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Blue Dogs vs. House Liberals

As of two days ago, the Blue Dogs had enough "no" votes to kill health-care reform in the House. Then they got some minor concessions and agreed to the bill's passage. Now, however, House liberals appears to have enough "no'" votes to kill the bill, and they want the concessions to the Blue Dogs reversed. It's not exactly clear where this leaves the bill. The concessions to the Blue Dogs were small enough that there's not really a lot of space to compromise on the compromise. And I doubt the Blue Dogs have much interest in capitulating to the House liberals.

What's a bit unsettling about this stand-off is that one group or the other is going to lose face. It's not clear that either can do that. So it's not clear what either can do.

Update: Jon Cohn has a more thorough rundown of the congressional maneuvering.

By Ezra Klein  |  July 31, 2009; 9:06 AM ET
Categories:  Health Reform  
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Comments

Regarding heath care -- or whatever -- there are basically three options.

Reality television shows like Food Network’s “Next Food Network Star” and Bravo Network’s “Top Design”, along with numerous others, often challenge amateur contestants to successfully accomplish a particular feat using a novelly restricted collection of resources: often, such resources are selected specifically to penalize the perceived strengths of one or more contestants. The popularity of shows employing the technique suggests that the methodology satisfies the American audience’s need to witness clear and decisive victory against all odds – to see a champion win with one hand tied behind his back, so to speak.

Our Nation’s preference for challenge and decisiveness is not new. Throughout our brief history, well-meaning efforts at compromise have typically led to increased conflict: we truly relish the contest of argument and tend to argue to absolute conclusion, largely ignoring both the nuances of persuasion and all those intermediate debates which result in measurably (or even perceivably) successful outcomes for both sides. We the people believe that right is right, wrong is wrong, winners are winners, and losers must endure at least the consequence of ignominy to assure that they will try harder, and perhaps even succeed, next time. In our unique form of democracy, though, we always offer the would-be losers the opportunity to join the winning team.

That would be option one. Option two is the more revolutionary approach (see for example, an interesting observation by Ness, Immanuel. "Could the great recession lead to a great revolution?". Christian Science Monitor, July 30, 2009. Available online.) while option three is the ever-present "do nothing" approach.

In this particular argument, I know on which option I'd place my wager... and also favor one option over the others.

Posted by: rmgregory | July 31, 2009 9:23 AM | Report abuse

This is ridiculous... generally, i'd probably be more sympathetic to the liberal faction of the caucus, but the concessions were pretty minor. the only one worth fighting over would be the medicare rates, and an easy compromise would be to give the plan access to those rates for 1 year...

one concession that better not be reversed is raising the income cap for small businesses to $500k. That is a good one for keeping moderates on board and making this easier for smaller businesses. i know a few folks who may be supportive that thought the $250k cap was ridiculous...

baucus has to love this, someone else might just be the goat afterall...

Posted by: tsweeney1 | July 31, 2009 9:42 AM | Report abuse

Well to get the 100 billion in savings they need to cut 200 billion from the cost of the orginial bill. The public plan medicare rates would have saved around 60 billion and the change to the employer mandate will cost about 30 billion. So the Blue dogs are demanding the bill be 20% less generous. That is a very dramatic change.

Posted by: JonWa | July 31, 2009 9:51 AM | Report abuse

Ezra, I hope you scan these comments because I thought of a question this morning and you don't have the opens threads like you used to.

Anyway, what does it take to get a bill scored by the CBO? Why haven't liberals submitted several bills for CBO scoring that are mostly identical but with small changes made to each? For instance, they could have one bill with a strong Insurance Exchange and a weaker public plan and another with a weak Insuranace Exchange and a strong public plan. They could try bills that eliminate the employer tax exemption and others that use Medicare rates for some period of time.

It just seems like if the CBO score is going to be so important to passing a bill it'd make sense to throw a bunch of bills at them so they can say, "See? Cutting the legs out from the Insurance Exchange actually makes this more expensive!" Why are they trying to craft a compromise bill that could just be undermined by a bad CBO score?

Posted by: MosBen | July 31, 2009 10:01 AM | Report abuse

Seriously- they are talking about scuttling the bill because the weakest set of concessions in history. Who cares if the public plan can set medicare rates? If the providers are not required to accept the public plan then them accepting the lower rates is not at all based on the medicare volume anyway- the plan can copy medicare rates just as any other insurance company could. I seriously don't get why people think this is a big deal.

I think when liberals hear "medicare rates" they have it in their mind that any provider that accepts medicare would also be forced to accept the public plan at the same rates. But as far as I have been told thats never been in any of the plans.

Posted by: spotatl | July 31, 2009 10:09 AM | Report abuse

It's about more than the substance: it's about the apparent belief among the Blue Dogs that they have a veto power that's not offset by the Progressive Caucus. They've behaved like spoilt children for too long, and been accommodated by the leadership.

Well, screw the Blue Dogs. Let them go back to their districts (with above-average numbers of uninsured) and talk about belt-tightening to those people.

Posted by: pseudonymousinnc | July 31, 2009 10:18 AM | Report abuse

i understand the general anxiety of giving the blue-dogs "veto-power" - but in reality the concessions weren't that huge. i'm glad the libs want to reverse some of them, and they should talk to their districts about trying to make the plan as strong as possible - but they shouldn't be willing to fall on their sword over these concessions. the more the Ds fight with each other about this the less popular the bill gets and the more likely we are to get NOTHING.

and really, the blue dogs are the more in-danger of the democrats, and getting a bill, AND keeping a majority are important things.

Posted by: tsweeney1 | July 31, 2009 10:32 AM | Report abuse

I hate all these plans, but here is a fact:

Only,8.9 percent of people with any small business income have incomes of over $250,000 and, thus, would even potentially be affected by these provisions.

(http://www.cbpp.org/cms/index.cfm?fa=view&id=2697)

You'd think if any of these discussions about small businesses was important, this would have come up.

HR676 is 70 pages long. It is the essence of simplicity.

Posted by: lensch | July 31, 2009 12:47 PM | Report abuse

"really, the blue dogs are the more in-danger of the democrats, and getting a bill, AND keeping a majority are important things."

Point taken, but I'd argue that a watered-down bill works against keeping Blue Dogs in their seats more than one which delivers to precisely the kind of people who ought to be voting Democrat for economic reasons, but have voted Republican for cultural ones.

Posted by: pseudonymousinnc | July 31, 2009 12:55 PM | Report abuse

As much as I may agree with the Progressive Caucus that given a clean sheet of paper we would have single payer (and thus we have compromised enough already), we have to be realistic: there is no way a public plan option at Medicare rates will fly---the reimbursements are too low. Heck, 27% of docs opt out of Medicare now because of the low rates. What would happen if a flood of under 65 beneficiaries came in?

Posted by: scott1959 | July 31, 2009 10:49 PM | Report abuse

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