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Susan Collins's health-care wish list

PH2009113000375.jpgAccording to Politico, Susan Collins met with the White House on Monday to offer her list of demands for health-care reform. And they sound, well, pretty good. "The senator said she put several amendment requests on the table: raising the penalty on hospitals with high rates of hospital-acquired infections, changing the small-business tax credit to prevent it from discouraging hiring and increasing wages and boosting the affordability of insurance."

The devil is in the details, of course, but this stuff is all supportable. The big exception is if Collins attempts to achieve affordability by watering down the basic benefits package. That doesn't make health-care insurance "more affordable" so much as it makes it "less useful," which really isn't the point of this exercise. But if Collins is willing to make insurance more affordable by increasing the subsidies, then that's all for the good.

Collins's support could lead to other improvements, as well. As Suzy Khimm notes, pulling Collins and Snowe onto the bill could leave you with a better bill. Ben Nelson, for instance, is drafting a "Stupak-like" amendment, while Collins and Snowe are both pro-choice. If one of them is willing to be the 60th vote, Nelson will have a tougher time taking abortion rights hostage.

But to flip that around, the issue isn't simply that Snowe and Collins are pro-choice, so Democrats should want them on the bill. If Snowe and Collins are pro-choice, they should want to be on the bill. It's pretty clear that neither of them loathe this legislation, and pretty clear that their presence could be decisive in preventing Nelson from helping Stupak rid primary insurance of abortion coverage. Naive as it is to say, it's a chance to make a very big difference on an issue that both have historically held quite dear.

Photo credit: By Harry Hamburg/Associated Press

By Ezra Klein  |  December 2, 2009; 5:43 PM ET
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The essential benefits package was already severely watered down when Reid made states financially liable for any addititional benfits they mandate. I'm sure someone got some insurance coin for that one, since it moves us closer to the insurer's goal of having a single national regulator.

I hope more Republicans vote for the bill. I hope Burris and Sanders do not. It's not progressive reform.

Posted by: bmull | December 2, 2009 6:03 PM | Report abuse

What is the point of Ben Nelson, btw?

I mean really, does he add any value to the party? I get that he's a warm body and a red state vote for Harry Reid (uh, yay?), but he sure seems to torpedo more good legislation than he produces. Can it really be true that the money the party is going to spend to win his next re-election will be a better investment than simply targeting a seat in a more "purple" state?

Dead serious, if this is the best we can expect from a Nebraskan Democrat, isn't the DSCC pouring money down the drain fighting there?

Posted by: NS12345 | December 2, 2009 6:17 PM | Report abuse

definitely have to see the details. but i especially like her first request, as it's the most straight-forward.

Posted by: schaffermommy | December 2, 2009 7:32 PM | Report abuse

It's nice to know there are still a few Repubs capable of intelligent thought and discussion.

Posted by: Falmouth1 | December 3, 2009 5:38 AM | Report abuse

This is a great post with many very good points. I think that among the most important is the one about what actual benefits will be.

I'll have to look for more information, but I haven't heard much about this. I HAVE heard that PREMIUMS will be reduced and SUBSIDIES will be provided to help extend INSURANCE COVERAGE. However, I have not heard much about the BENEFITS or the CO-PAYMENTS or the CO-INSURANCE.

I'm concerned that the reason I haven't heard about these important bits is because insurance companies will keep a lot of leeway in what they offer. Will we get "affordable" insurance with terrible "benefits" and costly utilization penalties?

Posted by: bcbulger | December 3, 2009 9:46 AM | Report abuse

"The big exception is if Collins attempts to achieve affordability by watering down the basic benefits package. That doesn't make health-care insurance 'more affordable' so much as it makes it 'less useful,' which really isn't the point of this exercise"

Actually, higher co-pays and deductibles, in combination with open pricing, do reduce the cost of health care.

Posted by: staticvars | December 3, 2009 11:09 AM | Report abuse

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