I’m seeing two moves on the reform front that seem to be pretty smart.
The first is the opt-out public option. Per Sam Stein:
[T]he “opt-out” approach would start with everyone having access to a public plan. What kind of public plan isn’t yet clear. States would then have the right to vote — either by referendum, legislature, or simply a gubernatorial decree — to make the option unavailable in their health care exchanges.
Why is this smart? Well, it allows the government to set up a large, robust, national public option instead of smaller local or regional ones. This public option would have serious bargaining power and a good risk pool. Additionally, it would allow Congressmen and Congresswomen on the fence to punt the decision to the states. I like it because it also forces the public option to put its money where its mouth is. If it works as promised, it will be hard for state governments to deny it to its citizens; if it’s a failure, then more and more states will opt out.
The second smart move comes courtesy of The Hill:
Speaker Nancy Pelosi (D-Calif.) will submit multiple versions of the House’s healthcare bill for cost estimates, she announced on Thursday.
The first proposal will include a “robust public option,” which would tie doctor reimbursement rates to that of Medicare plus five percent. The remaining two drafts submitted for the Congressional Budget Office’s consideration would include a public option based on “the negotiated rates that some in our caucus have supported and which was passed by the Energy and Commerce Committee,” the speaker explained during Thursday’s press briefing. (h/t Bob Cesca)
Why is this smart? Since she knows that the public option reduces the cost of the bill, and she also knows that the Blue Dogs swear they are committed to fiscal sanity, Speaker Pelosi is going to force them to explain why they are opposing bills that save money and favoring bills that cost more. It won’t be easy.
I’ve never been the biggest fan of this form of incremental reform, but it’s moves like this that make me believe that they are actually going to get this passed.