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An Interview With Sen. Olympia Snowe

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When Sen. Olympia Snowe (R-ME) became the first congressional Republican to cast a vote for health-care reform, she also became the most influential Republican on health-care reform. Keeping her vote is a priority for Senate majority leader Harry Reid. "He is prepared to do what he can to keep her on board,” said Reid spokesperson Jim Manley. I spoke with Snowe on Thursday about the death of bipartisanship, the argument for a trigger, and the need for health-care reform to deliver benefits before 2013. A lightly edited transcript of our conversation follows.

You were the only Republican to support the Senate Finance Committee’s bill. What do you see in the bill that your colleagues don’t?

Well, it’s hard to speak for others. Could be a philosophical difference or a policy difference. They would have liked more time, and I don’t disagree with that. In the Gang of Six, when the deadline was September 15th, we wanted to continue instead of ending at that point, but the chairman felt he had to move forward. There are a lot of issues. I said in the committee the other day I still have concerns.

You mentioned the Gang of Six. Looking back, would you consider that process a success or a failure?

It was an outstanding process. I think that if the American people had had a window into those deliberations people would have felt very encouraged. It’s a rarity today in many ways to have that opportunity to sit down with your colleagues, face to face, several days a week for multiple hours, just working through issues. It didn’t culminate in agreement, but it did establish the foundation and essence for the legislation that was ultimately reported to the Senate Finance Committee.

When Obama was elected, there was a real hope that we’d be entering a less partisan, more cooperative era. Was that an unrealistic expectation?

It shouldn’t be. I think the art of legislating has somewhat been lost here in Congress. It generally just boils down to simple talking points and soundbites, rather than really immersing ourselves in the substance and complexities of any given issue. You really have to take the time to examine all facets of it. People question that this took several months. It should have taken longer, frankly.

Was it strange to turn on the TV in August and hear Glenn Beck going on about death panels?

I was stunned. And I still am stunned. It’s reflective of the discourse. People want us to reform the health-care system, but they’re not sure we can get it right. And that’s understandable, to be honest with you. I don’t think Congress has lived up to the standards that elected officials in the U.S. Congress should have in these monumental times. I think we have fallen short. We should be drafting legislation in a way that ultimately will achieve broad bipartisan support. If I think back to Social Security and Medicare, for example, they did garner broader support in terms of passage.

But Medicare and Social Security were much more radical than anything we’re discussing now, much more liberal, and they still had much more bipartisan support. That suggests to me we’re dealing with a different political system, or a different moment in the country.

Unfortunately, the political system today preys more on people’s fears than their hopes. It’s all about winning or losing rather than fashioning the right type of approach to a serious problem that cannot be deferred into the future. We have an impending crisis and we can’t seem to muster the political capacity or will to forge political consensus. I don’t expect it to be easy, but I would expect there would be more willingness to work together.

What’s your role in the discussions to merge the bill with the HELP Committee’s proposal? Is there anything from the HELP bill you find attractive?

I’m still examining that. I haven’t had the opportunity to focus on the bill as much, but I do intend to. I know there are a number of issues that still have to be addressed in the finance committee legislation, and I’m working with other colleagues. I’m going to have discussions with Sen. Dodd about that as well.

What are your personal concerns going forward?

I’m still struggling with affordability. The Congressional Budget Office has produced charts showing that the American people will achieve savings, but we have to make sure that is the case. Just thinking out loud here, maybe you make the “young invincible plans” more available to people, or bring down the bronze plans to 60 percent [of expected actuarial value].

I also struggle with the individual mandate. It could be my libertarian streak. I understand the rationale and the need to bring everybody into the system, but until we’re sure the system will work, I’m reluctant to impose those fees.

Both of those ideas achieve affordability by making the insurance packages less generous. Another idea people bring up is to increase the subsidies. If the bill passed $900 billion, but did so in a deficit-neutral way, could you support that?

Yes, if you could do it in a neutral way. I was talking to Sen. Stabenow the other day about bringing some of these benefits forward in some way.

So they began before 2013?

Yeah, maybe a transitional tax credit that gives people a means to access health insurance. We did that in the Medicare Prescription Drug Benefit ... we gave them a drug card worth $600 before the full program was implemented. It was a transitional benefit. Otherwise, people will be wondering why they’re not realizing benefits sooner. But we’d need money for that.

I also think we should include something on medical malpractice. I can’t imagine why we wouldn’t. Maine has a very successful dispute resolution process. It’s been in force for 25 years and has been very successful. That’s one dimension that has contributed significantly to rising costs.

You’ve been supporting a trigger proposal that would bring a public option into being if insurance didn’t prove affordable over the next few years. Why wait?

We need a lever to force industry to drive down prices. If the goal of the public option is to ensure the industry performs, then the same could be true of a trigger mechanism. That lever could be equally potent in providing the maximum incentive to the industry to perform. The CBO has said we’d realize $15 billion in savings. I think that would be preferable to giving a disproportionate advantage to government. There’s not an incentive for the government to be very efficient at what it does. It can do it, and sometimes we need to rely on it. But I don’t think it would be preferable if we could accomplish the goal in other ways.

The trigger would run concurrently with the submission of the insurance company’s bids to the exchange. If affordable plans weren’t available in any particular region, then the mechanism would kick in for that year. The industry would have one opportunity to recalculate their bid and give a better bid, but it would be measured against specific standards of affordability.

What’s the single idea you’d most like to see in the bill but that you don’t think is politically feasible?

That’s a good question. You mean politically feasible?

Yeah. Like single-payer, for some people, or Wyden-Bennett for others. A big idea you’d like to see included but is currently outside the range of discussion.

I don’t know that I have anything in that category. I believe we should build upon the current system. We don’t want to disrupt that. I’m traditional in my approach towards reforming health care. Given the size and the amount of money we spend on it, I think it would be far too disruptive to upend the system. I think it’s preferable to build on what has worked well in our system and change the egregious practices in the insurance industry. I think the skepticism of that industry has been understandable and I share it, that’s why we really need to look at all facets to ensure they live up to certain standards and perform. But if they don’t, I think a trigger could be a powerful lever in that regard without having the government involved at the outset.

An edited version of this conversation also appears in this weekend's Outlook section.

Photo credit: By Charles Dharapak — Associated Press

By Ezra Klein  |  October 16, 2009; 5:15 PM ET
Categories:  Interviews  
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Comments

Thanks for this fantastic interview. I think other politicians could take a few pointers from Senator Snowe, who seems to be honest and dedicated to improving our country.

Posted by: jzimmerm1 | October 16, 2009 5:35 PM | Report abuse

Nice interview.

I'd love to see a post where you explain whether Democrats should consider adding $50 billion more in subsidies in exchange for implementing the CBO-scored malpractice reform. I could guess the answer, as I suspect your desire to help the uninsured has limits too-- just like everyone else in Washington.

But if the CBO has scored it, then its as simple as adding malpractice reform in exchange for $50 billion more in subsidies.

So, are you with the uninsured patients or the lawyers?

Posted by: wisewon | October 16, 2009 5:42 PM | Report abuse

"Given the size and the amount of money we spend on it, I think it would be far too disruptive to upend the system."

Of course, it would be disruptive. That would be the benefit, an end to spending twice what we should be spending to get less than we deserve.

I'm glad she's truly interested in reform. However, she still suffers from the same neurosis that obstructs the best options.

Posted by: bcbulger | October 16, 2009 5:44 PM | Report abuse


olympia snowe is a really impressive person. her early years were filled with so much adversity. really hard things that might have embittered a lesser person.
i credit her so much, especially as a woman, that she was able to rise above extremely difficult life circumstances, and devote herself to service, and follow her own conscience on different issues. i cant say that i always agree with her, but i greatly admire many of her qualities, and the fact that she is an extremely conscientious senator.
thank you for this interview.

Posted by: jkaren | October 16, 2009 6:01 PM | Report abuse

its a shame (and scary) she doesn't get the idea of the individual mandate's importance. A weak mandate will be this reform's downfall. Strengthen it and give subsidies where needed to offset it. We can't have 18-25 million still uninsured if pre-ex is ended.

Posted by: visionbrkr | October 16, 2009 8:51 PM | Report abuse

Good interview, Ezra. I agree we should bring forward the parts of the program which can be implemnented quickly so that by 2012 everyone will see how unworkable Obamacare is and then we can get a new President who will fight for a public plan.

Posted by: bmull | October 17, 2009 2:46 AM | Report abuse

I also want to point out that Sen. Snowe clearly is not familiar with the HELP bill, which is outrageous for a person in her position.

I also want to point out that 60% AV junk insurance is no solution to the affordability problem. People already have relief from catastrophic health costs through the bankruptcy courts. Mandatory junk insurance is nothing but a new tax on the middle class.

Posted by: bmull | October 17, 2009 5:18 AM | Report abuse

Nice work, Ezra.

Posted by: slowpoke132 | October 17, 2009 6:24 PM | Report abuse

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