of things he was for on the campaign trail.”

The House proposes paying for its bill by imposing a surtax on high-income Americans. And though there’s been speculation for months that the final reform package will include a combination of both sources of revenue, Pelosi, who’s already had to accept the demise of the public option, wants the excise tax gone.

Those “high-income” Americans that would be subject to the surtax are actually millionaires–couples making more than $1 million, a much, much fairer solution than the Chevy excise tax. Given everything progressives have had to swallow in this process, a fairer tax structure is little to ask for the price of their votes. Bloomberg reports that one option being considered for compromise is revisions to the Senate’s “0.9 percent Medicare tax on individuals earning more than $200,000 a year in salary and on joint filers who make more than $250,000.”

Another top priority for the House is affordability. From that same Bloomberg article:

Providing subsidies for low-income people to buy insurance will be “a critical part of this discussion” with the Senate, Van Hollen said. The House version “is much more generous” for people who earn more than the poverty level and don’t qualify for Medicaid, he said.

The Senate version would provide $426 billion for such subsidies while the House would offer $602 billion. “Since we are asking people to share in the responsibility for purchasing health care for the first time, we need to make sure that it’s affordable,” Van Hollen said.

HuffPo reports that “Obama agreed at Tuesday evening’s meeting to help strengthen affordability measures beyond what’s in the Senate bill.” That’s good news for the millions of Americans who should not be forced into buying insurance they can’t afford.

Of course, the excise tax and affordability issues come back to the same basic principle that all Democrats should be able to agree upon: “reform” on the backs of an already stretched thin middle class is no reform at all.


Categories: Politics Tags: , , , , ,

House Quietly Pushing for Their Bill?

January 6th, 2010 admin No comments

Via Jon Walker, here’s a handy list that Nancy Pelosi should keep in hand during the non-conference conference negotiations–the multiple reasons why the Senate’s bill is deficient compared to the House version. Jon provides this list:

  1. Weaker employer mandate
  1. Most regulations won’t apply to the large group market
  1. Lower minimum benefit requirements
  1. Large age rating
  1. Multiple state-based exchanges versus one national exchange
  1. Lack of a public option
  1. Later start date
  1. Does not repeal health insurance anti-trust exemption
  1. Smaller Medicaid expansion
  1. Does not increase payments to Medicaid primary care providers

Add to that the regressive “Chevy” tax on benefits and it’s a fairly comprehensive list, drawn from this memo [pdf] just released by House staff that details the differences between the two bills.

It’s entirely possible, as Brian Beutler suggests, that the very existence of this memo is a signal that the House “conferees” aren’t quite ready to roll over for the Senate version of the bill, particularly given the message with which the first page summary of similarities in the bill concludes:

However, especially on a topic as historic and sweeping as health reform, there are differences between the chambers that will need to be resolved.

The following eleven pages detail those differences. There are a few elements where the Senate bill is stronger, at least in terms of consumer protection. It maintains SCHIP, while the House sunsets it out with the start-up of the exchanges. It has better affordability credits for people between 250-400% of the federal poverty level. It has a good state innovations waiver provision (with waivers not available until 2017–a drawback) that could actually help spur some real reform among the progressive states.

If the House is going to capitulate on the public option (which Ben Nelson has almost certainly assured) and abortion (which Rosa DeLauro has almost certainly assured), then perhaps this is a signal that they’re already considering the possibility considered in David’s post that they’ll demand “demand a generous raft of such items as partial payment for the surrender forced on them by the hostage takers.”

To do so, of course, they might have to buck the White House, which is in just pass any damned bill mode, and is downplaying any differences between the bills.


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Laine Ewen: Bucs vs. Saints Preview: Winning on Waivers?

December 26th, 2009 admin No comments

This week, I’m starting the following running backs on my fantasy football team:

Thomas Jones (NYJ)
Jerome Harrison (CLE)
Quinton Ganther (OAK)

Only one of these three players was on my roster 3 weeks ago. (Three guesses which one…) But then my fantasy team is not very good–I made the playoffs thanks to a tie in week 1–and each week, as I face the Chris Johnsons and MJDs of the world, I have to hit the waiver wires to pick up someone, anyone, who might score enough points to help me eke out a win.

Last week I lost by 40 points. For the record.

I only mention my pathetic fantasy team because over the past couple of weeks the Bucs seem to be hitting the waiver wire as much as I have. After Sammie Stroughter was put on IR this week, the Bucs dropped midseason pickup Yamon Figurs and added former Buc and the team’s first ever kickoff-returner-for-touchdown Micheal Spurlock to the team. (The Bucs still intend to use rookie Kareem Huggins on kickoff returns.) On Wednesday the Bucs picked up WR Mark Bradley, who was released by the Kansas City Chiefs after dropping nine passes this season. (Though Michael Clayton will be back this week, so the Bucs should have their dropped pass quota covered without him.)

I’m aware that Exalted Mediocrity (my team) is seriously lacking in talent, and no matter how many moves I make in the next week or two I’m going to get pummeled, but I wonder if the Bucs are similarly aware of their chances for the rest of the season–particularly against the Saints this week.

The Bucs face the Saints at a bad time. Not only is the NFC South’s top team coming off their first loss of the season (which means that they are out to prove their mettle), but they still need a win to bank the top slot in the NFC and home-field advantage throughout the playoffs (which means they will not likely be benching their starters).

I suppose it might be argued that the Saints are facing the Bucs at a bad time, too. After all, the Bucs are coming off their second win of the season–a complete butt-whooping of the Seattle Seahawks. Not only did rookie QB Josh Freeman get his mojo back–throwing for two touchdowns in the second half and only one interception in the game–but the much improved defense held the ‘Hawks to 7 points total.

But let’s be realistic, the Saints are not the Seahawks. Last time the Bucs and Saints played each other, the Saints won 38-7. In fact, the loss was so bad that Coach Raheem benched Defensive Coordinator Jim Bates immediately afterwards and took over the defensive play-calling himself. And though the Bucs defense has seen tremendous improvement since Rah has been in charge, the Saints have approximately 72 capable receivers in the passing game, and an extremely effective rushing game–ranked 5th in the leage–led by Pierre Thomas. The Bucs will have to improve on their 30th-ranked rush defense to have a chance to stop the Saints this week.

The Bucs offensive success will rest on the running game as well. The Saints are ranked 18th in the league against the run, and Offensive Coordinator Greg Olson will have to keep sending Cadillac Williams and Derrick Brooks up the gut in order to gain yardage. Because the Jets game was proof that Josh Freeman is not going to have any luck forcing balls to receivers when they are well-covered (<> Darelle Revis <>), and Darren Sharper isn’t going to let Kellen Winslow become a major factor in this game. Which leaves a banged up Antonio Bryant, Michael Clayton, Maurice Stovall, and Brian Clark to gain yardage in the pass game.

Oh, and Mark Bradley. Thank goodness for him.

Cross-published on chicksinthehuddle.com.


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Laine Ewen: Bucs vs. Saints Preview: Winning on Waivers?

December 26th, 2009 admin No comments

This week, I’m starting the following running backs on my fantasy football team:

Thomas Jones (NYJ)
Jerome Harrison (CLE)
Quinton Ganther (OAK)

Only one of these three players was on my roster 3 weeks ago. (Three guesses which one…) But then my fantasy team is not very good–I made the playoffs thanks to a tie in week 1–and each week, as I face the Chris Johnsons and MJDs of the world, I have to hit the waiver wires to pick up someone, anyone, who might score enough points to help me eke out a win.

Last week I lost by 40 points. For the record.

I only mention my pathetic fantasy team because over the past couple of weeks the Bucs seem to be hitting the waiver wire as much as I have. After Sammie Stroughter was put on IR this week, the Bucs dropped midseason pickup Yamon Figurs and added former Buc and the team’s first ever kickoff-returner-for-touchdown Micheal Spurlock to the team. (The Bucs still intend to use rookie Kareem Huggins on kickoff returns.) On Wednesday the Bucs picked up WR Mark Bradley, who was released by the Kansas City Chiefs after dropping nine passes this season. (Though Michael Clayton will be back this week, so the Bucs should have their dropped pass quota covered without him.)

I’m aware that Exalted Mediocrity (my team) is seriously lacking in talent, and no matter how many moves I make in the next week or two I’m going to get pummeled, but I wonder if the Bucs are similarly aware of their chances for the rest of the season–particularly against the Saints this week.

The Bucs face the Saints at a bad time. Not only is the NFC South’s top team coming off their first loss of the season (which means that they are out to prove their mettle), but they still need a win to bank the top slot in the NFC and home-field advantage throughout the playoffs (which means they will not likely be benching their starters).

I suppose it might be argued that the Saints are facing the Bucs at a bad time, too. After all, the Bucs are coming off their second win of the season–a complete butt-whooping of the Seattle Seahawks. Not only did rookie QB Josh Freeman get his mojo back–throwing for two touchdowns in the second half and only one interception in the game–but the much improved defense held the ‘Hawks to 7 points total.

But let’s be realistic, the Saints are not the Seahawks. Last time the Bucs and Saints played each other, the Saints won 38-7. In fact, the loss was so bad that Coach Raheem benched Defensive Coordinator Jim Bates immediately afterwards and took over the defensive play-calling himself. And though the Bucs defense has seen tremendous improvement since Rah has been in charge, the Saints have approximately 72 capable receivers in the passing game, and an extremely effective rushing game–ranked 5th in the leage–led by Pierre Thomas. The Bucs will have to improve on their 30th-ranked rush defense to have a chance to stop the Saints this week.

The Bucs offensive success will rest on the running game as well. The Saints are ranked 18th in the league against the run, and Offensive Coordinator Greg Olson will have to keep sending Cadillac Williams and Derrick Brooks up the gut in order to gain yardage. Because the Jets game was proof that Josh Freeman is not going to have any luck forcing balls to receivers when they are well-covered (<> Darelle Revis <>), and Darren Sharper isn’t going to let Kellen Winslow become a major factor in this game. Which leaves a banged up Antonio Bryant, Michael Clayton, Maurice Stovall, and Brian Clark to gain yardage in the pass game.

Oh, and Mark Bradley. Thank goodness for him.

Cross-published on chicksinthehuddle.com.


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David Latt: Republicans In League with Lobbists to Weaken Health Care Reform

December 26th, 2009 admin No comments

Liberal bloggers have attacked the health care reform bill now in the conference committee. The all-but-eliminated-public option, the proposed taxes on so-called Cadillac health plans won by union workers over years of difficult labor negotiations, the attack on abortion rights, the lack of restraints of insurance company fees, the rejection of competition in drug pricing, all these and many more failings in the bill have been railed against on this site and others.

The amount of money spent by lobbyists on the campaign to influence the health care debate has been enormous. Their successes would appear to be the direct result of a massive PR campaign combined with seemingly unlimited political donations.

There is no doubt that health care reform has been weakened by these pressures. But let’s not forget that in the end more Americans will be covered by health care and egregious practices such as being denied health care coverage because of a previous medical condition will have been ended.

Unfortunately, notwithstanding the tremendous efforts by the President and the Democratic leadership, the resulting bill will create a health care system as ugly and absurd as a gerrymandered Congressional district.

The blame for these defeats invariably is placed on the Democrat’s lack of will in facing up to lobbyists. President Obama too is attacked for not sticking to his principles and caving in to special interests and big campaign donors.

I think there are failings a plenty on that side of the aisle, but let’s not forget that the Republicans have entirely removed themselves from this process. The mealy mouthed Mitch McConnell, leader of the Senate Republicans, and his disingenuous side-kick in the House, Eric Cantor, have played the spoiler role. Offering up only the most cynical counter-proposals, they have stayed on the side-lines hectoring the effort.

Without a legitimate, elected opposition engaged in the process, lobbyists gained undue power. Did the Republican Party make a backroom deal with the lobbyists? Whether or not it was done covertly, the lobbyists did the Republican Party’s dirty work.

Republicans opened the door to the lobbyists and they rushed in. If liberal bloggers want to attack the process, put the Republican leadership into their sights .

More on Mitch McConnell


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David Latt: Republicans In League with Lobbists to Weaken Health Care Reform

December 26th, 2009 admin No comments

Liberal bloggers have attacked the health care reform bill now in the conference committee. The all-but-eliminated-public option, the proposed taxes on so-called Cadillac health plans won by union workers over years of difficult labor negotiations, the attack on abortion rights, the lack of restraints of insurance company fees, the rejection of competition in drug pricing, all these and many more failings in the bill have been railed against on this site and others.

The amount of money spent by lobbyists on the campaign to influence the health care debate has been enormous. Their successes would appear to be the direct result of a massive PR campaign combined with seemingly unlimited political donations.

There is no doubt that health care reform has been weakened by these pressures. But let’s not forget that in the end more Americans will be covered by health care and egregious practices such as being denied health care coverage because of a previous medical condition will have been ended.

Unfortunately, notwithstanding the tremendous efforts by the President and the Democratic leadership, the resulting bill will create a health care system as ugly and absurd as a gerrymandered Congressional district.

The blame for these defeats invariably is placed on the Democrat’s lack of will in facing up to lobbyists. President Obama too is attacked for not sticking to his principles and caving in to special interests and big campaign donors.

I think there are failings a plenty on that side of the aisle, but let’s not forget that the Republicans have entirely removed themselves from this process. The mealy mouthed Mitch McConnell, leader of the Senate Republicans, and his disingenuous side-kick in the House, Eric Cantor, have played the spoiler role. Offering up only the most cynical counter-proposals, they have stayed on the side-lines hectoring the effort.

Without a legitimate, elected opposition engaged in the process, lobbyists gained undue power. Did the Republican Party make a backroom deal with the lobbyists? Whether or not it was done covertly, the lobbyists did the Republican Party’s dirty work.

Republicans opened the door to the lobbyists and they rushed in. If liberal bloggers want to attack the process, put the Republican leadership into their sights .

More on Mitch McConnell


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Peter Dreier: Pass the Health Care Bill – Then Improve It

December 25th, 2009 admin No comments

There are many lessons to learn from the health care war that has raged over the past year. We’ll get to some of them below. But here’s the bottom line: Pass the bill, then improve it.

The health care bill that will emerge from the House-Senate conference committee won’t be what most progressives had hoped for, but it is a major, historic turning point in American social reform legislation, comparable to the Social Security Act, the National Labor Relations (Wagner) Act, the Fair Labor Standards (minimum wage/40 hour week) Act, the Civil Rights and Voting Rights Acts, the Clean Air Act, and other progressive breakthroughs. None of those laws were what their advocates wanted. They all involved compromises that, at the time, were heart-breaking to activists. Each one was subsequently improved by amendments, although not without reformers doing battle with reactionary opponents.

It is incredibly irresponsible for some radicals and progressives to call for killing the health care bill. It is important to push for changes that would improve the Senate version of the bill. For example, the House funding plan (a tax on families with incomes over $1 million) is much better than the Senate version (a tax on so-called “Cadillac” health insurance plans). That’s what the labor movement, liberal and progressive Democrats in Congress, pro-choice advocates, and others will be doing in hopes of putting a better bill on President Obama’s desk, as Harold Meyerson discusses in his latest Washington Post column. But the idea that we should scrap this bill and start from scratch next year is both immoral and impractical. If we don’t pass health care reform now, we won’t have another chance for at least a decade. And, like taking food out of the mouths of hungry children, killing this bill will hurt tens of millions of real people who are now suffering physically, psychologically, and economically.

For proof, check out this chart, put together by Jonathan Cohn and Jonathan Gruber (a health care economist at MIT), based on CBO cost estimates of the Senate bill. It shows the health care cost projections for a family of four at different income levels. For example, a family of four earning $60,458 — 250 percent of the federal poverty line — would pay an estimated annual premium of $12,042 and an annual out-of-pocket maximum of $12,600 without the legislation (in total, 41 percent of annual income). If the legislation passes, the comparable numbers are $5,797 and $6,300, respectively (or 20 percent of annual income). Families with lower incomes benefit even more. Here’s Cohn’s article, that explains this in greater detail.

After the Senate passed its version of the health care bill earlier today, Obama said: “This notion that somehow the health care bill that is emerging should be grudgingly accepted by Democrats as half a loaf is simply incorrect,” Mr. Obama said. “This is nine-tenths of a loaf. And for a family out there that right now doesn’t have health insurance, it is a great deal. It’s a full loaf for a lot of families who have nothing to fall back on if they get into a medical emergency.”

We can differ with Obama on the math — I’d say the House bill is 3/4 of a loaf and the Senate bill is 2/3 of a loaf — but he’s basically correct about the real human impact. The bill will make life better for most Americans — those who don’t currently have health insurance and those who currently have inadequate health insurance. Every serious progressive health care expert agrees that the bill is a significant step forward — a stepping stone toward universal health insurance — although they may differ on some particular issues. The health care experts writing this week in the left-wing The Nation, the progressive American Prospect, and even the barely-liberal New Republic share this view.

Here’s what J. Lester Felder writes in The Nation :

“Despite these very serious shortcomings, however, the bill the Senate passed would reduce the number of uninsured Americans by 31 million by 2019. The Medicaid program will be open to new ranks of the country’s poorest residents, and the near-poor and middle class will get subsidies to buy insurance. The Senate also advanced some important delivery system reforms that could chart a path towards reining in costs.

As disappointed as progressives are with the compromises Democratic leaders made to get this bill through the Senate–and as tempting it is to believe they may have gotten a better deal if they’d pursued a more aggressive strategy–they are on the verge of doing many other lawmakers have tried and failed to do. And if this effort fails, another generation may pass before another chance will come to try again.”

Here’s what Jacob Hacker, the policy expert and Yale political scientist who is credited with devising the original “public option” plan, wrote in the New Republic :

“Since the first campaign for publicly guaranteed health insurance in the early twentieth century, opportunities for serious health reform have come only rarely and fleetingly. If this opportunity passes, it will be very long before the chance arrives again. Many Americans will be gravely hurt by the delay. The most progressive president of my generation–the generation that came of age in the anti-government shadow of Ronald Reagan–will be handed a crippling loss. The party he leads will be branded as unable to govern…

The public option was always a means to an end: real competition for insurers, an alternative for consumers to existing private plans that does not deny needed care or shift risks onto the vulnerable, the ability to provide affordable coverage over time. I thought it was the best means within our political grasp. It lay just beyond that grasp. Yet its demise–in this round–does not diminish the immediate necessity of those larger aims. And even without the public option, the bill that Congress passes and the President signs could move us substantially toward those goals.

As weak as it is in numerous areas, the Senate bill contains three vital reforms. First, it creates a new framework, the “exchange,” through which people who lack secure workplace coverage can obtain the same kind of group health insurance that workers in large companies take for granted. Second, it makes available hundreds of billions in federal help to allow people to buy coverage through the exchanges and through an expanded Medicaid program. Third, it places new regulations on private insurers that, if properly enforced, will reduce insurers’ ability to discriminate against the sick and to undermine the health security of Americans.

These are signal achievements, and they all would have been politically unthinkable just a few years ago.”

Paul Krugman in the New York Times, Ezra Klein in the Washington Post, Paul Starr in the American Prospect, and many others echo versions of these same sentiments.

The bill that eventually winds up on Obama’s desk won’t be what we’d hoped for a year ago. There will be lots of articles and even some books diagnosing what went wrong and what went right. Some initial thoughts:

1. Lesson #1: We need major campaign finance reform, preferably mandatory “clean money” public financing plan (http://www.publicampaign.org), as an alternative to our current system of legalized bribery.

The biggest obstacle to more progressive reform is our system of campaign finance. The drug companies, insurance companies, the hospital lobby, and the American Medical Assn. have too much political influence because they’ve spent hundreds of millions of dollars in campaign contributions and lobbying — something I’ve written a lot about over the past year. The Republican Party is a wholly-owned subsidiary of the medical industrial complex, as they’ve shown during throughout the battle over health care reform. Unfortunately, a handful of moderate Democrats in both Houses are also in the pockets of the health industry lobby – most obviously Senators Max Baucus, Ben Nelson, Mary Landreiu, Blanche Lincoln, and Kent Conrad. And let’s not forget one-time-Democrat-now-Independent-who-acts-like-a-Republican Joe Lieberman, whose vanity, hypocrisy, and double-cross should be rewarded by the Democrats by stripping him of his committee chairmanship. Moreover, all people of conscience around the country should unite in defeating Lieberman when he runs for re-election for his Senate seat from Connecticut in 2012. I’ve written about Lieberman as the “Senator from Aetna” , but he’s worse than that.

2. Lesson #2: Kill the undemocratic filibuster rule.

Lefties have been too quick to criticize Obama and the Democratic Party for compromising with the moderate Dems and their sponsors, the insurance industry. The truth is that of the 58 Democrats in the Senate, 53 of them supported the public option and, later, even more supported the Medicare buy-in proposal (for people 55-64), as a way to create competition with the insurance industry. In a true democracy, 53 votes (out of 100) should be enough to pass a bill. So the second obstacle to real reform is the filibuster rule, which gave the five-member “Baucus Caucus” (who together represent states with 3 percent of the country’s total population), and then Lieberman, too much influence.

3. Lesson #3: Grassroots organizing saved health care reform from an early death.

Recall, at the end of the summer, pundits were already writing obituaries for major healthcare reform. Particularly during the August Congressional recess, an epidemic of right-wing anger against Obama and his policy agenda–of which healthcare reform was simply an immediate and convenient target–captivated the media, which reported disruptions at Congressional town hall meetings as though they were an accurate reflection of public opinion rather than a pep rally for extremists, encouraged by Fox News and talk-show jocks. The right-wingers stoked fear and confusion by warning that Obama’s “socialized medicine” plan would create “death panels,” subsidize illegal immigrants, pay for abortions and force people to drop their current insurance. Republican officials, including Senator Charles Grassley, Senator Jim Demint, and Republican National Committee chair Michael Steele, and conservative pundits Glenn Beck, Rush Limbaugh, Sean Hannity, Bill O’Reilly and Betsy McCaughey repeated these myths. And support for the public option tumbled over the summer in response. In June, 62 percent of Americans told Washington Post/ABC pollsters that they favored a public option. By mid-August, support had slipped to 52 percent. Obama’s popularly fell, too, as jobs continued to disappear and the administration’s proposals to bail out the banks and the auto industry met with right-wing attacks and public skepticism. The death in August of healthcare reform stalwart Senator Ted Kennedy bolstered Baucus’ influence as chair of the Senate Finance Committee.

As Marshall Ganz and I wrote in the Washington Post at the end of August , the grassroots momentum from the Obama campaign seemed to be stalled. To the rescue came Health Care for America Now (HCAN), a coalition of unions, community organizations, consumer groups, environmentalists and netroots groups such as MoveOn, that began spearheading the reform campaign since the group was launched in July 2008.

I’ve written about HCAN’s influence elsewhere. Suffice it to say that in late August, seeing defeat on the horizon, HCAN and other reform activists regrouped. They decided to act more like a grassroots movement and less like an interest group. That meant mobilizing voters, focusing attention on the insurance industry, humanizing the battle by giving insurance company victims an opportunity to tell their stories and using creative tactics to generate media attention. They sponsored rallies and protests, including civil disobedience, in cities around the country. They helped focus public attention on the insurance industry’s outrageous profits and executive compensation, its abuse of consumers and its outsized political influence. And they warned Democrats not to get duped by the industry’s pledges of cooperation. Public support for the public option recovered after taking a tumble over the summer. In late October, a Washington Post/ABC poll found that 57 percent favored a public insurance option, while 40 percent opposed it. If a public plan were run by the states and available only to those who lack affordable private options, support for it jumped to 76 percent. Under those circumstances, even a majority of Republicans, 56 percent, favored it. That kind of grassroots pressure helped the liberal Democrats in the Congress fight to keep a decent bill alive, even though eventually Lieberman forced the Dems to compromise on the public option and then the Medicare buy-in.

4. Lesson #4: Watchdog the media.

The mainstream media made it very difficult for Obama, the progressive Democrats, and health reform advocates. During the past year, the mainstream media gave right-wing activists a megaphone that gave them a much larger voice than they deserved. The ultra-right — including the “tea party” lunatics, and reactionary Republicans like Senators Jim DeMint and Charles Grassley, egged on by Glenn Beck, Bill O’Reilly, and their Fox News colleagues — got much more attention than they should have. As Todd Gitlin and I noted, the media covered the right-wing protests AGAINST health care reform, but barely reported on the protests sponsored by health care reform activists like HCAN.

The mainstream media acted like stenographers, repeating the right wingers’ lies about the health care plans, without trying to verify them or put their outrageous statements in context. At the same time, the mainstream media completely shut out the voices of the left wing of the health care debate, the advocates for a single-payer system. With a few exceptions, the media repeated the right wing’s lies about Canada’s health care system without correcting them, and allowed them to frame the mainstream Democrats’ public option plan as “socialism.” Trudy Lieberman, the nation’s best media critic, has been keeping tabs on the media’s misreporting of the health care debate all along. It is worth reading her regular columns and blogs to see how much the media set the public agenda and framed the debate in ways that undermined progressive activists and President Obama.

5. Lesson #5: This isn’t just about health care.

Last summer, Republican Senator Jim DeMint of South Carolina said out loud what most Republican members of Congress were thinking and plotting. DeMint called the president’s health care proposal “D-Day for freedom in America” and said that stopping Obama’s plan for health care overhaul could be the president’s “Waterloo,” a reference to the site of Napoleon’s bitter defeat in 1815. What DeMint meant, and what his Republican colleagues and their allies like Glenn Beck, Rush Limbaugh, and others intend, is that defeating Obama’s health care reform would undermine his presidency, and set the stage for major GOP victories in the 2010 elections and again in 2012, including defeating Obama’s re-election bid. They understood that if the unholy alliance of medical industry muscle, right-wing mob tactics, Republican Party hardline unwillingness to compromise, and a handful of conservative Democrats’ obfuscation is able to defeat Obama’s health-care proposal, it will write the conservative playbook for blocking other key components of the president’s and progessives’ agenda — including action on climate change, immigration reform, marriage equality, a second jolt of economic stimulus, and updates to the nation’s labor laws. So those progressives, like Howard Dean, who say, “kill the bill” are doing more than dooming tens of millions of Americans to health care hell; they are setting the stage for a Republican resurgence.

Obama has certainly disappointed many progressives on a number of fronts, including the Wall Street bail-outs, the weak foreclosure program, the too timid stimulus plan, and most recently by expanding the war in Afghanistan. What’s missing from these criticisms is the failure of progressive forces to mount an effective grassroots movement to push Obama and the Democrats. Both grassroots groups (including unions, enviros, community organizing groups, gay rights groups, peace groups, and others) and the Obama administration haven’t yet learned how to play the inside-outside strategy game as effectively as they could. Like FDR, Obama’s success depends on the existence of a progressive movement that organizes, protests, influences public opinion, lobbies, and keeps the heat on so that the inevitable legislative compromises are stepping stones to further reform. When activists asked FDR to support progressive legislation, he told them, “I agree with you. Now go out and make me do it.” Obama has sent the same signals.

The Right understands this. That’s why Glenn Beck, Limbaugh, O’Reilly, Congressmembers King and Issa, and others have been so persistent at attacking SEIU, ACORN, Van Jones, and others. They want to destroy the progressive movement and make it more difficult for Obama to be a successful (and two-term) president.

For example, The Right’s persistent attack on ACORN over the past year and a half was effective. ACORN, with a strong constituency in Arkansas, was expected to play an important role in keeping the heat on Senator Blanche Lincoln, a moderate Democrat who seemed to be in bed with the insurance industry. ACORN did some effective grassroots organizing to hold Lincoln accountable, but it was weakened by the Right’s attacks, and so busy fighting for its own survival, that it couldn’t mount the kind of full-court press on Lincoln that was needed.

The failure of many Democrats, even many liberal Democrats, as well as many liberal funders, to stand up for ACORN when it was under attack made it more difficult to pass health care reform, and to build the kind of progressive grassroots movement that is necessary to pass reform legislation. Their behavior is even more shameful in light of a new report, released this week by the nonpartisan Congressional Research Service, documenting that the various accusations against the group by Republicans and the right-wing media echo chamber — especially about alleged “voter fraud” — are totally bogus. Here are some of the report’s key findings:

  • There were no instances of individuals who were allegedly registered to vote improperly by ACORN or its employees and who were reported “attempting to vote at the polls.” Memorandum from the Congressional Research Service to the House Judiciary Committee, “ACORN Investigations” (December 22, 2009), at 1.
  • As of October 2009, there have been 46 reported federal, state, and local investigations concerning ACORN, of which 11 are still pending. “ACORN Investigations,” Table 1.
  • No instances were identified in which ACORN “violated the terms of federal funding in the last five years.” “ACORN Investigations,” at 1.
  • Recently enacted federal legislation to prohibit funding to ACORN raises significant constitutional concerns. The courts “may have a sufficient basis” to conclude that the legislation “violates the prohibition against bills of attainder.” Congressional Research Service, “The Proposed ‘Defund ACORN Act’ and Related Legislation: Are They Bills of Attainder?” (November 30, 2009), at 25. [A recent court ruling did, in fact, find that the legislation violated the law]
  • Concerning recent “sting” operations relating to ACORN, although state laws vary, two relevant states, Maryland and California, “appear to ban private recording of face to face conversations absent the consent of all the participants.” Memorandum from the Congressional Research Service to the House Judiciary, “Allegations of Recording Conversations with Various ACORN Affiliated Individuals without Their Consent” (October 9, 2009), at 1.

Peter Dreier is Professor of Politics and director of the Urban & Environmental Policy Program at Occidental College.

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