Health Politics

Be careful  what you wish for! Maggie Mahar,  who writes the Century Foundation's Healthbeat blog,  had a piece in the Washington Post's Sunday Outlook section calling for a public plan option -- but telling progressives who had yearned for a fully single payer system to visualize the downside.  Just imagine, she wrote, if a movement conservative like Sarah Palin ends up making the rules.  That could make the current controversy about abortion in the health insurance exchange seem tame. What about coverage of contraceptives? Or the ability to decline life support? Think the government wouldn't intrude on such sensitive private decisions? Ever heard of Terri Schiavo?

Of course, we do usually have checks and balances in our system. The party that controls the White House doesn't always control Congress, and it's even rarer for one party to control the White House, the House and a filibuster-proof Senate. And as anyone who has watched the long and winding road of President Obama's health reform agenda, even a filibuster-proof Senate has a mind (and politics) of its own.  Still, Maggie makes a point:

One of the nice things about our jobs here at the New America Foundation is that we get paid to do things like read Gail Collins. So since today is really gray and wet and yucky here in Washington, and we're stuck in one of those capital of the free world moments of Waiting for the CBO, we're gonna share her latest column. You can pretend you are working too.

In troubled times, it is important to try to maintain a certain level of serenity. Right now we citizens have quite a lot on our plate and there is no reason to go completely crazy about the least little thing. 

For instance, at that right-wing tea-party rally in Washington last week, it seemed a little weird when Jon Voight warned the crowd that if President Obama wasn't stopped, the United States would wind up with a health care system like New Zealand's.

At the time, I could not help wondering what New Zealand ever did to Jon Voight. Also if he's made any movies since the one where he got eaten by a really big snake.

First, thank you to all our veterans for their service and sacrifice.

This Veteran's day we're a bit caught up in the upkeep of grant reports, so he's a quick run down of the news and issues that caught our attention:

Tuesdays with Harry: Politico reports that Senate Majority Leader Harry Reid took procedural steps yesterday that would allow him to open debate on a bill Tuesday next week. Of course there a lot that needs to happen before then, including the release of bill with CBO scores, but still, it's a good sign that things are moving in the Senate.

My Life, Your Work: Former President Bill Clinton spoke to Senate Democrats at their weekly meeting Tuesday. His message? Git'er Done. "The worst thing to do is nothing," Clinton told reporters.

The baton has been passed from the House to the Senate and the latest reports suggest legislation may come to the floor as early as Monday next week. The Hill's J. Taylor Rushing lays out how things could play out in the Senate:

Senior aides and senators say Democrats plan to pivot quickly and file the first procedural vote as early as Monday. A "motion to proceed" vote, which brings the bill to the floor, would require 60 votes -- a first, critical test of the caucus's unity on procedural votes.

Senators don't expect any momentum from Saturday's successful 220-215 House vote, however. They say the most realistic scenario is for a Senate vote by Christmas followed by final passage in mid-January.

That would allow sufficient time for House-Senate conference talks and final House-Senate votes during January's first weeks. Such a scenario would also put final passage around the time of President Barack Obama's State of the Union address.

Roll Call's Emily Pierce has more on the logistics and politics of this move:

Health bloggers were so busy linking to David Leonhardt's excellent New York Times Magazine piece on the lessons about cost and quality drawn from Intermountain Healthcare that we nearly overlooked another piece in the magazine -- a profile of conservative activist Dick Armey -- that tells another, more alarming, story about the politics and ideology of health reform.

Armey and FreedomWorks had a hand in the angry and chaotic town hall meetings of last summer. (Freedomworks isn't the same as the Tea Party, but they overlap.) And health care, for Armey, isn't just about health or care.  It's a vehicle for the rise of the right. The economic conservative far right. The right that wants to stop government in its tracks. Or shrink it. The right that believes the American way is all about the rights of individuals, not the needs of community. And of course, the "rights" of individuals have to do with things like the flat tax, not health coverage. The right to health care, however, doesn't seem to figure in here too much.

There were enough live-bloggers and Twitterers, and news alerts about the House health care vote on Saturday night that we decided not to add to the cyber-din. But that doesn't mean we weren't curled up on the bedroom floor, glued to the television, Blackberry in hand, trying to carry on five or six email conversations with people we've known for years, who also savored this moment. (Probably none of my email pals were simultaneously running up and down stairs from bedroom to kitchen during particularly windy speeches baking a basketball-themed birthday cake for a nine-year old but that's not strictly relevant). We are all too well aware of the obstacles remaining in the Senate, and we will post an update on that shortly. But watching that vote, seeing the satisfaction -- not political satisfaction, something deeper -- replace the exhaustion etched on Nancy Pelosi's face, was a remarkable moment. Long time coming.

One of the emails I got after the vote was from Len Nichols, the director of our health policy program (aka my boss). Len loves political courage. He loves bipartisanship. He also has a particularly soft spot for New Orleans. So naturally, Len was pretty impressed with Anh "Joseph" Cao, the sole Republican with whatever the Vietnamese-American equivalent of "chutzpah" is to vote for the Democratic health reform bill.

Today was a big day for the House's health reform efforts.

The AARP, the American Medical Association and the American Cancer Society Cancer Action Network publicly announced their support for the Affordable Health Care For America Act (H.R. 3972) (and, particularly for the doctors, the Medicare Physician Payment Reform Act (H.R. 3961) aka the "doc fix.")

Today was the first time that the AARP has put its "full weight behind a comprehensive health reform package," the AARP statement says. "We started this debate more than two years ago with the twin goals of making coverage affordable to our younger members and protecting Medicare for seniors," said AARP CEO Barry Rand. "We've read the Affordable Health Care for America Act and we can say with confidence that it meets those goals with improved benefits for people in Medicare and needed health insurance market reforms to help ensure every American can purchase affordable health coverage."

Last night, the Congressional Budget Office released a preliminary analysis of the House Republican health care bill. The bill focuses mostly on cost and repackages a lot of the conservative ideas that have been around for years (and never came to fruition even while Republicans held the torch.)

According to the CBO, by 2019, the Republican bill would only extend health coverage to three million more Americans and reduce the federal deficit by $68 billion. In comparison, by 2019, the House Democratic bill would insure 36 million more Americans and reduce the federal deficit by $104 billion.

David Rogers, now with POLITICO, formerly of the Wall Street Journal, may be the least chatty reporter in Washington (trust me, I sat about 5 feet away from him for 12 years in the Senate Press Gallery... although I suppose if you averaged his taciturnity with my extroversion, you would have had two average chat-ers). He's also one of the best and clearest-thinking. He has institutional memory and historical context often lacking in the 24/7 rush-rush of much of the media today. So while so many people are hyperventilating about whether two off-year GOP gubernatorial wins will spell doom for health reform, David comes up with this reassuring and well-reported story, "Dems want to seize historic moment."

Health care is big for House Democrats: big like Social Security in the '30s and civil rights in the '60s, big like the war stories retold now in party caucuses as lawmakers grapple with the floor vote that is just days away.

All politicians live in the present -- or risk perishing, as seen Tuesday night. But history also sits on the shoulders of Democrats these days, and having failed to act on health care in 1994 -- and then having lost power -- they feel an almost inexorable push to seize this moment before it slips away.

The AP reports that the AARP is ready to announce it's support for the Democratic health reform legislation in the House. The endorsment from the influential retiree's lobby should provide a big boost as House Democrats are expected to vote on H.R. 3962 Saturday evening. Streaming video of the AARP announcement, set to begin at 11:30 a.m., is available below.

Meanwhile, the American Medical Association will announce it's position on the House bill's at 12 p.m. More on that after we get off the call.