Is the White House open to negotiation on the public option?
Today, everyone is up in arms about a Wall Street Journal story in which Rahm Emanuel goes through those motions. I’m not particularly up in arms about this, because it’s not a change in rhetoric. At all. They’ve been saying the same thing since the first day. Barack Obama has said this. Kathleen Sebelius has said this. Nancy DeParle has said this. And Rahm Emanuel has said this previously. As it has been, so it still is.
But I was struck by the rationalization Emanuel provided for the so-called “trigger” public plan. This is not an argument I’ve heard before:
Mr. Emanuel said one of several ways to meet Mr. Obama’s goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.Putting aside the success, or lack thereof, of Medicare Part D, this is a bit of a weird comment. In 2003, Republicans controlled the White House, the House of Representatives, and the U.S. Senate. As such, when they tried to pass their legislation adding a private prescription drug benefit to Medicare, they allowed a small concession to Democrats: a weak public plan that would be activated if certain conditions weren’t met by private industry.
Brian Beutler in TPM
Republicans and conservative Democrats have proposed a small handful of alternatives to the public option–all of which have been rejected by reformers. But according to the Wall Street Journal, Obama isn’t standing so firm. “Mr. Emanuel said one of several ways to meet President Barack Obama’s goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own.” Emphasis mine.
This is the so-called trigger mechanism, and it’s been roundly rejected by reformers who view it as an escape hatch for insurers who seek to at least delay the creation of a public option. Obama’s openness to this idea puts him at odds with key Democrats in both the House and Senate. On Sunday, in words reminiscent of a pledge put forth by the campaign Health Care for America Now, Sen. Chuck Schumer (D-NY)–a key point man on the public option–said that a public “has to be available, on the first day, to everybody…so there shouldn`t be a trigger.”
Michael Goldfarb in TWS
Lee Stranahan in HuffPo
The President quickly walked back the comment, saying that “one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest.”
It’s curious that Emanuel cites the trigger in the prescription drug benefit. That has never been tripped, and indeed the White House needed to strike a deal with the pharmaceutical industry to lower costs under Medicare Part D. So a lack of competition unnecessarily raised profits for the industry by at least $80 billion (the cost of the deal) over a decade, and there’s STILL no public drug company option. These triggers are Washington compromises designed to never meet the standard where they would have to be tapped.
Emanuel’s orientation is to accommodate centrists and kick liberals. He’s been doing it since he entered politics. There’s plenty of elements to health care just as important as a public option, but that’s the most controversial, and so the Chief of Staff wants to cave on it to reach a compromise. The other issues, like the health insurance exchanges, the subsidies for the poor, Medicaid eligibility, the baseline level of care, etc., isn’t getting the same attention, so Emanuel figures he can just strangle them behind closed doors. With the public plan, a high-profile issue, Emanuel probably thinks he has to lay the groundwork for a capitulation. Or, he’s maybe lowering expectations, so Chuck Schumer can rush in and dictate the process, watering down the public plan down to a “level-playing field” piece of insignificance.
A key Democratic Senator who met with Rahm Emanuel last night is denying an explosive report saying Emanuel privately signaled the White House’s willingness to take the public option off the table to get health care reform done.
A spokesperson for Senator Kent Conrad tells me that Emanuel was making a far more general comment and was “in no way” talking about doing away with the public option.
Karen Tumulty in Swampland
UPDATE: More From Beutler
