Interesting idea: "HCR is solved! Pass the Reform Bill Now-Reconcile a Medicare 'Buy-In' in January"

[Pirate Smile]

Daily Kos Diary:

***HCR IS SOLVED!!! PASS THE REFORM BILL NOW-- RECONCILE A MEDICARE "BUY-IN" IN JANUARY***

by BenJah
Mon Dec 14, 2009 at 08:16:23 PM PST

Writing an obit for HCR brings a couple of things immediately to mind.

First, we should all acknowledge that Max Baucus was right. He located the 60 vote pivot-point perfectly with the bill that emerged from his Senate Finance Committee. As much as we progressive may not like the bill, Baucus knows the Senate better than we do. He knew what it would take to get 60 votes. The bill that becomes law will be substantially the same bill that Baucus reported out of his Committee.

Second, real HCR reform is not dead. Over the jump is the way we can do this.

UPDATE: Lots of great support for this idea. Please REC this so we can keep spreading the word and get rid of all the bitter "Fuck You Joe Lieberman" Diaries. We need to replace bitter resignation with a will to keep fighting.

BenJah's diary :: ::

There are several problems with using reconciliation to pass the bill:

1. The Reconciliation Process (RP) can only work with existing programs. We cannot create new programs, as this bill does. We cannot create meaningful reform without creating some new programs.

2. RP requires all measures to be germane to the budget process. Again, that means we would lose a great deal of reform, simply because it does not affect the budget per se.

3. RP is subject to esoteric parliamentary rules that few people understand. Suffice to say that any HCR reform bill that emerges from RP will be a disgusting cross between swiss cheese and sausuage. (definitely NOT kosher)

So what to do?

The answer is simple and requires a 3-part strategy.

First, we pass the Lieberman-Weasel Bill now. Let's face it, we may want a public option, but this bill would still be meaningful. This bill is WAY more powerful than no bill at all. It improves the healthcare of millions of Americans.

Second, we use a Manager's Amendment, so that the bill can pass straight through the House without the delay of a Conference Committee. President Obama can sign this before the Christmas Break.

Third, as soon as the bill is signed into law, we insist that the Senate takes up a Medicare Buy-In Deficit Reduction Bill that will make it through the RP in one piece.

A medicare buy-in works perfectly with RP. First, it modifies an existing program. Second, it will reduce the deficit substantially, and is thus germane to the budget. Finally, it can be crafted in a way intended to survive the RP in one piece. We can even reduce the buy-in age to 50. This may be the WH strategy already. The key is for all of us to keep up the pressure for a medicare buy-in AFTER the Lieberman-Weasel bill passes. Then we will have the best of both worlds, and we can focus our attention to finding a new Chairman for Homeland Security.

http://bit.ly/6RKGCE

[Clio the Leo]

1. They're all acting like they know something we dont.....

.... that's for sure.

[lapfog_1]

2. Ok, I'll ask the obvious question...

Why not pass the Medicare Buy-in first by RP, as you say. Why must it come last?

Modifying Medicate does not affect the other part of HCR (or, as I prefer, Health Insurance Reform), so it's not dependent on passing HIR first. That stuffs it in Joe fucking LIEberman's weasel little face. And make the age 18 not 55. Schip covers the underage, Medicare for any that want it afterward. And make sure that the government subsidy can be used to buy Medicare (now THAT part might have to be in the HIR).

Pass it first, not last.

There is even MORE important work to be done. (I know, health care reform is the most important thing, except it isn't, Global Warming is more important, and I say this as someone that hasn't had health insurance in over a decade).

It's my belief and fear that they will pass the POS HCR with the mandates and shit, and never come back to this.

[pnwmom]

4. Because this is the harder thing to pass, since we need 60 votes.

If we alienated too many people first with a Medicare buy-in, it would make it harder to get the other essential pieces -- no lifetime limits, no preexisting condition bans, and no dropping people after they get sick.

[lapfog_1]

5. Fine, let them be on record as opposing

HIR, especially with no "public option" or even an "exchange". Let everyone know that they refused to hold the insurance companies responsible for policies such as pre-existing conditions and lifetime caps.

If the Senate was to pass Medicare-21 as an option under reconciliation first, then the only two things I give a damn about in the whole HIR are those two items. Insurance companies want to raise premiums, fine, I'll buy in to Medicare instead. I just don't want Medicare to become a dumping ground for insurance companies for their "sickies".

My guess is that 50% of Americans would opt for Medicare in the first 5 years of operation, and that kills the insurance companies (shrinks them to the point they can be "drowned in a bathtub" - that's the operative phrase, isn't it?)

[LooseWilly]

13. I'm with lapfog_1 ... who cares if this thing fails, if medicare is extended to 18+?

If Lieberman wants to threaten to kill it, after Medicare buy in for all is in place already... let him threaten. All that will do is make private insurance less able to compete with medicare.

And who cares if the private insurance companies continue those despicable practices, if people have the option of abandoning those private insurance plans to sign up for medicare??

Pass the medicare expansion through reconciliation first... then let the private insurance reform "chips fall where they may"...

:+

[Pushed To The Left]

16. I agree, the Medicare RP should definitely come last

Petty, pathetic little men like Lieberman would filibuster even the most moderate HCR to get his version of revenge. Pass the bill so Lieberman can feel powerful and pleasure himself, then pass the Medicare Buy-In with the RP. I love this idea!

[TheWraith]

3. They're probably going to do something similar. nt

[LooseWilly]

6. I'm not sure I'm on board for step 2 there, Hoss.

Pass it through the House without a vote?... the same POS that went through the Senate... then presume that something meaningful will be made of it later??

I'm not buying that.

If the Merger includes mandates, it damn well better include a strong public option. If not, I sure as shit hope that the Progressive caucus will KILL IT DEAD.

I don't trust the Senate to take up shit after the bill is passed... and I don't trust the Obama administration to push them to take up shit once a bill is passed either.

And mandating that all of us who have no health insurance and are under 50/55, with no public option to even begin to control costs, so that 50/55-64 year olds can buy into Medicare... assuming that the Senate ever gets around to this step 3 you mention... that's some fucked up shit to ask when so many under 50/55 are unemployed/underemployed/not-likely-to-ever-find-a-health-care-providing-job-ever-again-in-their-lifetimes.

No... count me out, I'm not buying it.

[emulatorloo]

7. That's an interesting idea. Wonder if all the pieces are there and will it work?

[mcablue]

8. The Industry-owned Congress does not want the buy-in

Nor does it want drug re-importation. It's not happening.

[Pirate Smile]

9. kick

[riskpeace]

10. I'm hopeful about this scenario

They can't pass the changes in regulations of the insurance companies without 60 votes. These changes are necessary to give public programs an equal chance at an equal risk pool and similar premiums. Changes to Medicare would have to be re-authorized but surely Medicare has an impact on both the budget and debt. So they could use reconciliation to pass it. At least, that's how I understand the Senate rules.

[Pirate Smile]

11. kick

[andym]

12. I thought the same thing (tried to rec but too late)

Here's my post-->
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x58864

I think we should really make an effort to lobby for this!

[quakerboy]

14. reverse the order, and we have the beginnings of a plan

Do the reconciliation bit first as a measure of good faith. Worry about the other part later. What says we have to pass Liebermans mandate first?

[laughingliberal]

15. Nice idea. I don't think it will happen. I don't think anything will get fixed until they let the

monstrosity go through, see the rape of the people by the insurance industry over the next couple of years, and have that V8 moment when they realize the taxes and fees they are collecting ahead of time will now not cover the subsidies. they're gonna be on the hook for in a couple more years.

If they had the political will to pass it under reconciliation they could pass most of what they have now with it. I'm convinced it could be done. It starts with the public option into which everyone is allowed to buy if they choose. With the government providing citizens subsidies to cover part of the premiums, every damn thing the insurance companies do will relate back to the budget. See how that works? Premiums rising? Tax payers on the hook for more money. Okay, here's another one. Denying preexisting conditions? Dumps people into the PO. Raises the cost of the PO due to sicker population utilizing it. Affects the budget. Forbid them to deny preexisting conditions. They did it anyway? Hefty fines to replenish our fund for the PO.

Let's brainstorm this. I think adding a PO makes everything the private insurance companies do relevant to the budget. They could do it. They don't wanna.

edited punctuation

[backscatter712]

17. It's an interesting idea.

It helps keep the reconciliation clusterfuckery from endangering the other necessary parts of the bill such as insurance regulation...

[uponit7771]

18. Like I said yesterday, Lieberman is a red herring while REAL problem is Harry Reid & reconciliation